*********@*****.*** @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