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0-5 years of experience
Managed a staff of 30; including hiring, training, performance reviews and disciplinary action.
- Responsible for the accounts receivable of 17 different [company name] clients totaling $5 million in charges each month, including credentialing, denial management and third party follow up.
- Analyzed the top denials for each client and identified solutions to increase cash and A/R days.
- Reduced average days in A/R from 79 to 60 in a 3 month time period. Increased net collections from 65% to 80%.
- Built collector workfiles and monitored the performance of the staff.
- Worked with the clearinghouse and the payers to ensure all claims were processed and received by the insurance companies in a timely manner. Reduced clearinghouse denials from 39% “bomb” rate to 15% in a 6 month period of time.
- Maintained a strong relationship with all clients and presented trends to them on a monthly basis.
- Wrote policies and procedures for billing, collection, and posting.
0-5 years of experience
Managed six direct reports, seven indirect reports, including financial operations team. Directed the full lifecycle of revenue
cycle operations. Established and implemented new departmental revenue cycle processes. Advised clinical personnel on all
revenue cycle procedures and resolved coding issues for clinical and financial staff. Managed Oncology’s Chargemaster
(CDM) and IDX Dictionary updates. Served as liaison between the practice and all other associated internal departments.
- Recognized for distinguished project execution on transition to new system.
- Overhauled policies and procedures to eliminate gaps and standardize processes.
- Reduced time to learn new software applications with development of instructional training manuals.
- Reduced waiting time for insurance reimbursement having conducted a need gap analysis, developed and implemented
- Maintained quality levels by conducting random charge/coding audits and working with personnel to resolve problems.
- Trained physicians and lead in-service presentations to ensure compliance on correct coding and documentation
0-5 years of experience
Managed health insurance billing, collections and eligibility as it pertains to commercial, managed care, government and self pay reimbursement concepts for busy practice. Utilized extensive knowledge of electronic billing systems for front end and back end functions via IDX.
- Handled financial analysis and reporting of billing revenue cycle and practice operations. Monitored revenue progress against benchmark front-end metrics and accounts receivable targets, and the resolved actual-to-budget variances.
- Developed and implemented policies and procedures for financial transactions resulting in standardized reports
- Improved initiatives of practice and communicated revenue performance results to departmental and faculty practice leadership.
- Identified operational problems and implemented procedures to correct them.
- Exceeded departmental cash receipts goals each year, including 35% of goal for 2005.
0-5 years of experience
Directed healthcare revenue cycle for primary care services including time of service collections, charge entry, cash management, and account progression and resolution initiatives.
- Implement process and technology training for staff to achieve goals, maintain proficiency, efficiency, compliance and customer service.
- Ensure data accuracy accountability for divisional financial performance, charging methodologies and capture, and revenue enhancements.
- Effective development, implementation, monitoring and communications of goals, objectives, budgets and expected performance outcomes.
- Analyzed critical operations on an ongoing basis, and developed reports that evaluated and demonstrated productivity and performance gains.
- Provided instruction, leadership, and supervision for team of more than 20 employees.
0-5 years of experience
Managed the billing operations for 20+ hospitals, which included Anesthesia, Emergency Room, and Neonatology.
- HR responsibilities include staff recruitment, training, supervision, and development for staff of 25-30 administrative employees across the United States.
- Served as a primary point of contact for, and liaison between chiefs, physicians, and directors to facilitate proper lines of communication and expedient problem solutions.
- Provided physician education in pinpointing documentation issues on an as needed basis.
- Conducted monthly spot audits on both facilities and staff to ensure timely and accurate billing processes within 48 hours turn-around time.
- Managed and monitored front-end department billing production and workflow.
- Revenue Cycle Management: Coordinated efforts across all departments to decrease billing errors and increased revenue, working closely with billing & collections to determine opportunities for improvement.
0-5 years of experience
Managed the entire revenue cycle of a diagnostic laboratory including payer billing, collections and patient account activities. Responsible for day-to-day operations and long term planning and budgeting. Oversaw credentialing, client contracts, call center and billing department. Partnered with the sales and client representatives to help with client acquisition.
- Responsible for collection, aging, establishing write-off standards and claim denial management
- Evaluated effectiveness of the process, recommended and implement changes to policies and procedures
- Responsible for hiring, firing, and disciplinary actions within the department.
- Decreased billing cycle turnaround time by 40% by implementing automation into the process.
- Improved productivity and decreased backlog by 25% within the first 3 month
- Developed, implemented, and continually improved policies, processes, and procedures.
- Organized regular meeting with the sales team and client representatives
0-5 years of experience
Directed all facets of revenue cycle management for 3 hospitals with total of 600 beds.
- Conducted assessment of patient billing and revenue collection systems to design and implement revenue cycle improvements.
- Developed and introduced plans and policies that reduced bad debt, charity, and collection costs.
- Created and maintained crosswalk tables from patient accounting to general ledger.
- Prepared and presented adhoc reporting for VP of Finance and Regional CFO.
- Served as project lead for implementation and integration of joint venture financial processes.
- Improved non-financial staff understanding of financial statement information by providing education sessions hospital-wide.
6-10 years of experience
Coordinated SAP process and Fixed Assets/CIP. Managed the Fixed Assets system including the monthly depreciation entries to ensure proper accounting treatment; researched and retrieved information for audits.
- Managed, trained and developed a staff of 23 direct reports including hiring, professional development and annual evaluations Implemented and maintained a system to ensure that assets are adequately reported and compliant with all financial policies, and ordinances.
- Managed and directed supervisors, reviewed operations, and established objectives within my department.
- Managed all operations of billing and collections involving managed care contracts for inpatient and outpatient claims.
- Managed, developed and implemented managed care contracts.
- Managed all aspects of projects designed to improve and enhance the organization’s ability to adhere to regulatory requirements.
- Established policies, procedures, guidelines and project schedules.
6-10 years of experience
Coordinated SAP process and Fixed Assets/CIP. Managed the Fixed Assets system including the monthly depreciation entries to ensure proper accounting treatment; researched and retrieved information for audits.
- Managed, trained and developed a staff of 23 direct reports including hiring, professional development and annual evaluations Implemented and maintained a system to ensure that assets are adequately reported and compliant with all financial policies, and ordinances.
- Managed and directed supervisors, reviewed operations, and established objectives within my department.
- Managed all operations of billing and collections involving managed care contracts for inpatient and outpatient claims.
- Managed, developed and implemented managed care contracts.
- Managed all aspects of projects designed to improve and enhance the organization’s ability to adhere to regulatory requirements.
- Established policies, procedures, guidelines and project schedules.
0-5 years of experience
Developed leadership plans as Liaison for TFPS and worked closely with Billing Company staff of 56 employees plus 3 local employees to identify issues and solutions for reimbursement delay for over eighty five physicians.
- Responsible for providing training and analytical support to the Revenue Cycle Senior Leaders and employees
- Researched and analyzed revenue and reimbursement trends
- Reviewed and/or conducted the research needed for reimbursement management decisions for TFPS managed care contracts
- Monitored revenue cycle and reviewed with Practice Administrators monthly financial reports
- Over see various healthcare function such as: Interpretation of Managed Care Contracts and confirmation of correct reimbursement, Negotiated reimbursement from all LOA’s, Pre-registration, Insurance Verification, Billing, Account Follow Up, Registration, Coding, Point of Service Cash Collections, Cash Posting, Bad Debt, Credentialing, Medical Records, Financial Counseling, Customer Service Collections
0-5 years of experience
Developed leadership plans as Liaison for TFPS and worked closely with Billing Company staff of 56 employees plus 3 local employees to identify issues and solutions for reimbursement delay for over eighty five physicians.
- Responsible for providing training and analytical support to the Revenue Cycle Senior Leaders and employees
- Researched and analyzed revenue and reimbursement trends
- Reviewed and/or conducted the research needed for reimbursement management decisions for TFPS managed care contracts
- Monitored revenue cycle and reviewed with Practice Administrators monthly financial reports
- Over see various healthcare function such as: Interpretation of Managed Care Contracts and confirmation of correct reimbursement, Negotiated reimbursement from all LOA’s, Pre-registration, Insurance Verification, Billing, Account Follow Up, Registration, Coding, Point of Service Cash Collections, Cash Posting, Bad Debt, Credentialing, Medical Records, Financial Counseling, Customer Service Collections
0-5 years of experience
Responsible for overseeing all activities that involve the generation and collection of income.
- Responsible for monthly financial reports and practice statistics for review of productivity standards.
- Monitored and assessed quality assurance with all staff to ensure maximum reimbursement.
- Assisted with implementation of electronic system to include training staff, ensuring system adequacy, and developing new policies/procedures.
- Coordinated change of practice wide installation of new system software in preparation for ICD-10.
0-5 years of experience
Manage Billing and Charge Capture process for 200 plus physician’s and mid level provider’s.
- Responsible for writing and implanting policies and procedures for all revenue cycle functions.
- Responsible for developing and implementing standardized encounter forms.
- Managed, measured and monitored the performance of the out sourced billing company.
- Responsible for the managing the payer credentialing process.
- Created Revenue Cycle Dashboards that include key performance indicators in measuring against best practice.
- Created a Denials Management process that resulted in a 20% reduction in denials in just six months.
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Last edited by: Gabriela Barcenas, CPRW, Content Writer II -
Gabriela Barcenas
CPRW, Content Writer IIGabriela is a Certified Professional Resume Writer (CPRW) and career adviser. With 10 years of digital media experience and five years of resume writing expertise, her publication history includes fashion, education, travel, social justice, equitable design and career advice.
