LINN ROCHE, BA

N **** County Road V Holmen, WI **636

312-***-**** ad1xx1@r.postjobfree.com

REVENUE CYCLE LEADER

Result-driven professional with experience in medical billing, revenue cycle management, enrollment, front office to back office, accounting, customer service, credentialing, implementation and oversight of projects as well as call center management. Extensive management experience in multiple-location health care facilities. Vast experience with Medicare, Medicaid, Tricare, Commercial, HMO, Self-Pay and workman compensation carriers.

PROFESSIONAL EXPERIENCE

Bay Street Orthopaedics and Spine

Director of Revenue Cycle 9/2022 to 12/2023

Responsible for Seventeen providers; seven physicians and ten mid-levels

Complete day to day operation and provide ample support to all staff to ensure patient satisfaction and excellence in health care.

Delegate tasks to guarantee responsible financial management of the company. This includes, but is not limited to negotiations with vendors and insurance contracts.

Communicate effectively throughout the company’s one hundred and two employees as well as the six locations in Northern Michigan, including three fast-paced Urgent Care Centers.

Develop and integrate new and positive strategies to aid the company in its operation and growth in underserved communities in Northern Michigan.

Onalaska Care Center

Health Information Manager 8/2021 to 8/2022

●Responsible for all MDS audits and transmissions in a timely manner

●Accountable for all Policy and Procedures relating to patient information.

●Complete the coding of all patient charts for MDS purposes

●Verify all new admissions

●Oversight for all facility reporting to CMS and WI Medicaid

●Communicate with families to answer all questions regarding insurance and billing.

Huff Senior House Calls

Director of Operations and Revenue 1/2020 to 7/2021

●Responsible for the setup and implementation of a new practice. Practice has 2 doctors and 4 Nurse Practitioners

●Setup EMR, Labs, Mobile X-Ray, New Patient Paperwork, Home Health Portals, Billing System, Phone and Fax Systems

●Credentialed all providers with all requested insurance companies.

●Oversaw the hiring of support staff, training of all staff, establishment of workflows and the development of all Policies and Procedures

●Managed all revenue cycle activities, patient verification, entry into various systems, billing and all follow up

●Responsible for all provider scheduling

RenPro

Admissions Manager 8/2017 to 12/2019

●Verified and obtained all necessary authorizations to ensure accurate Dialysis Patient Admissions

●Responsible for all CMS reporting

●Maintained the CMS Crown Web Portal

●Responsible for all EMR updates and reporting functions

●All after hour and weekend staff reported to me

Concerto Renal Services

Director of Reimbursement and Operations 3/2016 to 8/2017

●Responsible for the management of three teams; Admissions, Billing/Collections and Crown Web for thirty-one clinics

●Credentialed and contracted all providers and facilities

●Project Managed new billing system with QMS implementation.

●Reduced A/R days from 122 to 32 days by initiating new workflow for follow up.

●Introduced new procedure for authorizations, reducing denials by 47%

●Converted the Admission process from a paper system to electronic

●Developed training and education on insurance documentation to ensure the highest reimbursement

●Corporate contact for all non-clinical operations

Gundersen Health System

Prior Authorization Specialist 1/2015 to 2/2016

●Initiated and tracked authorizations for three departments, ensuring prompt timely payment and reducing

denials

●One of three prior authorization specialists chosen to head up a training team for providers and access personal

●Examine and work any denials

Mercy Hospital and Medical Center

Director of Physician Revenue 1/2013 to 1/2015

●Responsible for all revenue activities for 250 physician providers, 60 Residents and 32 Nurse Practitioners

●Billing, Collection, Credentialing and Patient Access Departments all reported to me

●Oversite of all revenue activities for FQHC, Hospital Activities, Hospice and 11 satellite locations

●Ensured all providers were credentialed at all facilities, reducing denials by 54%

●Revised provider onboarding process, ensuring timely credentialing

●Brought billing in-house, purchased new software. Developed workflow for inhouse revenue cycle

●Hired and trained staff

●Established Charge Sheets for all provider specialties

●Devised audits to ensure charge capture

●Developed and instituted education for all patient access teams, regarding new insurance market and outsourcing of Medicaid program

Fresenius Medical Care

Manager of Billing and Front-End Operations 8/2010 to 12/2012

●Responsible for Insurance Verification, Document Control, and Billing teams who provided front end revenue cycle services for 132 dialysis clinics

●Revamped workflow to ensure the correct revenue source was captured timely, reducing the overstatement of revenue by 63%

●Implemented production matrix

●Implemented a monthly call, where challenges and successes were discussed, to improve communications with field operations

●Project Managed with the Director of Financial Counselors, new processes to ensure consistent processes and timely, streamlined workflow between the departments

●Selected to serve on two Six Sigma committees that were tasked with completing a complete overhaul of all front-end processes in the billing office and the clinics

Da Vita Village Health

Revenue Cycle Manager 5/2008 to 6/2010

Manager oversight of Enrollment, Provider Services, Call Center, Reimbursement, and Part C Replacement Demonstration Plan as well as Disease Management Program.

Oversaw the process of bringing claims payment from an outside BPO to an in-house payment group.

My Team was responsible for the payment of all claims for all members, in 6 States and the District of Columbia, enrolled in our plan.

Trained all staff in the payment of all types of claims, physician (all specialties) facility, home health, hospice and drug claim.

Tracked and addressed all grievances and appeals according to CMS guidelines.

Implemented audit procedures to ensure timely and accurate payment of all claim types in accordance with Medicare guidelines.

Responsible for all RAPS, LICA, RX and MMR monthly reporting and reconciliations

Managed the on-site staff, in the central business office as well as teams in the field which included disease management nurses.

Operationally supported remote nursing staff who were providing disease management services to patients with CKD or ESRD

EDUCATION

BA, Business Management and Communications, 1983, Alverno College, Milwaukee, WI

AWARDS

Core Value Award for Team, 2009

Received the distinguished Core Value award for Team. DaVita Village Health had 7 core values, and if leadership deemed a teammate had demonstrated one of the core values, the teammate is recognized at the annual meeting. I was presented with the Team Core Value award for teammate retention (100%) and positive attitude that showed in all teammates that reported to me.

REFERENCES

Available Upon Request

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