Financial Analyst Front Desk

JUANA ERIKA FRIAS

CMBA, SSYB, RHIT, CHTS-IM

***** ** **** ******, ******** 18,

Pembroke Pines, FL 33026 305-***-**** **********@*******.***

SUMMARY OF QUALIFICATIONS:

Dynamic professional with over 12 years of healthcare related experience is seeking an analyst, management or consulting role with greater challenge and responsibility. Experienced in healthcare regulations specifically federal and state guidelines related to revenue cycle coding and billing practices. Knowledgeable in ICD-9-CM, ICD-10-CM, DRG’s, and CPT coding fundamentals. Demonstrated excellent interpersonal skills and experience in interacting with all levels of management and effectively work with other functional teams intent on meeting company’s goals and deadlines. Detail-oriented and self-motivated with strong analytical and communications skills.

PROFESSIONAL EXPERIENCE:

Recovery Unplugged, Fort Lauderdale, FL 2019

Revenue Cycle Analyst (August 2019 – December 2019)

Maintain complete working knowledge of all aspects of the revenue cycle and provide operational expertise, direction and input to Information Technology as it relates to revenue system issues.

Provide status report(s) to VP of Revenue Cycle Management, Finance department leadership and other revenue cycle stakeholders to ensure awareness of relevant information and action items pending to meet deadlines, as assigned.

Provide support on processes across all Recovery Unplugged locations

Analyze complex business problems and issues using data from internal and external sources to provide insight to VP of Revenue Cycle Management and key Finance decision-makers.

Identifies and interprets trends and patterns in datasets to locate influences.

Assist with new revenue cycle related system implementations enhancements, testing and rollouts.

Uses analytical skills to investigate and determined the accuracy and feasibility related to pursuance of a change/enhancement request, documenting any procedural changes for Revenue Cycle Management

With guidance from Department Director, design, test and implement system enhancements in accordance with established corporate standardization guidelines to ensure data reliability and integrity.

Contributes and plays an active part with the team in the design/build/revision of system parameters, tables and master files.

Analyses, interprets and summarizes performance improvement data from the Revenue Cycle perspective.

Prepares and distributes reports/charts to Revenue Cycle stakeholders.

Active member of the revenue cycle team who routinely steps in to provide back-up coverage within the posting, collections, verification and other key needs of the department as needed.

Participates in Weekly Revenue Cycle Management team meetings.

Develop and maintain ad-hoc reporting models for the purposes of budgeting, cost containment, process improvement and other related requests.

Mednax, Sunrise, FL 2016 – 2019

Financial Analyst II (April 2018 – August 2019)

Analyze historical and projected financial and operational information, with the goal of delivering actionable recommendations for improvement to managed care operations.

Lead the monthly financial and workplan review process, as part of the division presentations, and at the region level with operations leaders.

Proforma development, financial modeling, valuation analysis, and other complex business modeling.

Design and develop standardized tools and templates to provide self-service solutions to contracting teams, utilizing large datasets from information systems.

Maintain and develop thorough understanding of existing and future managed care payment methodologies in order to recommend improvements to corporate infrastructure and managed care operations, in support of the changing marketplace.

Revenue Cycle Management Analyst II (August 2017- April 2018)

Responsible for the reporting and analysis of A/R in support of assigned RCM departments and including Accounting, Finance, IS, Business Systems, and Coding as needed.

To balance tie outs from billing and patient accounting systems (GPMS, NextGen, Medsuite, OBR, Availity) to Financial Database and/or Cognos on a weekly and monthly basis.

Create and distribute daily, weekly, biweekly, monthly and as requested Reporting, Analysis and Trending. Create new reports for the RCM Auditing, Contract Revenue, Coding, Billing and Business Systems Departments; and troubleshoot future issues or modifications.

Analyze A/R, collection, reimbursement trends and RCM performance. Provide feedback to RCM leadership as assigned as well as reporting at CBO monthly operations meetings. Assist and attend Monthly/Annual CBO RCM Revenue Cycle Analyst meeting.

Identification of root causes obtained through analysis and communicate findings as appropriate.

Create, maintain and distribute monthly staffing matrices to RCM leadership to determine necessary staffing to support operations.

Support and Training, by providing ongoing support to the CBO RCM Revenue Cycle Analysts.

Contract Revenue Analyst (September 2016- July 2017)

Analyze hospital agreements and identify administrative requirements for the Contract Revenue Department to ensure compliance with contract requirements, and company internal policies.

Maintain measurement systems to monitor the number of active, expiring, and dormant contracts.

Works simultaneously with Legal, Operations, and Accounting Departments to ensure proper allocation of revenue.

Analyze financial reports using Excel modeling (V-lookup, Pivot Tables, Formulas, etc.).

Represent contract revenue and corporate patient accounts management in meetings and committees.

Monitors and analyzes services and financial performance. Conduct regular internal audits to ensure timeliness and accuracy of each department’s billing, collections, posting, refund, and accounting practices.

Verify documentation protocol for billing agreements and SOX compliance are followed and maintained.

Assist with mergers, acquisitions and organic growth initiatives as well as on various special projects as determined by management.

Broward Health, Fort Lauderdale, FL 2016

Business Systems Analyst for 3M and Revenue Cycle (February – April 2016)

Technical support over 3M application for coders and HIM leaders.

Contact and communication with 3M designated analyst for work queue tickets management (internal BH and external 3M) and troubleshooting.

Direct participation during 3M-Cerner RHO (Remote Hosting) application flip.

Memorial Healthcare System, Fort Lauderdale, FL 2010 – 2016

Charge Description Master CDM – Revenue Cycle Analyst (2012-2016)

Ensures proper maintenance and update of the bi-annual CDM and related charge capture processes.

Reviews and implements internal requests to create or modify charge codes, descriptions and billing rates, resulting in 50,000+ newly built codes annually.

Ensures updates to all impacted hospital systems when changes are made in the CDM.

Leads a weekly system-wide procurement task force to ensure accurate identification and costing of implants and supplies, resulting in ~90% reduction of implant and supply work queue errors.

Oversees system-wide compliance for over 200 charge capture work queues.

Provides ongoing education to end users on how to post charges properly, accurately, and timely to correct and avoid errors in the charge capture work queues resulting in improved compliance of 5% average to 95%+ by the end of each month.

Serves as a system-wide subject matter expert for charging, billing and reimbursement issues.

Coordinates with Hospital and Clinic Administrators, direct care clinicians, Patient Access, Billing & Coding departments to identify opportunities to better address issues related to appropriate charge capture.

RCM Project Lead for Epic ancillary systems implementation.

Contract Compliance Specialist (2010-2012)

Ensured and maintained contract compliance in accordance with appropriate record retention procedures and internal controls.

Developed and prepared performance specifications and requests for proposals and monitor project payments.

Established schedules and methods to provide contract compliance and document management. Reviewed needs with management for allocation.

Prepared analytical and statistical reports on operations and activities.

Resolved contract payment delinquencies and coordinated resolution with divisions or external entities.

Weston Outpatient Surgical Center, Weston, FL 2007 – 2010

Patient Account Representative (2008 – 2010)

Operated hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials.

Maintained records of charges, payments, third party charges, etc.

Managed correspondence regarding collection activity and recorded results.

Reviewed and verified claims, denials, and payments.

Business Office Floater (2008-2009)

Answered telephones, scheduled patient appointments and registered patients at the front desk.

Obtained and verified patient’s medical clearance and insurance eligibility.

Managed and updated accounts for payments received from patients and insurances.

Confirmed appointments and arrange transportation services as needed.

Front Desk Registrar (2007-2008)

Greeted patients and visitors, in person or on the telephone; answering or referring inquiries.

Maintained and assembled patient accounts by obtaining, recording, and updating personal and financial information including insurance eligibility.

Maintained inventory of supplies; including medical scrubs for physicians.

Sorted and distributed mail, internal and external correspondence.

Helped patients by providing any additional information needed.

EDUCATION:

Florida International University, Miami, FL 2012

Corporate Master in Business Administration (CMBA)

St. Thomas University, Miami Gardens, FL 2009

Bachelor in Health Care Services

Broward College, Fort Lauderdale, FL 2008

Associate in Health Information Management Honors

Nova Community School, Fort Lauderdale, FL 2005

Medical Office Insurance/Coding

LICENSE & CERTIFICATIONS:

EPIC Charge Description Master (CDM) Management Certification 2015

Yellow Belt Six Sigma Certification (SSYB) 2014

Implementation Manager Certification (CHTS-IM) 2013

AHIMA Certified Healthcare Technology Specialist (CHTS)

Registered Health Information Technician (RHIT) 2008

AFFILIATIONS:

American Health Information Management Association

Florida Health Information Management Association

Florida International University Alumni

St. Thomas University Alumni

VOLUNTEER EXPERIENCE:

Broward County Board of County Commissioners 2017 - Current

Health Facilities Authority

Assist health facilities in the acquisition, construction, financing and refinancing of projects in any incorporated or unincorporated area of Broward County. Health facility means any private corporation organized not for profit and authorized by law to provide hospital or nursing home care services or life care services, including facilities that provide developmental disabilities and mental health services.

SKILLS:

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

AdvantX

Medsuite

Brio

Vision

ZirMed

Mainframe

Sovera

3M Coding/Billing

Encoder Expert Pro

EPIC

Monarch

Crystal

Cognos

Bilingual, Spanish

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