Revenue Cycle Specialist, Analyst, Manager

FRANK C ZAMARRIPA *** NORMAN AVE. DALHART, TX ****2

Summary

Seasoned professional working in the healthcare industry for 11years. My focus has been on the revenue

cycle which encompass’ admitting, billing, denials, charge master, and collections. In the past 4 years I

have taken the time become familiar with the Health Information Management (HIM) part of the revenue

cycle by attending coding classes and coding seminars. I’m an active member of the AAPC and AHIMA

looking to become a CPC H, CPCO and CCS within the next year; currently assisting with outpatient,

inpatient, surgical coding and have performed E/M auditing for other providers. I have also participated in

educating providers on the importance of improving Clinical Documentation with the expectation of ICD 10

implementation in October 2015.

Experience

Revenue Cycle Analyst

Union County General Hospital 300 Wilson St. Clayton, NM 88415

25 Bed Facility Critical Access Hospital (CAH)

From August 2013 to Current

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Type of Bill (TOB) 111, 131, 851, 117, 137, and 857

MAC: Novitas Soutions

Team Leader for all departments

Duties Include but not limited to analyzing workflows and business workflows to identify where there may be weaknesses in

proposed flows and create solutions to prevent delays, backlogs, and deficiencies in data being set to the business

systems, designing processes and implement policies and procedures, in conjunction with leadership team, necessary to

achieve and sustain accurate and timely billing and collection of accounts receivables, and working with operations and

knowledge holders within the system to bring forward best practices.

Additional responsibilities include utilizing and maintaining current knowledge of patient account management techniques

and management information systems for registration, charge entry, coding, billing, clinical research, and accounts

receivables, optimizing procedural systems with other related departments (coding, contracting, information services,

medical records) to accelerate the timing and amount of cash flow within the enterprise, and ensure all revenue cycle

practices across the enterprise are compliant in all regulatory and contracted areas and that employees understand their

role as it relates to compliance policies established

UR Coder and Billing Specialist

New Mexico Heart Institute 502 Elm St.

Albuquerque, NM 87102

Cardiologist group; over 20 providers – 12 remote locations

November 2010 to July 2013

Billing Form: HCFA 1500

MAC: Trailblazer/Novitas

Team Leader for: Billing Team and A/R Clerks

Duties included but not limited to, educating, training, and auditing the work of physicians and staff on compliance with

proper billing procedures obtaining maximum reimbursement confined within those of documentation and overall coding.

Areas include E&M, diagnostic testing and procedures for cardiology, electrophysiology, cardiothoracic and vascular

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surgery, and chart auditing. Additional duties included charge entry for routine office based services, capturing and entering

charge data for routine hospital based services, reviewing of documentation and follow up with providers as needed.

Billing Specialist

UNM Hospitals 2211 Lomas Blvd NE. Albuquerque, NM 87105

580 Certified Bed Facility – Level 1 Trauma Center

November 2010 to July 2013

Billing Form: HCFA 1500

MAC: Trailblazer/Novitas

Team Leader for: Billing Team and A/R Clerks

Duties included but not limited to: registration, billing, claim follow up, remittance posting and reconciliation. Job involved

extensive communication with third party payers and government payers to resolve claim issues and ensure payment. Other

duties included research and correction of ICD 9 and CPT coding, modifiers, revenue coding, occurrence and values codes

as appropriate for field locators on the UB04 Claim form; determination of potential patient eligibility for Medicaid such as

EMSA and Presumptive Eligibility Medicaid. Area of expertise during this time period was Medicare billing, CMS guidelines,

and MAC Trailblazers, Noridian, and Palmetto GBA

Patient Service Representative

UNM Hospitals 2211 Lomas Blvd NE. Albuquerque, NM 87105

580 Certified Bed Facility – Level 1 Trauma Center

November 2010 to July 2013

Billing Form: HCFA 1500

MAC: Trailblazer/Novitas

Team Leader for: Billing Team and A/R Clerks

As a PSR responsibilities included all patient accounts receivable functions as assigned. Reconciled, researched, corrected

and submitted third party claims and resubmitted errors or denied claims. Communicated with insurance companies and

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government payers to resolve claim issues and ensure payment. Researched and corrected ICD 9, CPT coding, modifiers,

revenue coding, occurrence codes and value codes as appropriate. Collaborated with the Income Support Division and the

Medical Assistance Division in regards to eligibility for Medicaid. Interviewed and approve patients for UNMH charity

programs. Provided customer service to patients by researching billing issues with various departments and resolving the

issues. Reconciled remittance advices and patient accounts and resolved discrepancies.

Billing Analyst and Admitting Rep

Gila Regional Med Center 1313 E 32nd St. Silver City, NM

68 Bed Facility Acute Care Hospital

November 2010 to July 2013

Billing Form: HCFA 1500

MAC: Trailblazer/Novitas

Team Leader for: Billing Team and A/R Clerks

Job duties included but not limited to: completing patient admission/registration process by reviewing accounts for

completeness also all required compliance related documents. Obtained and documented missing information required for

completion of admission/registration. Interviewed patients on day of service to obtain complete accurate demographic and

financial information, referring all non sponsored inpatients to a Financial Counselor.

As a Billing Specialist I continuously worked all patient accounts current to over 30 days and beyond while ensuring

compliance with billing policies and standards, state and federal laws while increasing collections/revenue and maintaining

the maximum amount under 150 days as possible. Area of expertise during this time period was working third party claims

and MAC Trailblazers

Summary of Skills

Experience in the medical field specifically within the revenue cycle. Seven years were dedicated to hospital and

physician billing combined, as listed above. Four years dedicated to patient registration and charge entry and utilized

in every job thereafter. In the most recent four years I have gained experience in coding, mostly very difficult inpatient

and outpatient cardiology surgeries and procedures but poses the ability to code almost any case. I am currently in the

process of testing for a coding certification and soon after that working on a compliance certification both through

AAPC. Other skills include those of a Charge Description Master and EDI Coordinator, familiar with the following

coding sets: CPT4, ICD9 (all volumes), ICD10 (all volumes), and Anesthesia. Proficient with all Microsoft Office

components and all office equipment.

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Education

Silver City High School

May 1998 High School Diploma

Business Professionals of America

Accounting

Mathematics

Band

Choir

Western New Mexico University

May 2007 Bachelors of Business Administration in Accounting

References

Provided Upon Request

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