Teresa Riggs

Greenwood,Indiana *****

317-***-****

ad4094@r.postjobfree.com

www.linkedin.com/teresa.riggs

Summary

A dynamic and hardworking finance professional and people leader with a diverse record of experience in claims management, revenue cycle operations, network operations management, provider and staff education, presentations and training, accounts receivable management, collections, cash management, and system functionality testing. Leverages excellent communication, organizational, and leadership skills, with a proven aptitude for collaborating with vendors, physician practice leadership, system application finance, and compliance specialists. An innovative problem solver who quickly crafts solutions to address issues, identify outages, and develop permanent solutions.

Experience

Pinnacle Healthcare Revenue Solutions

Cash Applications Manager, 2023-2024

Managed cash applications team of 10. Co-managed Accounts receivable team of 16.Manged edits, as well as back end rejections for large multispecialty group. Monitored issues and trends, providing feedback and opportunities for education and recoverable revenue. Developed effective and accountable workflow for all teams. Hired, trained and coached staff.

Trained and incorporated cash team into department workflow, enforcing production and quality standards for organizational efficiencies.

Developed operational workflow supportive of all current clients and staff to monitor and track issues and trends to identify gaps in revenue flow and accountability,

Implemented Cash application and reconciliation process to newly acquired multi-specialty clients.

Incorporated Denial Analysis into Follow Up workflow.

Worked with front-end leadership/coding department on edits and education on coding denials, decreasing claim rejection rate from 85% to 15%.

Implemented feedback loop for education of cleients and front-end staff on proper billing practices after coding/billing errors resulted in denials.

Created and Implemented policies and procedures for Revenue Cycle department.

IU HEALTH, Indianapolis, Indiana

Team lead, 2013-2023

Monitored quality performance data for providers and promoted improved healthcare outcomes. Utilized analytics and identified and targeted providers for trends and missed revenue recovery opportunities. Routinely consulted with medical providers to clarify missing or inadequate medical record information and to determine appropriate training and development implementations. Developed and presented month end presentations and training to large and small groups of clinicians, practice managers, and Executive leadership; developed training to fit specific provider/department needs. Managed accounts receivable for multi-specialty health system, including Behavioral Health, LTC, Transplant and AHC. Managed 18 central business office staff and 6 Customer service call center staff. Analyzed reports and worked closely with local operations and application support teams to create front-end rules to decrease back-end claim denials and identify trends. Hired, trained, and coached staff. Managed the customer service call center and staff.

Managed onshore and offshore denial teams for AHC Health Systems spanning multiple counties Managed staff regarding workflow in Med-metrix upgrade/implementation. Monitored issues and trends, providing feedback and opportunities for education and recoverable revenue.

Educated providers and staff on billing regulations and changes as related to quality and risk adjustment to ensure compliance with state and federal regulations.

Provided measurable, actionable solutions to providers, resulting in improved accuracy for documentation and practices.

Reviewed selected medical documentation to determine if assigned diagnosis, procedures codes, and ICD-10 codes were appropriately assigned.

Reduced days in A/R from 78 to 36.

Created and Implemented policies and procedures for Revenue Cycle department.

Reduced authorization denials from 45% to 6%.

Created quality and metric standards for Customer service and Billing.

Trained and incorporated offshore team into department workflow, enforcing production and quality standards for organizational efficiencies.

Developed operational workflow supportive of onshore and offshore teams to monitor and track issues and trends to identify gaps in revenue.

Incorporated Denial Analysis into Follow Up workflow.

Worked with front-end leadership/coding department on edits and education on coding denials, decreasing claim rejection rate from 40% to 8%.

Implemented feedback loop for education of physicians and front-end staff on proper coding after coding errors resulted in denials.

ST. VINCENT HEALTH SYSTEM, Indianapolis, Indiana

Revenue Cycle Account Receivable Rep/Biller, 2010-2012

Led an accounts receivable team of 7 for multi-specialty health system, including Behavioral Health and RHC.. Analyzed reports and worked closely with local operations and application support teams to create front-end rules to decrease back-end claim denials and identify trends. Trained, and coached staff.

Reduced AR accounts receivable days from 69 to 42 after IDX/GE implementation.

Decreased day’s accounts receivable from 42 days to 31 days after Soarian implementation.

Achieved overall claim rejection rate of 6%.

Implemented Hospital DNFB reporting strategy.

Met with Acquired practices and staff on denial trends and billing needs.

Monitored production and quality metrics put in place for other staff.

Led a training team for new billing programs and audits.

Additional Experience

STFRANCIS HOSPITAL AND HEALTH CENTERS, Beech grove, Indiana, Cash Poster Representative, 1999-2003. Oversaw postings and collection of patient accounts, Secondary insurance claims submissions, routine patient contact Reviewed charity applications. Liaised between self-pay agency and business office. Supervised challenging accounts.

FRANCISAN ALLIANC, Indianapolis, Indiana Denial and Collection Representative, 2012-2013. Oversaw senior auditor responsibilities. Trained front office staff. Executed Medicare billing and follow-up. Performed data entry and specialty projects. Implemented policies and procedures for denials team and reducing end user errors.

INDIANA HEART PHYSICIANS Beech Grove, Indiana 2003-2005 Oversaw postings and collection of patient accounts, Secondary insurance claims submissions, routine patient contact Reviewed charity applications. Liaised between self-pay agency and business office. Supervised challenging accounts.

2005-2009 Worked at American Health Network and Adult and child

2005-Current Office manager at Indy It pro

Technical Skills

Cerner, All scripts, Soarian, Med-Metrix, Fivos, OTTR, EPIC, ECW, NEXT GEN, Zellis. ECHO Payments, EPREMIS, Claim source,

Education

Associate Degree Business 2003 Indiana Wesleyan University

Medical Assisting Diploma 2008 Kaplan College

Contact this candidate