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Medical Project Manager

Location:
Olympia, Washington, United States
Posted:
September 25, 2018

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Resume:

Contact Information

Email

ac66hc@r.postjobfree.com

Phone

503-***-****

Address

** ** *** **

Chehalis, WA 98532

Skills

● Medical Coding (CPT, ICD10,

HCPCS, CDC)

● Medical Billing (FQHC,

Fee-for-service, APM)

● Financial Analysis

● Revenue Cycle Management in

Healthcare

● Insurance Contract Nego a ons

● Medical Claims Denial

Management

● Excel, Word, Outlook, Google

Apps.

● EPIC, Greenway

Jonique

Dietzen

Project Manager and Revenue Cycle Specialist looking to use my experience and knowledge to improve the health and well being of my community. Experience

Multnomah

County Health

Department

Portland, OR

Nov. 2014 -

Present

Project Manager, Medical Coder

Analyze financial reports to locate sources of loss and poten al ways to increase revenue. Create workflows and execute policies to improve the financial health of the medical clinics.

Familiar with FQHC billing and the APM and PMPM reimbursement models. Discover and correct coding and billing errors to reduce risk and improve claim payments.

Train medical providers on the proper use of CPT, HCPCS and ICD-10 codes. Lead over a team of medical coders.

AKT, CPAs,

Advisors and

Consultants

Lake Oswego, OR

April 2014 - Nov.

2014

Revenue Cycle Specialist

Assist physicians and execu ves of medical prac ces with cash flow and their en re revenue cycle.

Nego ate new provider contracts and act as a liaison between the medical prac ce and insurance company.

Assist physician billing with proper claim documenta on, clear communica on with insurance companies and organized administra on prac ces. Aetna

Bismarck, ND

2006-2013

FamilyCare

Portland, OR

2014

Senior Consultant, Claim Processor

Provided award winning service as part of an exclusive team to create las ng rela onships with clients.

Handled complex projects that involved high financial risk. Able to perform and manage difficult tasks independently.

Processed medical claims on UB04 and HCFA1500 forms. Interpret plan benefits and applied insurance contracts. Processed enrollments and posted demographic updates for plan members. Education

Dickinson State

University, ND

Bachelor of Finance

Finance and Accoun ng

Bismarck State

University, ND

Associate of Science

Science, Computers and Mathema cs

Projects

Improved claim accuracy project created a hold queue of the most common coding errors. The hold queue allows the codes to be corrected before they are sent to insurance. This project reduced the volume of claim denials and currently allows $450K in claims being reviewed for accuracy each month. Coding and financial analysis project revealed coding errors and missing use of a common coding modifier

(25). Through this project I was able to reduce fee-for-service denials of office visits and increase revenue by $691k per year.

Revenue Cycle Analysis Project for a rural hospital and healthcare system. As part of the analysis I interviewed staff members at six different loca ons. As part of the interview process I sat with medical providers, billing and coding staff, and front desk staff members. Through this analysis I was able to assist the hospital with reducing their days in AR from 83 to 60 and the outstanding AR from $1.8M to $1.0M. Certifications and Courses

AAPC Certified Professional Coder (CPC) #01338792, Sept. 2014 - Current NACHC Revenue Cycle 360 2016

Columbia University of NY HI-FIVE: Health Informatics For Innovation, Value & Enrichment 2015



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