Senior Revenue Cycle Specialist Resume Example
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SENIOR REVENUE CYCLE SPECIALIST
Professional Summary
Experienced revenue cycle analyst with over 10 years of experience in healthcare industry . Excellent reputation for resolving problems, improving customer satisfaction, and driving overall operational improvements. Consistently saved costs while increasing profits.
Computer-savvy and quick learning with expert skills in medical billing software.
Skills
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Work History
Senior Revenue Cycle Specialist06/2013 to Current
Aramark Corporation – Bronx , NY
Aramark Corporation – Bronx , NY
- Perform daily review of all incoming EOBs and ERAs to verify correct payment and identify any billing issues.
- Reviewed all Radiology, Surgery, ER, Toxicology, OP Labs, and Clinic claims prior to billing to ensure coding accuracy and profitability.
- Perform in-depth analysis of billed claims to find different billing techniques and ways to increase revenue.
- Review and bill for Covid-19 and Respiratory Pathogen Panels.
- Worked as a liaison between revenue cycle department and physician practices to improve lines of communications and processes.
- Increased upfront collections, by training staff how to correctly verify benefits and how to explain responsibility to patients.
- Discovered trends for how insurances pay claims and created spreadsheet showing how each insurance pays for outpatient procedures and which ones require authorizations.
- Worked with Lab director and COO to create charge panels for RPP testing and Toxicology.
- Put in processes to verify all Medicare LCD's prior to sending claims, dramatically reducing denials.
- Performed cost analysis on every patient seen and able to increase cash flow by determining profitability for each claim sent.
- Discovered process of coding BCBS radiology claims to double our reimbursement for radiology procedures.
- Recoded and re-billed BCBS radiology claims for last 12 months resulting in additional revenue of $50,000.
- Worked directly with senior level management to identify new lines of business.
- Balanced and reconciled accounts.
- Reached out to insurance companies to verify coverage.
- Identified and resolved payment issues between patients and providers.
- Reviewed established accounting systems, historical information to identify strengths and weaknesses of existing methods and controls.
- Maintained excellent attendance record, consistently arriving to work on time.
- Saved $1 million by implementing cost-saving initiatives that addressed long-standing problems.
- Resolved problems, improved operations and provided exceptional client support.
Billing Specialist04/2010 to 01/2013
Jefferson Healthcare – Port Ludlow , WA
Jefferson Healthcare – Port Ludlow , WA
- Billed insurances for MRI's, CT's, XRAY's, Ultrasounds, and Mammograms.
- Responsible for insurance verification, coding, billing, and collections for 2 Cardiology, 1 Urology, and Ambulatory Surgery Center.
- Ran and analyzed daily insurance exception report to find underpaid claims.
- Analyzed insurance contract to improve reimbursement rates.
- Obtained pre-authorizations for radiological exams using web resources and calling direct to AIM, Medsolutions, Humana, United
- Performed trend analysis to spot trends in denials and underpaid claims and created corrective actions to resolve these trends.
Patient Financial Counselor01/2009 to 01/2010
Seton Medical Center Austin – City , STATE
Seton Medical Center Austin – City , STATE
- Performed financial screenings for patients with no insurance, and Medicare only, to determine if they were eligible for charity assistance.
- Explained patient responsibility of providing necessary documentation to qualify for charity
- Verified patient insurance using online applications, such as Navinet and Availity.Met weekly and participated in Medicare Discharge meetings with VP Medical Director, Case Managers, and Social Workers to ensure patients were financially cleared and had a plan of discharge.
Education
Associate of Applied Science Degree: Electronic Engineering Technology12/1998ITT Technical University-
City,
State
Diploma: MEDICAL BILLING12/2009Everest Institute -
City,
State
Medical Insurance Billing and codingCertification in Total Quality ManagementEverest College - Anaheim-
City,
State
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Resume Overview
School Attended
- ITT Technical University
- Everest Institute
- Everest College - Anaheim
Job Titles Held:
- Senior Revenue Cycle Specialist
- Billing Specialist
- Patient Financial Counselor
Degrees
- Associate of Applied Science Degree : Electronic Engineering Technology 12/1998
Diploma : MEDICAL BILLING 12/2009
Medical Insurance Billing and codingCertification in Total Quality Management
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