Revenue Cycle Front Office
Resume:
Sheila Sievers
Dubuque, IA *****
*************@*****.***
To bring to your organization enthusiasm, dedication, responsibility, and good work ethic, combined with a desire to utilize my skills obtained through experience. Authorized to work in the US for any employer
Work Experience
Revenue Cycle Manager
HILLCREST FAMILY SERVICES - Dubuque, IA
June 2023 to Present
Supervises and oversees all out going billing (CMS-1500 forms), invoices and statements for submission to appropriate client, agency, or insurance company or sends data information electronically for payment. Provides work direction and assignment of responsibilities to Revenue Cycle staff. Develops and maintains standard billing protocols, including billing, posting of payments and claim follow-up activities. Oversees compilation of spreadsheets summarizing billing information for tracking issues for distribution within and outside the agency. Supervises and oversees the preparation of client accounts for collections of account is deemed outstanding and no attempt has been made to pay. Reviews and approves uncollectable, write-off of 3rd party balances and adjustments for general ledger.
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Patient Services Manager
Primary Health Care, Inc. - Des Moines, IA
August 2022 to June 2023
Provides oversight and continuity for the beginning phases of the revenue cycle. Ensures consistent and efficient patient registration and enrollment in appropriate health benefit programs. Serves as a liaison between the clinics and the finance team to facilitate payment for services. Is the direct supervisor for the Health Benefits Specialists team, and the dotted supervisor for the registration staff in 9 medical and dental clinics.
• Oversees the first step in the Revenue Cycle: patient registration, receivables, and benefits assignment.
• Manages HBS team including staffing, orientation and training, performance management, and competency assessments. Provides ongoing coaching and feedback to guide performance achievement and employee engagement. Travels between all clinic sites regularly to provide on-site leadership for direct reports.
• Ensures consistency, efficiency, and quality assurance of front office operations. Collaborates with Clinic Directors to ensure that front office functions are fully integrated and aligned with the overall goals of the clinic
• Maintains knowledge of current health benefit options and practices, Medicaid, Medicare, and Commercial insurance, sliding fee discount program, and outreach along with enrollment activities to ensure patients receive appropriate assistance in applying for health benefits and access to care. Fosters a service-oriented environment and identifies trends in patient satisfaction results.
• Partners with the training coordinator to build an effective training program that equips front office staff for accurate registration and insurance registration Eligibility Supervisor
Coresource/Trustmark Benefits - West Des Moines, IA February 2021 to July 2022
Responsible for the day-to-day supervision and management of an Eligibility team enabling the team to meet its client and corporate commitments. Responsibilities include but are not limited to, the successful achievement of team quality, production, and service expectations, staff development, successful implementation of new clients, and retention of existing clients. Responsible for providing technical guidance and coaching, answering complex or difficult questions, advising team members regarding processes and procedures, and providing support to ensure all department goals are met.
• Manage, monitor, track, and report the performance of staff to ensure inventory, turnaround time, production, quality, and service objectives are achieved. Assign daily work and projects. Adjust as needed based on staff availability and business need.
• Create and run recurring and custom reports. Track inventory, turnaround time, and quality of work.
• Assist with training team members
• Serve as a resource to the team members and promote a positive work environment.
• Handle personnel matters including mentoring, coaching, motivating, performance evaluation and feedback, recognition, performance evaluation, and time tracking of direct reports.
• Provide input into compensation and promotion increases
• Resolve client or member/employee escalated issues
• Interview and recommend viable candidates for job openings Patient Service Representative Supervisor
Grand River Medical Group - Dubuque, IA
September 2020 to February 2021
Responsible for the supervision and daily operations of patient scheduling, demographic review, and updates, the check-in and out process, and phone call management
• Provide direct supervision to assigned department’s Patient Service Representatives and call center staff
• Manage the training and development of current and newly hired staff
• Prepare schedules and assign work to ensure adequate and efficient staffing levels to deliver a high standard of patient service
• Perform evaluations and address performance issues
• Monitor patient feedback and serve as a key problem-solving resource to staff on patient service issues
• Prepare and monitor timekeeping reports, compile data and reports, and managing electronic medical records
Senior Configuration Analyst/PBM
DST Health Solutions/SS&C Technology - Kansas City, MO August 2005 to March 2020
Principle Pharmacy Benefit Analyst
• Provide expertise analysis and benefit setup for customers and internal departments
• Work closely with the clinical and account management staff to determine the most appropriate solution for pharmacy benefit set up and implementation.
• Train/Mentor new employees
• Perform validation and testing for customer pharmacy benefit structures. Senior Billing Specialist
Southview Homecare - Kansas City, KS
March 2002 to August 2005
• Responsible for electronically billing all Medicare RAPS and claims
• Worked with the finance and clinical staff to ensure timely filing/visit reconciliation
• Prepared standard and special reports related to the Medicare billing system
• Assisted with month end process in all areas related to Medicare and estimated revenue calculation, contractual adjustments and cash receipt tie out • Maintained updates for billing software; monitored and tracked all program issues
• Transmitted OASIS data to the state and distributed validation reports
• Primary contact for Procura Home Health software support and training Product Specialist - FirstNet - Software Support
Cerner Corporation - Kansas City, MO
June 2001 to March 2002
• Provided troubleshooting support and knowledge transfer to clients and Cerner associates
• Investigated, analyzed, and provided comprehensive solutions for approximately 10-15 service requests daily
• Maintained daily customer service level agreements for the emergency medicine application
• Entered and maintained accurate documentation on all service calls
• Worked with CCL which is Cerner version of SQL
• Completed several training courses - (FirstNet - Overview and Troubleshooting, Discern Explorer (CCL) Support Services Supervisor
Laboratory Corporation of America - Kansas City, MO February 1995 to June 2001
• Managed employees and interacted with internal dept. managers and outside vendors
• Applied systematic operation concepts to ensure repeatable, producible metrics in my department to ensure attainment of production/accuracy goals
• Responsible for all employee performance evaluations and disciplinary action; processed and maintained payroll records for the department
• Responsible for hiring/training and supervising approximately 30 subordinates on a variety of shifts; organized and planned all workloads
• Ensured that all medical laboratory billing ordered from various physicians and hospitals was submitted to Medicare, Medicaid and all third-party payers in a timely and accurate manner; gathered data to resolve suspended claims and work on all aging/collections
• Traveled to other Lab Corp site's to train and implement new data entry/billing software; provided billing software support for entire Midwest division Education
1.5 years of college classes in Business Administration Metropolitan Community College-Kansas City - Lees Summit, MO August 2000 to June 2001
Certificate in Medical Assistant
National Education Center - Kansas City, MO
August 1988 to March 1989
Skills
• Microsoft Excel
• Microsoft Office
• ICD-9
• Transcription
• Basic math
• English
• Management
• HIPAA
• Recruiting
• Microsoft Powerpoint
• Practice management
• Office experience
• Typing
• Pharmacy technician experience
• Software troubleshooting
• Cerner
• Account management
• Laboratory experience
• Patient care
• Math
• Order entry
• Microsoft Outlook
• Clinical laboratory experience
• Training & development
• ICD coding
• Hospital experience
• Customer service
• Medical terminology
• Patient service
• Medicare
• Insurance verification
• EMR systems
• Medical coding
• Financial management
• Medical scheduling
• Data entry
• Filing
• Medical records
• Employee Evaluation
• Leadership
• Communication skills
• Interviewing
• Word processing
• Windows
• Revenue cycle management
• Operations management
• EMR systems
Certifications and Licenses
Driver's License
CPR Certification
Property & Casualty License
Assessments
Work motivation — Proficient
May 2021
Level of motivation and discipline applied toward work Full results: Proficient
Work style: Reliability — Proficient
March 2022
Tendency to be reliable, dependable, and act with integrity at work Full results: Proficient
Customer focus & orientation — Proficient
May 2021
Responding to customer situations with sensitivity Full results: Proficient
Attention to detail — Proficient
April 2023
Identifying differences in materials, following instructions, and detecting details among distracting information
Full results: Proficient
Work style: Professionalism — Proficient
August 2021
Tendency to be accountable, professional, open to feedback, and act with integrity at work Full results: Proficient
Social media — Proficient
February 2023
Knowledge of social media techniques and analytics interpretation Full results: Proficient
Medical billing — Proficient
February 2023
Understanding the procedures and forms used for medical billing Full results: Proficient
Customer service — Proficient
July 2020
Identifying and resolving common customer issues
Full results: Proficient
Administrative support professional fit — Proficient February 2023
Measures the traits that are important for successful administrative support professionals Full results: Proficient
Retail customer service — Proficient
September 2023
Responding to customer situations in a retail setting Full results: Proficient
HR: Compensation & benefits — Proficient
August 2021
Knowledge of compensation and benefits programs
Full results: Proficient
HR: Compensation & benefits — Proficient
February 2022
Knowledge of compensation and benefits programs
Full results: Proficient
Cleaner fit — Proficient
July 2023
Measures the traits that are important for successful cleaners Full results: Proficient
Work style: Conscientiousness — Proficient
February 2023
Tendency to be well-organized, rule-abiding, and hard-working Full results: Proficient
Office manager — Proficient
April 2021
Scheduling and budgeting
Full results: Proficient
Administrative assistant/receptionist — Proficient March 2022
Using basic scheduling and organizational skills in an office setting Full results: Proficient
Supervisory skills: Motivating & assessing employees — Proficient August 2021
Motivating others to achieve objectives and identifying improvements or corrective actions Full results: Proficient
Supervisory skills: Motivating & assessing employees — Proficient October 2020
Motivating others to achieve objectives and identifying improvements or corrective actions Full results: Proficient
Sales skills — Proficient
November 2020
Influencing and negotiating with customers
Full results: Proficient
Protecting patient privacy — Proficient
February 2023
Understanding privacy rules and regulations associated with patient records Full results: Proficient
Analyzing data — Proficient
March 2020
Interpreting and producing graphs, identifying trends, and drawing justifiable conclusions from data. Full results: Proficient
Office manager — Proficient
June 2020
Scheduling and budgeting
Full results: Proficient
Workplace safety — Proficient
October 2020
Using safe practices at work
Full results: Proficient
Management & leadership skills: Impact & influence — Proficient March 2022
Choosing the most effective strategy to inspire and influence others to meet business objectives Full results: Proficient
Spreadsheets with Microsoft Excel — Proficient
August 2021
Knowledge of various Microsoft Excel features, functions, and formulas Full results: Proficient
Management & leadership skills: Planning & execution — Proficient February 2022
Planning and managing resources to accomplish organizational goals Full results: Proficient
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