Revenue Cycle, Office Administration

Deborah J. Rumery, MBA, CCS, CPC

***** ******* ***, ********, ** 39305 559-***-**** *************@*******.***

Experience

Physician Coding Manager, Allegheny Health Network Jan 2020 - present

·Interim Director – November 2023 – January 2024

·Oversee daily operations including staff management, work queue optimization and Epic best practices for 100+ coders

·Successful implementation and daily management of state-of-the-art artificial intelligence software for radiology

·Successful implementation of physician organization claims scrubber

·Prepare and present executive monthly updates to the C-Suite

·Member of the following committees:

oCharge Router Governance Committee

oNew Business Review Committee

oVirtual Health Task Force Committee

oDenials Prevention Subcommittee

·Regular collaboration with Compliance, Revenue Integrity and Billing departments to ensure accuracy and quality in submission of claims

·Creation and implementation of Standard Operating Procedures for Professional Fee Coding

·Collaboration with institute personnel to assist with provider and staff education regarding code capture and reporting

·Review and assessment of yearly coding changes

·Departmental reorganization and streamlining projects related to operational workflows

Business and Compliance Manager, Internal Medicine Clinic, PLLC Oct 2013 – Jan 2020

·Supervised Revenue Cycle operations for a multi-specialty clinic using Greenway PrimeSuite EHR

·Created and implemented Revenue Cycle improvement policies and procedures

·Performed quality review audits and provided education and communication of post-audit findings to clinicians

·Compliance management and personnel training

·Created, implemented and managed MACRA and MIPS program adherence policies

Application Coordinator Specialist, Kaiser Permanente Sept 2012 – Sept 2013

·Provided technical expertise and support for EPIC EHR

oResolute PB Administrator Certified – 2011 thru 2013

·Created and implemented end user solutioning

·Identified significant process improvement opportunities

·Applied business process knowledge to design of proactive solutions in application structure

Charge Capture Consultant, Leader-Professional Fee Review, Coding Specialist, Kaiser Permanente Aug 2007 – Sept 2012

·Identified improvement opportunities in support of coding staff operational workflows

·Validated and recommended CPT codes and charges for professional fee services within various clinical disciplines for new charge capture initiatives

·QA review for monitoring charge capture initiatives

·Identified new processes and procedures in support of charge capture implementation goals

·Supervised data accuracy and quality audit teams for professional and facility claims review

·Retrospective reviews of professional and facility claims for compliance with regulatory standards

Education

MBA 2010 University of Phoenix

BS Healthcare Administration 2008 University of Phoenix

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