Los Angeles Primary Care

JUDY LANDRUM

*** * ***** ******, *** Angeles, CA 90003 (H) 323-***-**** (C) 323-***-**** *************@*****.***

Professional Summary

Skilled Billing Manager focused on team efficiency and producing high-quality work. Excellent collaborator and relationship-builder familiar with compliance and documentation requirements. Enthusiastic about taking billing operations to the next level through proactive leadership and skilled problem solving.

Skills

●Experienced in Pediatrics, Primary Care, Hospitalist, Infectious Disease, Urgent Care, Endocrinology, Cardiothoracic, Dermatology, OBGYN, and FQHC Clinic

●Computer skills: Microsoft Word, PowerPoint, Excel, Outlook, NextGen, Cerner Millennium, ECW, Imagine, Navicure, Allscripts, Mysis, Payer Websites, SnagIt

●Critical Thinker

●Excellent at multitasking

●Team leadership

●Process improvements

●Versed in Medicare, Medi-Cal, Commercial, PPO, HMO payers

●Strong presentation skills

●Knowledge of Medicaid statutes and regulations

●Training and development

●Project management

Work History

Revenue Cycle Manager

THE Clinic, Inc – Los Angeles, CA 01/06/2020 to current

Training & development of coding protocols and workflows for new team to effectively capture HEDIS measures & HCC coding resulting in incentive payments

Developed provider presentation to educate providers on HEDIS & HCC coding procedures and guidelines

Responsible for Medicare (PECOS) & Medi-Cal (PAVE) provider enrollments

Assisted in building reports for Billing Department to better identify unbilled charges & uncollected accounts

Worked FQHC unpaid accounts to payment resolution

Aided Billing Department in following compliant protocol for Billing and Coding

Implemented regular focused meetings to assure compliance in both Front Office and Billing Departments

Specialized in Medicare accounts assuring appropriate billing and payment

Initiated additional revenue via Medicare’s 0519 Wrap program

Regularly monitor A/R reports identifying denial trends and implemented workflows to target and rectify aged balances and decrease further denials

Maintain $4 million A/R between 5 clinics

Specialize in Medicare billing & collections

Payment posting (both electronic & manual)

E/M Coding (PMI certified)

Completed analysis for implementation of Medicare PPS rate and subsequent annual analysis to capture additional MA plans

Aided in submitting cost report annually

Instituted new workflows to ensure all HMO payers are reviewed for HEDIS measures for reporting and captured for Coders

Set up rules in eCW to assist with unnecessary manual scrubbing by Billers so they can focus on weightier matters

Educated the Billing Team on compliance issues they were not previously aware of pertaining to provider documentation (changing new patient to established) under the current guidelines,

Implemented workflow to communicate with providers for needed information for more accurate billing to stop denials on the front end

Perform provider in-services as needed to educate providers on documentation and billing guidelines

Meet with providers for individual education when needed

Performed Medicare (PECOS) provider enrollments

Performed Medi-Cal (PAVE) provider enrollments

Revenue Cycle Manager

Radiology Partners – Santa Ana, CA 10/29/18 to 12/29/19

Conducted analysis to address specific denial issues affecting revenue which led to decreasing A/R over 90 days and increased revenue

Managed and monitored 50+ onshore teammates to successfully bring desired revenue

Managed and monitored 35+ offshore teammates to aid in decreasing A/R over 90 days

Exceeded monthly targeted collection goals

Regularly monitored A/R reports identifying denial trends and implemented work flows to target and rectify aged balances and decrease further denials

Engaged in root cause analysis

Reported monthly on root cause analysis and existing issues pertaining to outstanding A/R to Leaders and members of Finance team

Conducted training for staff as needed for system needs (Microsoft, EHR, etc.)

Planned and executed targeted A/R focus, to aid in pointed rejection in A/R over 120 days

Planned and executed staff restructure to better A/R focus

Mentored staff leading individuals to Lead, Supervisory, and Management positions

Maintained multi-million-dollar A/R

Managed revenue cycles for 6 practices across the USA

Coordinated with Payment Posting, Customer Service, Production Control, System Set-up, and Client Service Liaison teams to help facilitate proper billing and collections

Met regularly with staff to assure productivity and job assignments

Billing Manager 08/2004 to 10/28/19

Torrance Memorial Health Association – Torrance, CA

●Conducted analysis to address specific denial issues affecting revenue which led to decreasing A/R over 90 days and increased revenue

●Managed and monitored 20+ staff to successfully bring in desired revenue

●Executed phone tree to reduce patient complaints in Customer Service Department

●Exceeded monthly targeted collection goals

●Regularly monitored A/R reports identifying denial trends and implemented work flows to target and rectify aged balances and decrease further denials

●Performed coding assignments within Infectious Disease office

●Conducted monthly audits post claim submission and educated physicians on outcomes

●Conducted monthly physician meetings reviewing productivity, visit counts, A/R, A/R days, and coding trends

●Conducted training for staff as needed for system needs (Microsoft, EHR, etc.)

●Created & implemented NextGen system training programs

●Planned and executed targeted A/R focus, to aid in pointed reduction in A/R over 90 days

●Mentored staff leading individuals to Lead, Supervisory, and Management positions

●Maintained $17 million A/R between network & private practices

●Managed revenue cycles for 25 practices within the Network

●Managed revenue cycles for up to 13 privately owned practices

●Aided in implementing and meeting meaningful use measures both with staff and physicians

●Interviewed and hired staff as needed to assure appropriate coverage for A/R analysis and customer Service departments

Customer Service Representative 09/1996 to 02/2003

Practice Management Group – Culver City, CA

●Worked and maintained secondary accounts.

●Successfully maintained entire revenue cycle for a single physician dermatology group.

●Successfully maintained entire revenue cycle for a Cardiology, Liver/pancreas Transplant Department, and a Plastic Surgery Center throughout my employment.

●Trained new staff

●Performed month end close

●Met month end deadlines regularly

Education

Certified Medical Coder Certificate4

Downtown Business Magnet - Los Angeles, CA

High School Diploma

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