Revenue Cycle Patient Access
Resume:
Carlota Garcia-Styczynski
Industry Lines
Health Care Management
Public Health System
Billing for all type of facilities
Medicare & Medicaid Managed
Care, Nursing,SNF Billing.
Medical Programs
Profit & Non-Profit Org
Computer Applications
MS Word
MS Excel
MS Outlook
Power Point
FOX editor
Meditech Applications
BAR, ADM, GL, PA, ABS, LAB
RAD, ER, CDM
Education/Qualifications
Bachelor’s in Science-
Psychology
Medical Doctor (UANL Mexico)
Master’s in Healthcare
Administration (in process)
Phoenix University
Professional Experience
Experienced healthcare professional, leadership and administrative oversight to all revenue cycle functions. Expertise in revenue cycle operations, healthcare management, financial reporting, credentialing, facility & professional contracting, patient access, hospital & professional billing, reimbursement & collections, clinical documentation specialist, coding, policies & procedures. (RAC) Liaison. Bachelor of Science Graduate. Medical Doctor Graduate. Independent Consultant. Bilingual Spanish. Principal Areas of Practice
Revenue Cycle Operations & Management Functions
• Develops Strategies and Operational RCM goals
• Accounts Receivables, Hospital & Professional Billing
• Clinical Documentation, Coding & Charts audits
• Medical Coding review for all billing procedures and infrastructure,
• Patient Access, Insurance verification and authorization,
• Facilities & Professional Credentialing.
• Facilities & Professional Contracting with payers
• Charge Master Coordinator (Meditech Operational System)
• Develop, implement, and monitoring RCM KPI.
• Federal and State financial reporting & audits, CMS, HFS, IDPH, RAC, OIG
• Utilization Review & Case Management
• Management Reporting, AR, Coding, QA, Denials, payments compliance
• Oversee Health Information Management Department. Financial Department Services
• Oversite of the financial department staff, account manager, controller, staff account, payable accounts manager, payable account clerk, payroll manager, Employee ‘s benefits specialist.
• Collaborate and assisting CFO to provide financial and accounting support. Maintaining & updating hospital financial policies & procedures. Supporting financial department with cost accounting reporting, vendor contracts, authorization of invoices for payment processing.
• Supporting payroll department to process and completing payroll cycles.
• Reviewing daily banking activities, EFT’s, daily remote deposits. Reviewing monthly statement, reconciliation.
• Processing payable accounts and payments of liability.
• Assisting CFO with monthly & yearly financial reporting for federal & state regulatory agencies.
Ambulatory Clinical Services
• Supervising daily operations for ambulatory clinics: OB-Gyn, Interventional Radiology, GI, Wound Care, Asthma Clinic, Pain Clinic, Adolescent Behavioral, Internal Medicine, General Surgery, Family Practice, Pediatrics, Cardiology, Ortho, Physical Therapy, Oncology, Rheumatology & Podiatry.
• Development and implementation of policies and procedures for HFAP.
• Coordination and management of physician billing. Managed 45 staff members, including admitting staff, billing staff, accounting service manager, medical records, coders, and multiple managerial positions across the organization.
Roseland Community Hospital, Chicago, Illinois March 2009 –Present Director of Revenue Cycle and Patient Access
• Hospital revenue cycle management, including identifying and implementing revenue cycle performance improvement initiatives, resulting in maximized charge capture, Carlota Garcia-Styczynski
Director of Revenue Cycle
************@*****.***
Areas of Practice
Revenue Cycle Operations
Healthcare Administration
Hospital Billing A/R
Financial Reporting
Credentialing
Clinical Documentation Spec
Coding Review
Auditing& GAP Analysis
Reimbursement & Collections
Compliance, P&P
Facility & Professional
Contracts
Facility Accreditation Programs
HFAP & Joint Commission
Revenue Integrity
Carlota Garcia-Styczynski
Areas of Practice
Revenue Cycle Operations
Healthcare Administration
Hospital Billing A/R
Financial Reporting
Credentialing
Clinical Documentation Spec
Coding Review
Auditing & GAP Analysis
Reimbursement & Collections
Compliance, P&P
Facility & Professional
Contracts
Facility Accreditation Programs
HFAP & Joint Commission
Industry Lines
Health Care Management
Public Health System
Medicare &Medicaid Managed
Care,
Medical Programs
Profit & Non-Profit Org
Computer Applications
MS Word
MS Excel
MS Outlook
Power Point
FOX editor
Meditech Applications
BAR, ADM, GL, PA, ABS, LAB
ER, CLINICAL, SX SDS
,RAD,PHARMCY.CDM
Educational qualifications
Bachelor’s in Science-
Psychology
Medical Doctor (UANL
Mexico)
Master’s in Healthcare
Administration (in process)
Phoenix University
Professional Experience
• Hospital revenue cycle management, including identifying and implementing revenue cycle performance improvement initiatives, resulting in maximized charge capture, improving total revenue collection by financial class & ins plan, decreasing total days in accounts payable (A/R).
• Medical coding review for all billing procedures and infrastructure, ensuring that professional and facility fees are accurately processed, and that medical record documentation, CPT-4 andICD-10 requirements are met.
• Overseeing Admitting & Registration Operations, insurance verification and eligibility admitting, pre-authorizations for all patients’ services, policies & procedures for optimal recovery of billed revenue in accordance with compliance to current regulations and payer requirements.
• Maintaining the Charge Description Master (CDM), including reviewing fee schedules and maintaining compliance with current regulations, ensuring accurate reimbursements.
• Conducting medical chart and clinical documentation review to ensure medical necessity criteria are met.
Thorek Memorial Hospital, Chicago, Illinois July 2006 Dec 2008 Collection Supervisor
• Developed and implemented proposal of billing protocols and guidelines for outpatient and in-patient procedures, skill nursing facility billing.
• Coordinator of charity program
• Audit of daily billing records
• Development and implementation of electronic billing procedures
• Developed and implemented improved clinical guidelines
• Supervision of daily activities for accounts receivable (AR),
• Instituted departmental auditing procedures
Chicago Orthopedic Rehabilitation Bone and Joint Center May 2005 – June 2006 Practice Manager
• Improved recovery reimbursement process, clinical documentation of procedures
• Oversight of daily operations, coordination of services for post op care, surgical charge captures and patient care coordination
• Supervision of daily operations for the rehabilitation, ortho clinic & surgical center
• Management of billing procedures, including oversight of out- patient facility billing for Ortho and Rehabilitation.
Additional Work Experience
• Su Saludad Medical Center 2004 – 2005 Practice Manager
• Bill-Tech Consultants Billing CP 2002-2004 Acct Receivable Manager
• Our Billing Department, Billing Co Inc. 2000 -2002 A/R, Recovery Credentialing Specialist
• Ankle & Foot Center of Elmhurst 1999-2000 Practice Coordinator
• University of Chicago Hospitals 1998-1999 Medicare Recovery Specialist
• Associates in Women’s Health 1992 –1998 OB-GYN Practice Manager
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