Cynthia Adams, BS, MBA

*** *** ** **** ******, NC

919-***-**** ad4b2k@r.postjobfree.com

PROFILE

Experienced business professional with 20 years of expertise in robust health services and diverse medical practices leading key elements of quality thru billing coding, claims and financial counseling. Reverent to timely and accurate data and processes supporting business and clinical operations as well as regulatory requirements. Compassionate team member and knowledgeable leader dedicated to service excellence

SKILLS SUMMARY

Accounting

Authorizations and Denials

Billing Budgeting, Forecasting

Build Clinical Trials Spreadsheets

Coding

EPIC, STAR, Cerner, Mosaiq

Financial Counseling

Healthcare Privacy & Safety

Internal & External Audits

Operational Goals & Metrics

Regulatory Compliance

Service Excellence

Word, Excel, PowerPoint

PROFESSIONAL EXPERIENCE

UNC REX Healthcare, Raleigh, NC 2000 to 2023

Revenue Manager 2022-2023

Create an annual budget for Billing Department and summarize the financials plans monthly.

Perform variance analysis monthly, monitor department financial performance against the actual budget and the forecasted monthly and annual amount.

Accounts Receiving and Accounts Payable

Manage the Revenue, Coding, and Authorization teams

Operations Manager Radiation/Oncology Facility, REX Cancer Research 2020 to 2022

Develop and consolidate financial plans for Radiation and Oncology Clinic

Create an annual budget for both clinics and summarize the financials plans monthly

Perform variance analysis monthly, monitor facility financial performance against the actual budget and the forecasted monthly and annual amount.

Meet internal and external customer needs.

Accounts Receiving and Accounts Payable

Financial Analyst, REX Cancer Research 2017 to 2020

Manage financial analysis requirements to meet the daily, monthly, and quarterly operations

Provide updates on financial status for assigned projects and client financial reporting needs

Monitor variances, compare and analyze plans and forecasts with actual results

Assist month-end closing activities, review contract payment schedules and monitors cash flow

Support internal and external audit, support initiatives to drive improved margins

Oversee all internal and external audits for clinical trials

Patient Financial Navigator, REX Hematology Oncology 2008 to 2017

Supported oncology patients in securing assistance to offset chemotherapy costs.

oInitiated and coordinated pre-certification and prior authorization for patients with their insurance carrier, provide financial counseling, collaborate for timely claim, account f/u

oVerified patient benefits to ensure appropriate coverage for treatment regimen ordered. Reviewed out of pocket costs and discuss options for payment or assistance

oPayment request from foundations to assist out of pocket expenses, ensure posting is accounted to correct account.

oConsult with insurance company to price out costly medications. Enrolled patients in the assistance programs and complete follow-up

oEnrolled uninsured patients in any free drug programs that apply to their regimen

oPerform monthly audits on accounts in regard to free drugs and revenues from pharmaceutical companies

oCompleted program application process, requested drugs from companies, documented and credit patient’s account based on drugs received

Completed authorizations from insurance company for chemotherapy regimens

Provided referrals to Social Work team per patient need and circumstances

Researched grants, scholarship, copay assistance cards, and free drug programs that will assist patients in paying for their out-of-pocket deductible, copay, and or coinsurance

Intake Specialist, REX Hematology Oncology 2000 to 2008

Supported oncology patients, service practices, and coworkers in provision patient intake:

oFacilitated accurate and timely account pre-registration, insurance real-time eligibility checks and verification. Approval, pre-authorization and prior-approval- before date of service for scheduled and pre-registered accounts

oSupported accurate collection and data entry of pertinent information via phone or forms.

oProcessed account transactions, Met departmental target for overall accuracy rate for all processed accounts. Ensured ADT information is current and accurate to ensure patient safety, charging, coding, insurance processing, and billing accuracy

Operated within compliance with all governmental, regulatory, and contractual requirements

oHIPPA, CMS, Joint Commission, Rex Policy & Procedure

Hospice of Wake County, Raleigh, NC 1998 to 2000

Medical Records Specialist

Supported Medical Records Service Need

oProcured data and records from outside facilities and referring services. Prepared charts to standard and organize for Physician and care team review

oAudited charts daily to ensure record completeness and accuracy. Prepared, maintained and disseminated timely health information and medical reports as requested

oSupported phone requests and transmission of medical information as appropriate

oEnsured safety, compliance, security and confidentiality: HIPAA, CMS, etc

EDUCATION

Master of Business Administration 2019

Western Governors University-Salt Lake City, Utah

Bachelor of Science-Accounting & Business Administration 2015

North Carolina Wesleyan College – Raleigh, NC

Associate of Arts- Business Management 2013

Wake Technical Community College– Raleigh, NC

ADDITIONAL EDUCATION &CERTIFICATIONS

Clinical Trial Billing Compliance

Human Subjects: Biomedical Research

Conflicts of Interest

UNC Health System Orientation for New Clinical Trial Research Personnel:

~Recruitment, Budgeting & Accounting of Funds

~Preparing NIH Grant Budgets, Billing Coverage Analysis

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