Healthcare Revenue Cycle Manager
Resume:
Phylisha J. Searcy-Allen
**** ********* ***** ****: 404-***-****
Grand Prairie, TX 75052 Email: acrpe8@r.postjobfree.com
Objective Obtain a challenging position utilizing my knowledge and expertise in the areas of customer service and the billing of healthcare insurance. Able to identify improvement opportunities in claim denials and cash collections.
Summary of Skills and Qualifications
Manage day-to-day operations for the revenue cycle management department in the areas of AR management, third party denials reduction, correspondence posting, refunds, mailroom and billing customer service call center operations.
Increase collections for reimbursement from par, non-par, patient and client billing.
31 years with Quest Diagnostics with operational knowledge in several different departments such as Specimen Management, demographic data entry, client customer service call center, front-end billing operations and patient services.
22 years in leadership as a supervisor and manager
Comprehensive knowledge of third party payer billing requirements for reimbursement such as Medicare, Medicaid, and other major commercial and managed care products.
Implementation of department goals and metrics with scorecards to measure and track performance
Understands how to read and interpret EOB’s and ansi codes and remark codes
Excellent oral and written communication skills
Managed processes in accordance to Compliance, Driver Safety, EHS, Performance Management and HIPAA
Excellent time management and prioritization skills
Strong PC skills with proficiency in MS Office Products (Excel, Access, Word, PowerPoint, Outlook), Quest Diagnostics Care 360, Quadax and OnBase imaging.
Six Sigma Greenbelt Certified. Familiar with Six Sigma, Lean and Kaizen process improvement projects
Professional Experience
Manager, Revenue Cycle Management Miraca Life Sciences 2013 - Present
Manage day to day operations of revenue cycle
Collaborate with Revenue Cycle Vice President and Director on process improvement opportunities related to reduction of third party denials, AR bad debt for contractual payers, correspondence denials and reducing credit balances related to refunds and line item adjustments
Managed projects related to patient and client collections strategies by designing new statements and client invoices.
Analyze opportunities for improving cash collections by reducing front end write offs
Support sales directors and account managers with client retention; subject matter expert related for billing issues
Monitor monthly performance metrics for Bad Debt and AR reduction efforts
Strategically improve patient collections by reducing holds and providing client education to help us bill clean claims
Analyze client and payer claim denials to identify opportunities for improvements
Increase team mate morale by recognizing top performers relating to our values
Responsible for mentoring, performance appraisals, hiring and firing
Billing Service Specialist Supervisor/Rep Quest Diagnostics, Inc. 2008 - 2013
Managed exempt level Billing Service Specialists for Revenue Operations
Visit clients for claim denial resolution; provided education on reimbursement requirements pertaining to medical coding, NPI’s, Physician Referral or Authorization, Medicare limited coverage determinations, ABN and frequency limitation policies. Also provided education and training for missing information and other specific billing information requirements for clean claims.
Overnight travel required 75% of the time for assigned territory covering Texas, Louisiana and Mississippi.
Assign geographical territories for all Billing Service Specialists
Support sales directors and account managers with client retention; serve as subject matter expert related to billing issues and resolution for their clients
Monitor monthly performance metrics for Bad Debt and MLCP reduction efforts
Met goal of reducing assigned territory bad debt for MLCP, third party denials and client AR by 8% in 2012
Analyze payer claim denials to identify opportunities for improvements
Review client pricing and create retros as needed for pricing updates
Attend conference calls and SLT Business Quality Council meetings in absence of the manager
Lead team meetings and one-on-one sessions
Responsible for performance appraisals and salary planning
Responsible for training, performance management, mentoring, hiring and firing of employees.
Front End Billing Supervisor Quest Diagnostics, Inc. 2002 - 2008
Supervised productivity and quality of non-exempt level Billing Data Acquisition call center representatives and Billing Data Entry employees
Managed department needs, staffing, time and attendance.
Post daily/weekly/monthly metrics on network drive by required deadlines.
Reported daily/monthly numbers to corporate
Analyzed trends for process improvements to drive growth and increase productivity
Responsible for annual performance appraisals and salary planning
Responsible for training, performance management, mentoring, hiring and firing of employees.
Specimen Management Shift Supervisor Quest Diagnostics, Inc. 1993 – 2002
Supervised productivity and quality of non- exempt Specimen Prep Technicians
Responsible for managing staffing needs, time and attendance
Attend BU upper management meetings to report on department completion times
Responsible for performance appraisals and salary planning
Responsible for training, performance management, mentoring and hiring of employees.
Client Services Rep II / Trainer Quest Diagnostics, Inc. 1987 – 1993
Answered phones in an ACD environment responding to clients needs for results, test requirements, patient and client pricing.
Called critical lab results and reported issues with test delays, insufficient quantity and lost specimens to our customers
Trained new Customer Service Reps; provided refresher training to seasoned reps
Specimen Processor / Technical Specialist Quest Diagnostics, Inc. 1982 – 1987
Prepared specimens for testing for clinical laboratory
Performed data entry of patient demographics and test orders
Pulled specimens from storage for additional testing
Achievements
Certified Miraca University Leadership Development Training 2014
Successfully completed IntelliQuest course titled
"Leadership Essentials: Leading Innovation." 2013
Smith Drivers Safety Certification 2012
Successfully completed 6 IntelliQuest courses in: 2012
1. Telecommunication Strategies for the Remote Employee
2. Managing Virtual Teams
3. Analyzing Your Use of Time
4. Planning and Prioritizing Your Time
5. Avoiding Time Stealers
6. The Health Care Industry Overview
Completed STARS Supervisor/Manager Training 2010
Certified Six Sigma Green Belt 2007
MLCP Bad Debt Reduction Outstanding Achievement Award 2004
Intermediate skills with Mircrosoft Office products such as Outlook, Visio, Word, Excel, Access
Power point and Publisher
References Available Upon Request
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