Customer Service Revenue Cycle

Bobbie Jones, MBA, MEd

214-***-**** ● ad0pv1@r.postjobfree.com

Eager to contribute seasoned background in the Healthcare Sector toward continuing opportunities in Management.

Patient Access Services ~ Patient Financial Services ~ Insurance Verification ~ Appeals/Denials

Revenue Cycle ~ Medical Audit Reviews ~ Management ~ Personnel Leadership ~ Business Process Improvements ~ Hiring & Interviewing ~Accounts Receivables ~ Business Coaching ~ Customer Service Communication ~Team building ~Healthcare operations ~Training ~Time Management~ payment processing ~reporting ~data testing

Profile

Accomplished leader offering 30+ years in healthcare administration encompassing medical office operations, patient access services, staff training, customer service, billing, coding, medical audits, and insurance.

Well-versed in medical terminology and Medicaid, Medicare, and third-party reimbursement regulations.

Adept at supporting, promoting, and maintaining a cohesive and respectful workplace climate essential to maximizing staff retention, morale, and satisfaction.

Advanced knowledge of outpatient oncology billing rules and regulations.

Autonomous and personable with superb consultative, instructional, interviewing, hiring, and managerial skills.

Contribute dynamic communication skills toward effectively liaising between executives and internal/external stakeholders in support of achieving corporate objectives.

Excel in analyzing existing healthcare practices and orchestrating process improvements to elevate patient satisfaction while controlling expenses.

Successful Completion of Front-Line Leadership Training

Professional Experience

TX Oncology, Richardson, TX 75082, September 2020 to Present

Revenue Cycle Trainer

Maintain communication with Clinic Management for any immediate training needs

Creates and designs comprehensive training programs for new hire trainees with an emphasis on business systems used in practices.

Develops mechanisms to test trainee knowledge of material.

Distributes, collects, and tracks post training surveys to evaluate overall training materials and presentation skills.

Develops, designs, and maintains training documentation, manuals, and training performance.

Responsible for monitoring new hire trainee processing, documentation in accordance with departmental guidelines, and providing individual and team feedback. Helps trainees to help them achieve individual and unit performance standards.

Consults with management team regarding performance issues. Assists in implementing plans for individual and team development. Gathers data and prepares training reports as requested on a daily, weekly, or monthly basis.

Plans and manages the development and review of test cases, test scripts and other testing variables. Manages defect tracking and adhere to testing methodology.

Defines environment preparation activities for the testing environment and oversee completion of all environment validation tasks.

Develops a testing methodology template for test plan and oversees the recording of test scripts. Defines, documents, and communicates the schedule for systems and integrating testing.

Facilitates testing status meeting to review the testing schedule, testing defects and related issues.

Tested all new software integrations as needed.

Report training metrics and generate training-related reports.

TX Oncology Dallas, TX 75230, 2016 to September 2020

Revenue Cycle Supervisor (Business Office Manager)

Delivering leadership to Revenue Cycle staff for oncology/hematology, pediatrics, blood marrow transplant, and radiation processes

Supervising multiple locations in the DFWW Region

Manage revenue cycle projects at the Practice level, such as audits and budgets.

Regularly provides senior leadership with revenue cycle status includes reports, metrics, and presentations.

Develops, monitors, and assesses business metrics to refine processes and improve efficiencies.

Uncover areas of financial discrepancy and inefficiency from the Hold Report which demonstrate A/R issues.

Supervises the daily business functions of the patient visits from point of entry to accurate adjudication of the patient accounts/Patient Facing Staff – (Pt Service Coordinators, Schedulers, Clinical Reviewers)

Monitor missing appointments and charge ticket reports for month-end close, and TES Edits

Reconciliation of daily cash collections, and bank deposits

Accurately accesses strengths and development needs of employees.

Resolves escalated and unique revenue cycle issues.

Collaborates with Operations which includes physicians and other clinical staff to ensure site is operating efficiently.

Responsible for quality work, meeting deadlines, and adherence to the Practice’s Standard Operating Procedures (SOPs)

Monthly, prepares revenue cycle financial analysis, including aged accounts.

oMonitors and assesses business metrics to refine processes and improve efficiencies.

oGuides individuals and teams toward priorities

oClarifies roles and responsibilities of others.

oCoordinates resources to meet objectives.

Champions new initiatives

oPaves the way for needed changes.

oManages implementation effectively.

oTakes ownership and accountability.

oConducts training on SOPs, systems, metrics, and government regulations.

Superuser for New PMS system effective November 2018

Staff payroll, evaluations, PTO requests

Performance improvement plans in Workday.

AmerisourceBergen Specialty Group, Dallas, TX, 2015 to 2016

Business Practice Coach

Delivered influential coaching to oncology practices by conducting assessments, translating key performance metrics into action plans for improvement, and serving as the primary point of contact for technology solutions.

Uncovered areas of overstaffing, financial waste/losses, and inefficiency, and drove business process optimization and best practices to garner rapid improvements for clients.

Partnered with the sales team as a key business advisor and solution advocate for Division’s products.

University of Texas Southwestern Hospital, Dallas, TX, 2012 to 2015

Quality Assurance Analyst

Meticulously audited back-end claim processing for quality assurance as well as front-end processes to validate revenue cycle via Epic HB/ADT system.

Leveraged considerable industry expertise toward training and coaching multiple departments in performing patient access and patient financial service activities.

The Methodist Health System, Houston, TX, 1995 to 2012

Revenue Integrity Analyst – Infusion/BMT Transplant Clinic (2007 to 2012)

Conducted detailed quality audits of oncology infusion billing processes for revenue capture and enhancement.

Diligently ensured CPT/ICD 9 codes and charges aligned with best practice guidelines.

Communicated daily with clinical staff, physicians, and healthcare information management to prevent denials prior to claim submission.

Handpicked to lead the Six Sigma Black Belt Lean project, successfully recouping $2M in unpaid/denied revenues.

Patient Access Services Supervisor (2005 to 2007)

Supervised, coached, motivated, counseled, interviewed, hired, and coordinated 35 (FTE) personnel within the cell and gene therapy, bone marrow transplant, and 11 other outpatient cancer infusion access services areas throughout the hospital.

Some knowledge of the ATS system for tracking good fit personnel.

Frequently reviewed patient accounts to ensure completeness and accuracy of insurance/precertification data.

Liaised with physician offices to validate CPT/ICD-9 codes for treatment plans and primary/secondary diagnoses.

Formulated and submitted reports to upper management detailing areas needing improvement.

Proactively generated dashboards to streamline and expedite audit processes for patient access services.

Revised patient access manuals to augment department training especially related to the revenue cycle.

Appeals and Denials Coordinator (2001 to 2005)

Scrutinized third-party payer denied claims and filed appeals when appropriate.

Documented and inputted denials in the database, promptly responded to appeal letters and played an integral role in establishing the Appeals unit and Contract & Compliance unit to bolster the departmental organization.

Assembled training manuals to effectively guide new staff in navigating appeal and denial processes.

Insurance Verification Supervisor (1995 to 2001)

Applied sharp organizational skills toward disseminating verification workload to staff, inputting data into hospital information system, and completing production reports.

Facilitated training for new hires and provided counseling and conflict resolution as appropriate.

Promoted from role as insurance verifier (1996 to 1999) based on exceptional performance and results.

Prior experience includes role as Admission Representative & Collections,

Methodist Medical Center Dallas in Dallas, Texas from 1992 to 1995.

Education & Certifications

MBA, Specialization in Healthcare Management, American InterContinental University, Houston, TX 2015

Delta Mu Delta Honor Society; Honors Induction

Sum Cum Laude, Honors Recognition Medallion; (GPA: 4.0)

MEd., Master of Education, Specialization in Leadership and Administration, graduated sum cum laude

Jones University, Denver, CO, 2010 (GPA: 4.0)

Front Line Leadership Training, McKesson, Las Colinas, TX, 2020

Coaching and Developing Employees, LinkedIn Learning Certificate of Completion, 2019

Certified Medical Office Professional, Texas School of Business, Houston, TX

Outpatient Billing Specialist Certification, American Institute for Medical Professionals, Houston, TX

Technology

Medisoft, Microsoft Office, Visio, Excel, Epic, Centricity, athenaIDX, Salucro, IKnowMed, 10-key by touch, Salesforce, G4/ULS systems, NextGen, Hospital Information Systems, Misys (vision), Mosaiq, Novitasphere, Availity, InstaMed, Relay Health (clearance), Workday, G2 (iKnowMed) EMR, AthenaIDX, Remedy-Force, Relatient, VSee, The LINK, Webex, Teams, Navigating Care, Leading Reach, Alevate

Memberships

Practice Manager Institute for Medical Office Professionals

Texas Hospital Association

American Institute of Healthcare Compliance

Delta Mu Delta Honor Society

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