Lisa D Wiggins

Objective: Manage, oversee, analyze and facilitate the Collection/ Accounting activity in the Healthcare Industry.

Reorganize opportunities to improve practice performances and implement new processes for long-term goals established by the practice.

Goals: To continue my 27 years of experience in decreasing the accounts receivable for multi specialties such as:

Radiology, Cardiology, Anesthesia, Radiation-Oncology, Primary Care, Urology and Hematology/Oncology, Pathology and Chiropractic facilities.

Professional Experience

Aug. 2012- Oct. 2012 Senior Account Manager-(TEMP) Porteck Jericho, NY

• Train medical practices on how to implement Revenue Cycle Management.

• Create new Intake packages for medical practice that pertain to their specialties such as Worker’s Compensation and No-Fault.

• Create and implement new ICD-9 and CPT codes for Chiropractic services for the encounter form.

• Create a step by step guideline for Medicare PQRS for multi-specialties

• Create a step by step guideline for Worker’s Compensation forms and variances

Present – Aug, 2012 Billing Manager Boyd Center for Integrative Health Connecticut

(The Boyd Center merged with Greenwich Hospital)

Continue to work all past due accounts receivable/payable for the Boyd Center

Feb. 08- July 2010 Billing Manager - Boyd Center for Integrative Health- Connecticut

Run reports for open balances due to contractual allowances, adjustments, deductibles and credit balances.

Monitor all denials are followed up and written-off if needed due to timely filing of out-of - network.

Manage the timely processing of all electronic claims and patient statements weekly

Prepare for next day activities for patients with delinquent co-pays and past due accounts, making sure referrals and pre-certification were received for future visits.

Scrub all super bills by reviewing Physician’s notes for office visits and Chemo Treatments, making sure all treatments were documented properly according to our flow sheets.

Verifying and entering all new patients insurance contracted and non-contracted.

Keeping updates on the NCCN Compendium use for Chemo drugs and ACCC Compendia.

Notifying staff of any changes due to precertification on drugs and changes in fees.

Counsel all new patients on first time Chemo Treatments, enrollment if needed for the Co-pay Assistant Programs and Foundations.

Credentialing our new Physicians. ( CAQH Data Base)

Interact with our Drug / Provider Representatives on any new changes concerning billing issues

Reconstruct all finance operations, which includes coding, charge entry and billing and assisting with collections.

Responsible for educating and training a staff of (7 FTE’s) and (3) Providers on new and existing Healthcare policies.

Implement updated technology that will make the practice more efficient and productive such as (Direct Deposit and the software EOB 1)

Monitor payers contracts are complying with contracts terms for reimbursement.

Monitor all dictation are completed and signed by each physician and encounters are charged

Interact with scheduling staff for all no-shows, cancelled and reschedule appointments.

Feb. 04-Jan.08 Billing Manager- Maimonides Cancer Center- New York

Reconstruct the entire billing department of (15 FTE’s) which included charge entry, payment posting and account receivables.

Liaison between our Provider Representative and the Providers, tracking any updates for open enrollments and literature for Chemotherapy billing and procedures.

Monitor all billable units for Chemo drugs.

Credentialing / Re-credentialing when needed ( CAQH Data Base)

Create special projects to improve the ability to collect total payments for denials and appeals when needed, this decrease our accounts from 105.3 million to 81.1 million, total credit balance by 1.7 million.

June. 99-Feb. 04 Billing Manager- Executive Physicians System - New York

Monitor patient’s accounts to maintain financial viability and to achieve maximum profitability, identify errors and

correct them in a timely manner to avoid audits

Oversee all billing and collection activities as well as other operation of the private practice to maximum revenue and

promote high quality service to patients

Ensure that staff understands updated policies, procedures,goals and objectives

Hire, train and supervise billing staff of ( 12 FTE’s)

Prepare monthly and annual reports to the Providers

Resolve day to day operational problems to ensure a smooth and efficient functioning work environment.

Holding monthly staff meeting and weekly meeting with Providers

Maintain contact with our third party representatives

Review profitability of participation agreements and identify new programs for potential agreements

Liaison between Physicians and Attorneys for legal action if needed

Sept. 94 - May 99 Billing Manager- Cornell Medical Center- New York

Troubleshooting and resolving collection and billing problems before litigation approval

Prepare and review Accounts Receivable/Payables

Run the DBMS (Database Management System) reports for direct pays, automatic write offs and transfers for all departments

Approve and review all revenue for commission fees, legal fees for litigation, prepare remittances for all nine vendors including auditing / accounting and charge backs

Create spreadsheets for month end though Excel

Manage a staff of (7 FTE’s)

June 89 - Jan 93 Finance Consultant- Beth Israel Medical Center- New York

Supervise and review Physicians daily schedule and activities for the department for Urology

Monitor all cash flow for future surgeries and call in for precertification if needed

Hold monthly meeting with Physicians to discuss the flow of the practice

Update the Credentials though our CAQH database

Post payment, charges and verify insurance if needed

Technical Skills – IDX (PCS, TES), EAGLE, HEALTHQUEST, OMI-PRO, IMPACT ATHENA, CENTRICITY, EOB-ONE, PMDS (BLACKBERRY),

MEDICAL MANGER AND SRS HYBRID (EMR) SYSTEM

PARCS AND SEQUELMED.

MICROSOFT WORD, EXCEL, OFFICE WORKS and LITE POWERPOINT

EDUCATION: Martin Luther King, HS – Class of 1984 (Diploma)

Adelphia Business Institute - Certificate 1985 (Business Administration)

Contact this candidate