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Patient Financial Services Professional

Location:
Atlanta, Georgia, United States
Posted:
January 21, 2018

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Resume:

ac34i8@r.postjobfree.com @YOLONDAGUTHRIE 678-***-**** www.linkedin.com/in/yeguthrie

YG

OBJECTIVE

Obtain a position where I can

maximize my revenue cycle

management skills, leadership

and project management

skills, quality assurance,

process improvement, strong

organizational and

communication skills,

educational background, and

ability to work well with

people.

SKILLS

Medicare/Medicaid

Commercial/Managed Care

Workers Compensation

Tricare

Veteran’s Administration

Accounts Receivable

Problem Collections

Denials Management

Organization

Communication

Time Management

Team Leadership

Research

Training

Vendor Management

YOLONDA GUTHRIE, MBA, CRCR

REVENUE CYCLE EXPERT 3645 MARKETPLACE BLVD

ATLANTA GA 30344

EXPERIENCE

Tanner Health System • Carrollton, GA 30117 2017 - 2017 Tanner Health System is a not-for-profit, regional healthcare provider serving west Georgia and east Alabama. Tanner Medical Center has five facilities, the largest is a 181-bed acute care hospital located in Carrollton, Ga.

**Due to unforeseen circumstances the CFO decided to go in a different direction and therefore my position was eliminated.

Director, Patient Financial Services

Manage and direct PFS Dept comprised of Billing and Collections, Financial Counselors, and Cashiers – Commercial/Managed Care Team, Medicare/Medicare Team, Self-Pay Team

Manage 40 employees. Manage quality and quantity of work produced within PFS for 5 Facilities with total of 354 beds

Manage and direct staff on projects to prioritize work tasks and ensure deadlines are met and ensure work meets quality standards. Focus on AR >90 days

Ensured clean claims, Insurance Follow up, Payment Posting, Self- Pay, Bad Debts and Denial Management policies were adhered to.

Monitor AR and collection trends – Experience in Denial Management Reporting

Increase Medicaid Outlier cash by 50%

Work with all third-party payers to resolve issues and implement new processes resulting in better working relationships and increased cash by 75%

Plan departmental goals, organizes structure and staffing, direct activities, evaluates and monitors employee performance – Incorporated Productivity and QA process to determine quality metrics

Maintain excellent working relationships between PFS and all other departments

Manage weekly high dollar meetings; identified Medicare/Medicaid process improvement

Health Management System (HMS) • Atlanta, GA 30339 2016 – 2017 HMS improves financial and health outcomes for at-risk organizations saving customers billions of dollars a year, helping to make the healthcare system better for everyone. Providing coordination of benefits and payment integrity to include comprehensive solutions for Medicaid and Medicare as well as Commercial and Managed Care payers. Provider Services Analyst

Onsite account analysis to identify and recover client overpayments. YG YOLONDA GUTHRIE, MBA, CRCR

REVENUE CYCLE EXPERT 3645 MARKETPLACE BLVD

ATLANTA GA 30344

2

TECHNICAL

SKILLS

CMS/DDE

EPIC

Meditech

McKesson STAR

Quantax

SSI, ePrimis

Siemens Invision

Compass Reporting

Tableau Reporting

CERTIFICATION

Certified Revenue Cycle

Representative (CRCR)

Healthcare Financial

Management Association

(HFMA)

2013

Worked remotely as well as onsite and maintained consistent communication across internal and external networks to ensure expectations are met

Consistently exceed monthly identifications by 190%

Reports to management on progress toward business goals

Exceed monthly collection goals of $45k – actual collections approximately $98k per month

Identifies sources of revenue

Lean Techniques utilized

Trending Analysis to improve cash and identify over payments

QA results at 95% and Production scores at 100%

YTD ending totals: identifications $1M; collections $916k

Focus on customer needs with uncompromising integrity Piedmont Healthcare • Atlanta, GA 30339 2006 - 2016 A private, not-for-profit organization serving communities across Georgia, with 8 hospitals – the largest with 488-Beds, 19 urgent care centers, and 94 physician practice locations. Piedmont continues to transform healthcare. In FY 2016, Piedmont provided more than $142 million in uncompensated care and invested an additional $9.6 million in community benefit programming, in an effort to better the health and well-being of the people in the communities they serve.

Government Third Party Revenue Cycle Supervisor

Achieve monthly Revenue Cycle goals to include Medicare $15M, Medicaid $40k, Tricare, VA & Worker’s Comp accounts.

Proven track record in improving process and financial performance in revenue cycle operations in CBO

Daily review and weekly analysis of accounts to improve staff performances by 95%

Focus on aging accounts >91 days for resolution

Medicaid and Medicare denials management reprocessing claims for immediate reimbursement

Managed Care Billing & Collections Supervisor

Weekly review of bad debt and underpayment accounts for quick resolution

Ensuring monthly A/R collection goals $75k are met YG YOLONDA GUTHRIE, MBA, CRCR

REVENUE CYCLE EXPERT 3645 MARKETPLACE BLVD

ATLANTA GA 30344

3

EDUCATION

Master of Business

Administration •

Healthcare Management •

2007 - 2009

American InterContinental

University

Hoffman Estates, IL

Master of Business

Administration •

Marketing •

2007 - 2009

American InterContinental

University

Hoffman Estates, IL

Manage review of vendor invoices for proper billing - resulting in monthly savings of over $50k

Frequent communication with Patient Access, HIM, Case Management, and ED to ensure accuracy and integrity of data

Commercial/Managed Care Biller

Manage contractual adjustment updates from multiple insurance carriers decreasing million-dollar write offs

Monthly profitability goals reached with clean claim rate of 85% or greater

Assist in meeting compliance and HIM deadlines

Children 1st Pediatrics • Fayetteville, GA 30312 2005 – 2006 internship Coding and Referral Specialist

Ensure proper ICD and CPT coding and documentation of patient charts

Through knowledge of physician contracts

Managed in network referrals and coordinated hospital authorizations Cigna Healthcare • Atlanta, GA 30339 1992 - 2005

Cigna is a global health service leader dedicated to helping people improve their health, well- being and sense of security. We work together with customers to help them lead a healthy, secure life. We provide customers with personally relevant products and services, and we help customers choose affordable health care and achieve optimal health outcomes. Health Services Representative

Contribute to cost savings initiative with timely clinical data input from providers

Verbal and written communication with on-site nursing staff for timely admissions

Primary resource for managing authorizations fornetwork providers Customer Satisfaction Represenative

Provider superior customer service tophysicias, hospitals & ancillary providers

Managing on time claims review and payment

Complete transactions requiring adjustments and reverse denials YG YOLONDA GUTHRIE, MBA, CRCR

REVENUE CYCLE EXPERT 3645 MARKETPLACE BLVD

ATLANTA GA 30344

4

Provider Relations Coordinator

Conduct seminars to increase knowledge of corporate policies and procedures

Deliver excellent provider support regarding claims payment, contract issues, and member eligibility

Specialized in benefit interpretation, member eligibility, and physician statuses



Contact this candidate