Cynthia Arriola

**** ******** **.

Bell Gardens, CA 90201

ad3ate@r.postjobfree.com

Objective

Detailed, organized individual looking to obtain a challenging position in a mission driven entity that will utilize my knowledge and forward thinking in Revenue Cycle Management for Community and/or Federal Qualified Health Centers expertise to its fullest potential as well as promote growth, advancement and mutual profitability. Professional Experience

Director of Revenue Cycle Manager – Robert Half, West Hollywood, CA • October, 2023 - January 2024 Luskin Orthopedic Children's Institute

● Responsible for day-to-day operations of the patient accounts office. Acts as authorized point of contact with Athena HealthCare Company (“Athena”) the billing software company.

● Automated all manual work and created a zero paper environment

● Found denials and implemented workflows and training to allow loss of implant and hardware revenue loss

● Organizes and prioritizes activities to meet organization’s goals and objectives.

● Audits ASC and Factor charges to ensure accuracy and appropriateness.

● Ensures that any errors identified by coder are corrected and pre-scrubbed in a timely manner to ensure clean claims.

● Monitors and manages the CareConnect Work Queues daily to assure that the revenue from CareConnect transfers correctly and timely to the Athena platform for billing.

● Maintains all Charge Masters

● EOB Remittance Review: Identifies procedures that were not paid or denied, reviews with

● Coding staff and appeals with appropriate documentation as needed

● On-Boards all new Providers and Staff members into Athena

● Prepares reports for providers and leadership team as requested

● Reviews and approves large dollar write offs and bad debt accounts after appropriate follow up

● Manages accounts receivable in coordination with reporting assistance from Finance Department

● Works with the third party payors to obtain letters of authorization or contracts for services to

● be performed

● Oversees all Factors billing activity, including charges, payment posting, adjustments and refunds to assure accuracy and stability of practice

● Manages financial activities of the department, including budgeting and review of revenue and

● expenses

● Oversees Medical Coding and Compliance for all ASC and OHMG Surgical Procedures

● Develops and implements policies and procedures that guide and support the department

● Responsible for recruitment, orientation, supervision and timely performance of department

● staff.

● Promotes an environment that encourages teamwork and open communication

● Ensures compliance with federal, state and county regulations and certification requirements

● Meet and maintain clean claim average of 95% as evidenced by Athena reports

● Maintain A/R, Aging and Days Revenue in AR at or below goal

● Provide timely and accurate data upon request

● Work closely with Patient Access staff to obtain authorizations and / or to quote case rates for services, as appropriate

Revenue Cycle Manager – Men’s Health Foundation, West Hollywood, CA • March, 2021 - October, 2022

● Assessed and ensured that workflows were in place

● Oversee service areas that are directly involved with Revenue Process

● Reviewed and revised current templates

● Provided training to entire organization of County programs

● Reviewed accounts to prevent error patient bills

● Reviewed accounts for payment plans

● Clean up AR from outsourced billing company from 2018-2020

● Rebilled old claims for potential revenue recoupment, generated $800,000 extra income one month after employment started

● Helped with the integration and training of new staff for the Billing Department

● Assisted in the implementation of Behavioral Health Services

● Submitted Medi-cal Applications for additional locations

● Submitted NPI applications for 3 locations and set up billing linkage

● Processed 8 months of billing that was sitting do to improper set up of system

● Contracting, Credentialing for Providers and additional locations

● Provide Data and Month End closing reports for Board Members

● Provided UDS Reporting, OSHPD

● Provided data for Medicare Cost Report

● Prepare Aging Reports and summary of old claims 120+

● Prepare and submitted Bad Debt Write off Reports to Chief Financial Officer

● Submitted Provider and Department Productivity Reports to Management

● Assist and contribute in multiple interoffice activities to promote employee and patient retention

● Maintain knowledge and updates on HRSA Rules and Regulations

● Created and maintained Billing Policies and Procedures and ensured these were implemented throughout the organization

● Fee schedule actualization

● Federal Poverty Levels updates and training

● Sliding Fee training and Implementation

● Quarterly Workflow Training Refreshers as well as Onboarding training of new staff

● Monitor metrics for indication of improvement in the areas of Scheduling, Insurance Verification, HEIDIS Measures, Coding, Medical Record completion, Billing, Collection, Payment posting, and Claim appeal.

● Oversee the hiring, training and termination of employees for various departments including (Referrals Department, Medical Records, Registration, Check In, Check Out and Billing Department.

● Counsel employees both ongoing and as part of the performance evaluation process

● Communicate effectively with staff to keep them informed of changes within and outside applicable departments

● Keep current on emerging industry issues and provide timely information to staff

● Act as a liaison with Finance, Reimbursement, Budget Planning, Human Resources, Managed Care, Legal, Compliance and Enrollment in regard to their contribution to Revenue

● Meet regularly operations to ensure performance expectations are clear and fulfilled

● Represent the Billing Department at meetings interdepartmentally; interface directly with other departments, lend administrative support for the benefit of all patients and or department business

● Payroll

● Knowledge of all departments in Clinical setting that allow for proper training for clean claims

● DHCSP County programs and year end reconciliation Billing Department Manager – Universal Community Health Center, Los Angeles, CA • April, 2019 – November 2021

● Implemented Billing Department and grew the organization from 2 locations to 10.

● Provided training to entire organization of different programs or required information for clean claims

● Implemented Patient statements

● Clean up AR from outsourced billing company

● Helped with the integration and training of new staff for the Billing Department

● Hospital, CPSP, OB and Behavioral Health Billing, UDS Reporting, OSHPD, HEIDIS Measures, Medi-cal Applications

● Contracting, Credentialing for Providers

● Provide Data and Month End closing reports for Board Members

● HRSA Rules and Regulations

● Created and maintained Billing Policies and Procedures and ensured these were implemented throughout the organization

● Sliding Fee training and Implementation

● Monitor metrics for indication of improvement in the areas of Scheduling, Insurance Verification, HEDIS Measures,

● Coding, Medical Record completion, Billing, Collection, Payment posting, and Claim appeal.

● Oversee the hiring, training and termination of employees

● Counsel employees both ongoing and as part of the performance evaluation process

● Communicate effectively with staff to keep them informed of changes within and outside applicable departments

● Keep current on emerging industry issues and provide timely information to staff

● Act as a liaison with Finance, Reimbursement, Budget Planning, Human Resources, Managed Care, Legal,

● Compliance and others

● Meet regularly operations to ensure performance expectations are clear and fulfilled

● Represent the Billing Department at meetings interdepartmentally; interface directly with other departments, lend administrative support for the benefit of all patient and or department business

● Successfully implemented Telehealth visits billing and collections during the pandemic Director of Business Dept – Central Neighborhood Health Foundation, Los Angeles, CA • February, 2016 – April 2019

● Oversee, assist and provide training to Billing Department

● Provided training to entire organization of different programs or required information for clean claims

● Patient statements, refunds, overpayments

● Helped with the integration of new clinics

● Assisted with new strategies in operations for quality patient care

● Hospital, CPSP, OB and Behavioral Health Billing, UDS Reporting, OSHPD, HEDIS Measures, Medi-cal Applications

● Contracting, Credentialing for Providers

● Provide Data and Month End closing reports for Board Members

● HRSA Rules and Regulations

● Created and maintained Billing Policies and Procedures and ensured these were implemented throughout the organization

● Sliding Fee training and Implementation

● Monitor metrics for indication of improvement in the areas of Scheduling, Insurance Verification, Coding, Medical Record completion, Billing, Collection, Payment posting, and Claim appeal.

● Oversee the hiring, training and termination of employees

● Counsel employees both ongoing and as part of the performance evaluation process

● Communicate effectively with staff to keep them informed of changes within and outside applicable departments

● Keep current on emerging industry issues and provide timely information to staff Act as a liaison with Finance, Reimbursement, Budget Planning, Human Resources, Managed Care, Legal, Compliance and others

● Meet regularly operations to ensure performance expectations are clear and fulfilled

● Represent CNHF at meetings interdepartmentally; interface directly with other departments, lend administrative support for the benefit of all patient and or department business

● Develop internal and external communications and reports as needed

● Present information and updates on EPIC to Revenue Cycle Director, CFO, Board of Directors, and other committees

● Recouped over $500,000 in potential lost revenue paid in 2019 for 2016 dates of service for Medi-cal.

● Assisted with preparation for Site Review Audits for HRSA Billing & Coding Specialist- oBand Medical Group, Marina del Rey, CA • October, 2014 – February 2016

● Billing

● Appeals for surgical and anesthesia claims

● Appeals

● Coding for professional and facility claims

● Insurance and patient collections

● Patient Balances and statements

Billing & Coding Specialist– Osborne Head and Neck Institute, Los Angeles, CA July, 2012 – October 2014

● Billing and Coding for Facility and Professional surgical claims. Maintain accurate logs of missing op notes for billing.

● Refund requests due to overpayments.

● Handle all collections and patient statements for delinquent accounts.

● Follow up on all surgical claims, appealing of denials when needed.

● Billing, coding and follow up on Imaging, Anesthesia, Surgical Suite, Professional claims for 6 offices. Billing Lead – The Children’s Clinic, Long Beach, CA August, 2008 – July, 2012

● Oversee, assist and provide training to 8 employees in the billing department.

● Presented training to all employees in the all staff meetings or breakout sessions.

● Coordinate with Human Resources new hire orientation in the billing aspect or The Children’s Clinic.

● Brought Medicare billing up to date

● Conduct productivity on a daily basis and coordinate with Billing Manager work to be completed by the billing staff.

● Process a minimum of 100 claims per day.

● Maintain accurate lists of pending information needed for billing from the clinic sites.

● Assist the billing department with questions regarding claims.

● Assist patients with questions regarding statements.

● Conduct follow ups on claims and adjust, re-bill or appeal as necessary for maximum reimbursement.

● Knowledge in multiple state and county programs and provide training and guidance as needed.

● Request refunds, payment posting, adjustment posting, transfer balances to self pay. ASC Billing & Coding Specialist – PMG Partners, LLC, Los Angeles, CA June, 2007 – April, 2008

● Surgery and Ambulatory Coding, process 250-300 claims daily, read operative reports, coded, itemized and entered billing into the system.

Office Manager/Medical Biller – Mediplus MultiSpecialty, Los Angeles, CA August, 2006 – June, 2007

● Supervised 2 receptionists, 2 back offices M.A., 1 Biller.

● High volume billing for clinic, hospital and boarding care, as well as billing directly for doctor. Medi-cal, CHDP, Family PACT Billing.

● 30-40 patients seen daily in clinic

● Ordering supplies

● Petty Cash

Medical Billing Lead/ Medical Assistant Kevin A. Brown a Medical Corp., Los Angeles, CA September, 2003- August 2006

● Multi-Practice- Family and Diagnostic Procedures

● Supervised billing department of four billers.

● Billed for 6 different facilities, 150-250 claims daily, payment, posting, outstanding balances, collections, appeals, Medicare, private pay, HMO billing.

● Assisted with blood draws, immunizations, ekg’s, vitaling or receptionist coverage as needed. Medical Assistant/Lab Tech – Beth Medical Center, Los Angeles, CA April 2001– August 2006

● Vitals, lab tech, wound debridement, assisted doctor with minor surgeries, billing preparation, and receptionist. Software Skills

Allscripts, Phreesia, eClinical Works, IMS, EPIC, NexGen, OMNIS Vision, MD Synergy, Lytech, Athena, Medicare CMS DDE, EPIC, Electronic Medical Records, Elligence, ClinixMD, MS Word, Nextech, Excel, Data Entry, Bilingual Spanish. Education

DHCSP County Programs Training 2021

MGMA Conference 2021

HRSA Ongoing Trainings 2018, 2019, 2020, 2021

MHLA Ongoing Trainings 2018, 2019, 2020, 2021

CCLAC Billing Managers Conference 2018, 2019, 2020 Healthy Way L.A. Billing Training, Lynwood, CA 2012 L.A. Care Billing Training, Los Angeles, CA 2011 Medi-cal Billing Seminars (Certificate of Completion) Long Beach, CA 2011 Medicare FQHC Billing Summit (Certificate of Completion) Sacramento, CA 2010 Certified Coding and Billing Specialist (License) – Allied Technical College, Los Angeles, CA 2003 Medical Assistant – Nova Institute of Health and Technology, Norwalk, CA 1996 High School Diploma- Vail High School, Montebello, CA 1995

Contact this candidate