Revenue Cycle Accounts Receivable
Resume:
KANGELA FREEMAN
***** ****** **, ******* ** *****
ad3b2u@r.postjobfree.com
https://www.linkedin.com/in/kangela-freeman-bb8710117/ Objective:
Highly experienced and dedicated with 33 years of expertise in revenue cycle billing and collections, patient access, medical records and payment posting for hospital and physician operations. Seeking a challenging position in a reputable healthcare organization where I can utilize my skills and knowledge to streamline revenue cycles, maximize reimbursements, and ensure compliance with regulatory requirements.
Summary of Qualifications:
Extensive knowledge of revenue cycle billing processes, including coding, charge capture, claims submission, payment posting, denial management, and accounts receivable management.
Proficient in various billing software systems, including [mention relevant software systems].
Demonstrated ability to analyze and interpret complex billing and reimbursement guidelines, including Medicare, Medicaid, and third-party payer regulations.
Proven track record of improving revenue cycles and increasing cash flow through process improvements, staff training, and effective denials management.
Strong understanding of healthcare compliance standards, including HIPAA and medical billing regulations.
Excellent leadership skills with the ability to manage and motivate a team to achieve departmental goals and objectives.
Exceptional attention to detail, analytical skills, and problem-solving abilities.
Effective communicator with strong interpersonal skills, capable of building positive relationships with both internal and external stakeholders. Technical Skills
Microsoft Office, Excel, Power Point, Share Point, PMP, Adobe, Zoom, Teams, Outlook, 10-Key, 10-Key,65 WPM, Sorian, EPIC HB and PB, Meditech 6.8, SMS, Eagle, HBOC Star, Cerner, Harvest Contract System, Optum 360, Wellington Denial System, Medicare DDE System, All Insurance Carrier Systems, Billing Systems (Epremis, SSI, Harvest), Medicaid by State (GA, KY, IN, MS, HI, MA, RI, CT, WA, IL, AL, NH, VT), Managed Care, Commercial, WC, Lability, Home Health, DME, ASC,CAH and Nursing Home.
Professional Experience:
KANGELA FREEMAN
18371 Walter St, Lansing IL 60438
ad3b2u@r.postjobfree.com
https://www.linkedin.com/in/kangela-freeman-bb8710117/ Revenue Cycle Project Operations Director Navient / Xtend Healthcare Feb 2020_Dec 2022
Works collaboratively with other departments/senior leadership to identify, install & manage revenue performance improvement initiatives.
Measure & manage staff performance/productivity and employment standards.
Providing strategic analysis/assessments for our clients resulting in long term RCM transformational work
A team player; a highly collaborative, team-oriented process. Leads development of opportunities and management of team resources to grow the business.
Provide analysis and data driven recommendations to senior management.
Mentors, develops and coaches new and existing staff.
Contribute to the compliance with, and development and updating of, department standard operation policies and procedures.
Implemented Hospital and Professional Billing Revenue Cycle Systems
Documents and supports the development and refinement revenue cycle workflows (patient access, insurance verification, charge capture, payment posting, self-pay and patient follow-up management)
Optimization, auditing, and setup of work queues for charge capture reconciliation, denial management, clearinghouse, claims management, and payment posting.
Ensure the integrity of the Revenue Cycle Systems databases and Master File and Dictionary Configuration
Participate in audit and execute recommendations for improvement of revenue cycle systems. Revenue Cycle Billing Manager Conifer Health Solutions Oct 2007 _ Feb 2020
Oversaw all aspects of the hospital's billing operations, managing a team of 45 + billing specialists and coders.
Implemented and optimized billing processes, resulting in a significant reduction in claim denials and increased revenue by 20% within the first year.
Developed and maintained billing policies and procedures to ensure compliance with Medicare, Medicaid, and commercial payer guidelines.
Collaborated with the finance department to create accurate and timely financial reports related to billing and accounts receivable.
Conducted regular audits to identify coding and billing errors, implemented corrective actions, and provided ongoing education to staff.
Negotiated contracts with insurance companies and third-party payers to optimize reimbursement rates.
Monitored key performance indicators (KPIs) to track and improve billing department performance, including days in accounts receivable and clean claim rates.
Served as a resource for staff, providing guidance on complex billing and reimbursement issues.
Revenue Cycle Senior Billing Specialist Conifer Health Solutions April 2003_October 2007
KANGELA FREEMAN
18371 Walter St, Lansing IL 60438
ad3b2u@r.postjobfree.com
https://www.linkedin.com/in/kangela-freeman-bb8710117/
Processed and submitted claims to insurance companies, ensuring accurate coding, documentation, and compliance with payer requirements.
Resolved billing inquiries and appeals, working closely with patients, insurance companies, and healthcare providers.
Conducted regular audits of billing records to identify and correct errors, resulting in improved accuracy and reduced claim denials.
Assisted in training and mentoring new billing specialists, ensuring adherence to billing policies and procedures.
Collaborated with the finance department to reconcile billing and accounts receivable data.
Maintained Quality Assurance score on a monthly basis of 98% with 10% denial rate. Accounts Receivables Claims Representative Piedmont Medical Group March 1999_ October 2002
Accountable for the entire receivable assigned to the 3rd Party AR Specialist, including verification, billing, analysis, follow-up, denial and appeal processing, and account closure for assigned third party payers.
Accountable of day-to-day clerical activity to ensure that all information for proper billing is complete and accurate; billing to assigned payers is transmitted or mailed within a timely manner.
Conducts follow-up of outstanding account balances with assigned payers and takes action for resolution.
Research, evaluates and processes all appeals through research and resubmission to appropriate third party of complete and accurate supporting documentation•
Recommends third party adjustments and write-offs to Team Leader or Supervisor. Perform adjustment or write off when once reviewed and approved by Supervisor.
Accountable for researching and handling all rejections, including understanding why a claim was rejected, how it must be fixed, whether the patient is now liable or whether the hospital is liable.
Must initiate any corrective action, including referral to the supervisor when appropriate.
Accountable for the processing of adjustments due to denials, contractual requirements, and credit balances
Resolve assigned accounts in a timely and accurate manner, which maximizes reimbursement in compliance with assigned payer regulations and department’s policy and procedure.
Maintains knowledge of federal/State documentation and payer requirements along with annual updates to CPT/ICD-10 coding guidelines.
Regular interaction with other departments of the hospital using electronic system tools to resolve accounts, including Medical Records, Physician's Offices, Utilization Review and Preadmission office.
Interacts on a daily basis over the phone and through correspondence with assigned payers. Cont’d Accounts Receivables Claims Representative Piedmont Medical Group March 1999_ October 2002
KANGELA FREEMAN
18371 Walter St, Lansing IL 60438
ad3b2u@r.postjobfree.com
https://www.linkedin.com/in/kangela-freeman-bb8710117/
Established working relationships with payer representatives to facilitate processing of Medicaid, Managed Care, Medicare, Workers Comp, Liability, Critical Access Hospital etc. service accounts.
Consistently achieves and maintains performance standards for assigned productivity, collections, and quality targets with a score of 97% or better,
Identify trends in workflows and rework and reports outstanding operational issues to management for further research and resolution.
Data Entry and Adjuster Claims Representative Electronic Data Systems (Perot Systems) GA Title 19 Medicaid
June 1991_ Feb 1999
Keyed all state claims into Ga Medicaid Systems with no errors.
Reviewed and Balance claim batches at the end of business correct if needed.
Work red folder claims from provider with urgent issues as priority.
Review return to providers errors and send letter to provider for corrections.
Review and process clean claims from Medicaid providers as adjudicated claims.
Worked as team lead to ensure weekly and monthly claims goals were met. Education:
Certification in Data Processing
Philadelphia Training Institute, Atlanta, GA 1988 to 1992 Certifications:
Certified Revenue Cycle Representative (CRCR)
2024 (Expires)
Spervision-skills-managing-employee-performance-final-assessment 2023
References:
Available upon request.
Contact this candidate