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Revenue Cycle Supervisor Resume Example

Resume Score: 80%

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REVENUE CYCLE SUPERVISOR
Professional Summary
I excel in fast paced environments and I have a strong understanding of the Revenue Cycle Management process for Physician/Facility medical claims. I work well with others, as well as independently. I am driven by results and have the ability to manage, coach, train and motivate others.
Knowledge Base
  • A/R Resolution
  • Denial Management/Appeals
  • EOB Review/Contractual Adjustments
  • Contract Interpretation
  • UB-04/HCFA 1500 claim forms
  • Physician and Facility Billing
  • Corporate Cash posting/Reconciliations 
  • Govt/Non-Govt payer guidelines
  • Medicare/Medi-cal/Commercial Insurance
  • Negotiations/LOA's
  • Meeting deadlines and quotas
  • Process Improvements
  • ​Patient Insurance and Benefit Eligibility
  • Month-end Reporting
Education and Training
Bachelor of Science:Healthcare Administration2018National University, CA, US60 units remaining until completion.
Experience
Hospital Business Services Inc.Ontario, CARevenue Cycle Supervisor08/2016 to Current
*Oversee Billing and Collections team, 25 employees.
*Establishing department goals, and insure processes and procedures are adhered to.
*Monitor accounts receivables, and analyze denials and claims rejections as well as reimbursements in order to maximize collection.
*Document billing defects by establishing and conducting quality checks of billing transactions.
*Distribute daily ATB work lists to employees for A/R Collections
*Monitor daily productivity reports to ensure targeted goals are met
*Motivate, train, coach and provide clear guidance to team members to get the various billing tasks done properly and efficiently.
*Set performance goals and objectives for the billing teams, collection analysts, cash posters and EOB reviewers.
*Point of Contact for Hospital Admitting Managers, HIM, Coding and Appeal departments.
*Conduct weekly/monthly meetings to provide managerial reports and identify areas of improvements for the CBO teams.
 *Hire, terminate assignments, coach, conduct annual performance evaluations, and provide disciplinary action for employees
*Identify payer denial trends
*Assign special projects, as needed.

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Conifer Healthcare Solutions/Healthcare ScoutsAnaheim, CAPatient Account Representative07/2015 to 10/2015
*Follow-up on all claims from billing to final resolution.
*Review and prepare claim for manual and/or electronic submission.
*Identify billing errors for correction and resubmit claims to insurance.
*Follow-up on payment errors, low reimbursement, denials.
*Review payer contracts and insurance EOBs to initiate underpayment, timely filing, medical necessity appeals.
*Initiate, review and follow-up on claim appeal status
*Outbound calls to Provider and access payer portal websites to check claim status.
*Accurately and thoroughly documents the pertinent collection activity in account ledgers.
*Assist with cash posting, credit balances and adjustments.
*Communicate issues to management, including payer, system or escalated account issues.
*Adhere to productivity daily goals of 60 accounts

Trio Code KESLos Angeles, CAMedical Billing Lead06/2013 to 06/2015
  • Entry of all client insurance and financial information.
  • Prepare claim data for transmission to Medicaid, Medicare, and Managed Care Plans.
  • Review and process payment denials.
  • Organize billing and medical records for resubmission.
  • Assist with coding error resolution and distribute copies of coding errors to management for educational purposes.
  • Review, correct and log all claim errors and notify management of trends.
  • Follow up with insurance companies for status of claims and make adjustments according to polices.
  • Handle reverse charges, voids and transfer of payments.
Anthem Blue Cross of CaliforniaPomona, CACustomer Care Associate III11/2007 to 03/2012
  • Respond to customer questions via telephone, email, written correspondence regarding health insurance benefits, provider contracts, eligibility and claims.
  • Analyze problems/concerns and provide information/solutions.
  • Thoroughly documents inquiry outcomes for accurate tracking and analysis.
  • Ensure customer request and questions are handled appropriately and in a timely manner.
  • Handle escalated calls/inquiries from customers, providers and account managers.
  • Initiate, track and provide status on provider/customer appeals.
  • Manually key Professional and Facility claims in to operating systems.
  • Effectively manage and distribute email inquiries to team members.
  • Direct contact for Account Managers and HR representatives.
  • Followed all HIPPA guidelines.
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Resume Overview

Companies Worked For:

  • Hospital Business Services Inc.
  • Conifer Healthcare Solutions/Healthcare Scouts
  • Trio Code KES
  • Anthem Blue Cross of California

School Attended

  • National University

Job Titles Held:

  • Revenue Cycle Supervisor
  • Patient Account Representative
  • Medical Billing Lead
  • Customer Care Associate III

Degrees

  • Bachelor of Science : Healthcare Administration 2018

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