Medical Billing Revenue Cycle

PROFESSIONAL SUMMARY

I have over ** years of remarkable experience with Revenue Integrity Management in the healthcare industry. I have attended school for medical billing and coding with coding and auditing knowledge. I am a hardworking, result-driven individual with strong leadership skills who values the importance of teamwork. I have an outgoing personality and a pleasant demeanor.

EDUCATION

Everest Institute, Decatur, GA

Medical Billing and Coding Diploma, GPA 4.0 2017- 2018

Anatomy and Physiology of ICD-10 CM/PCS

Bishop State Community College, Mobile. AL

General Education, GPA 3.5 1999 -2001

AREAS OF EXPEREINCE

Office Management * Healthcare Consulting * Revenue Cycle Integrity * Policies and Procedures * Project Management * CPT 4, ICD-10 * HCPCS Coding E/M Facility and Pro Fee Audits * Medical Billing* Medical Coding* Account Reconciliation* Denial Management*

PROFESSIONAL EXPERENCE

Bright Drive Healthcare Solutions, Schoharie, NY November 2020 to May 2024

Revenue Cycle Account Manager (Remote)

Collaborated with the medical directors to design an innovative a revenue cycle process that improved patient satisfaction and grew collections by 59%.

Implemented 20+ revenue cycle tools and technologies that enhanced operational efficiency by 80%.

Developed an electronic system to track 140+ weekly billing transactions, reduced 65% of manual errors and boosted productivity.

Resolved 70+ discrepancies identified when reviewing medical records for correctness and compliance with CMS requirements.

Provided quality care by ensuring accurate medical records data for 5400+ patients, positively affecting insurance reimbursements.

Provided clinical expertise to support coding accuracy, documentation, and 10+ other revenue cycle endeavors.

Scheduled weekly calls with the clients to discuss all high-level agenda bullet points and provide all updates about credentialing and billing.

National Premier Laboratories, Stockbridge, GA June 2016- November 2020

Revenue Cycle Manager

Responsible for managing the medical billing team, hiring, setting staff expectations, onboarding new employees, and daily approvals of employee production.

Work in tandem with the marketing and client operations team with cross-functional goals to ensure excellent quality, timeliness, and customer service throughout the entire claimant and customer experience.

Training and implementing all policies, procedures, goals, and objectives for assigned staff.

Ensures strict confidentiality of all medical records following all PHI regulations.

Responsible for managing and running analytical reports consistently updating the CFO of sales and sales team of any trends in revenue from government, commercial, and private payers.

Review and analyze clinic metrics to ensure meeting company goals (e.g., weekly, quarterly, annually, KPIs).

Responsible for all analytical reporting of government, commercial, and private pay

Maintained fee schedules and pricing.

Piedmont Hospital, Covington, GA April 2015 – May 2016

Medical biller /Credit Resolutions (Contract)

Credit resolutions, determining whether there is a credit balance that is due back to the patient, insurance

provider, or an adjustment that needs to be applied to the account,

Work on a team of three dropping the credit balance from $1,752,070.59 to $954,508.57 reducing the balance by $808,482.02.

AR follow up, cleaning up old legacy accounts working out of Epremis queuing claims or faxing claims with supported documents so that I can get the claim resolved and paid.

Working all high dollar accounts generating more AR cash from the month of December from $51,260.15 to

$187,247.64 for the month of March.

Ensures strict confidentiality of all medical records, and PHI.

American Clinical Laboratories Inc., Stone Mountain, GA September 2013 -March 2015

Medical Billing Manger

Oversaw and managed a team of 6 making sure that all tasks and job performance of the department’s daily Direct Management and leadership of entire team including: hiring, compensation, retention, performance management. Managed all staff and physician, nurse practitioner’s time off requests by ensuring practice had adequate coverage.

Provided monthly reporting with recommendations or action plans on any issues; interpret financial reports/data to effectively manage the office.

Managed all accounts receivables, payables, charge posting and payment processing tasks.

Managed the credentialing and re-credentialing for doctors with the physician practice. Payer and contracting management.

Managed team performance to meet and exceed targets for revenue and growth.

Coordinated all patients scheduled to receive infusion treatments within the infusion center. Verified patient’s benefits for treatment beforehand and requested prior authorization for treatment.

Monitored and analyzed data by generating revenue reports on a weekly and monthly basis.

Responsible for Greenway Medical Management Implementation/set-up and data migration for all providers. Set up in office training for staff.

Contact this candidate