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Revenue Cycle Systems Support Services Manager Resume Example

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REVENUE CYCLE SYSTEMS SUPPORT SERVICES MANAGER
Summary

Forward thinking healthcare revenue cycle professional with more than 20 years of experience in customer and vendor engagements, possessing a fundamental passion for working collaboratively towards team and organizational successes, specializing in healthcare revenue cycle billing within federal and multi-state regulatory and private health insurance plans spheres.
Proven strengths in effectively spearheading strategic initiatives resulting in electronic data interchange improvements which translate into significant organizational cost reductions.
Extensive experience in managing diverse billing systems and software support solutions within numerous network and cloud-based electronic health record platforms, successfully supporting customer key performance benchmarks, while cultivating and maintaining long-term business partnerships.

Experience
Oct 2015 - May 2020Tampa, FL
Revenue Cycle Systems Support Services Manager / The Corridor Group Holdings LLC
  • Oversee all home health and hospice billing department, cash department and clearinghouse spheres
  • Handled/monitored daily, weekly and month-end electronic claims for 31 clients; portfolio of $81M in yearly revenue
  • Configured and maintained financial/billing modules, charge master services/rates, payor plans, reimbursement methodology and reimbursement rates complying with CMS and managed contractual regulatory requirements and guidelines, including most recently FY2020 PDGM Reimbursement, within 12 different Electronic Health Record systems' environments
  • Diagnosed and liaised between internal/external teams and vendor relationships, including but not limited to operations leadership, finance, network administrators, IT, and clients to resolve issues related to systems, billing, payment posting, billed/unbilled revenue
  • Trained, cross-trained new system users and department employees in classroom type sessions to promote useful systems knowledge and operations expertise
  • Collaborated successfully with clients to achieve objectives by utilizing strong communication, interpersonal and people skills
  • Updated software platforms by implementing automation and efficiency improvements
  • Performed regular maintenance and testing to service and optimize complex computer systems, applications and environments
  • Assessed impact of emerging technology and system upgrades on workflow
  • Analyzed contract documents to identify ambiguity and conflicts between documents and guidelines/specifications
Jun 2012 - Sep 2015Tampa, FL
RCM Lead Systems Support & Billing Administrator / Transpirus LLC
  • Managed, coordinated and successfully transitioned 9 sunset-Electronic Health Record systems into new Electronic Health Record systems' environments for multiple clients.
  • Trained, cross-trained, coached and mentored billing and cash team staff in 12 different Electronic Health Record systems' environments to maximize department effectiveness.
  • Developed company documents, user guides, maintenance documents and project documentation.
  • Identified and implemented new methods to optimize billing, medical records management and cash application tasks, such as electronic data interchange transactions and secure file transfer protocol.
  • Used vendor end user classification manuals to gain additional knowledge of clinical and financial electronic health record modules and processes.
  • Researched and compiled statistical data to support cost control and care improvement initiatives.
  • Resolved conflicts and negotiated mutually beneficial agreements between parties.
  • Drove operational improvements which resulted in savings and improved profit margins.
Jan 2005 - May 2012Tampa, FL
Consulting AR Team Lead / Gentiva Health Services Inc.
  • Oversaw/managed/reconciled portfolio of $12M in Home Health, Hospice and Infusion client receivables from billing through payment.
  • Resolved delinquent accounts, attained collections goals and maintained high customer satisfaction ratings in fast paced environment.
  • Trained, cross-trained, coached, mentored staff in billing and collections best practice techniques to ensure timely resolution of receivables.
  • Lead resource and subject matter expert in timely resolution of payer denials, recovery projects, appeals, contractual/rate differential adjustments, refunds.
  • Drove operational improvements which resulted in savings and improved profit margins.
  • Developed team communications and compiled information for Monthly AR Client meetings.
  • Work with 8 client agencies to understand needs and provide Revenue Cycle Management services.
  • Resolve 121+ AR problems, improved operations and provided exceptional client support.
  • Daily, Monthly, Quarterly and Yearly Financial Analysis and Reporting; Federal Reports, Month-End Reports.
  • High Risk/High Dollar Accounts Review, Analysis and Action Plan Development for Resolution.
  • Cultivated client relations and facilitated effective and timely account escalation of problematic accounts during monthly executive leadership conference calls; as well as supporting clinical, legal team billing audits to ensure ongoing compliance and timely clean billing of unbilled services.
Highlights
  • New Client Billing Assessments, Onboarding, Implementation
  • Electronic Health Record Systems Expertise: Cerner, Maestro/Meditech, HCHB, Brightree, Delta-Crescendo, Careficient, Interlink, CareAnyware, Casamba-Healthwyse, Wellsky/Kinnser, McKesson, KanTime, Devero
  • EHR Systems Configuration & Maintenance
  • System Administration
  • Quality Assurance Software Testing & Troubleshooting
  • Electronic Medical Records
  • ICD-10 / ICD-9
  • CMS-1450, CMS-1500 Forms Specialist
  • Medical Terminology, CPT & HCPCs Coding
  • Remote Access Software
  • Secure File Transfer Protocol (SFTP)
  • Electronic Data Interchange (EDI)
  • Computer Skills
  • Technical Support
  • Support Ticket System Management
  • System Support
  • Medical Billing Manager
  • Payment Posting Manager
  • Clearinghouse Administrator: Waystar, Zirmed, NaviNet, Availity, SSI, Emdeon, OfficeAlly, Quadax Xpeditor, Ability, eSolutions,
  • Centers for Medicare & Medicaid Services (CMS) Regulatory Compliance
  • Revenue Cycle Team Management, Training, Development
  • Continuous Process Improvement/Development
  • Healthcare Collections Specialist
  • Account Reconciliation
  • AR Recovery Projects Specialist
  • Analytical Skills
  • Organizational Skills
  • Problem Resolution
  • Communication Skills
  • Client and Vendor Relationships Management
  • Account Management
  • Detail Oriented
  • Time Management
  • Senior Leadership
  • Consulting
  • Teamwork
  • Microsoft Excel
  • Microsoft Outlook
  • Microsoft PowerPoint
  • Microsoft Teams
  • Microsoft Word
  • Presentation Skills
Education
1985San Juan, PR
High School DiplomaOur Lady of Pilar High School
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Resume Overview

Companies Worked For:

  • The Corridor Group Holdings LLC
  • Transpirus LLC
  • Gentiva Health Services Inc.

School Attended

  • Our Lady of Pilar High School

Job Titles Held:

  • Revenue Cycle Systems Support Services Manager
  • RCM Lead Systems Support & Billing Administrator
  • Consulting AR Team Lead

Degrees

  • High School Diploma

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Revenue Cycle Systems Support Services Manager

The Corridor Group Holdings LLC

Tampa, Florida