Letha Berry, MSHI linkedin.com/in/letha-berry

mailto: adbwc8@r.postjobfree.com (931) 255–0617 Columbia, TN

Senior Revenue Cycle and Optimization Compliance Consultant

Revenue Cycle Management Strategic Planning/Analysis Training & Development Systems Compliance

Dynamic Healthcare Professional with 15+ years’ skilled in managing cross-functional team development utilizing coaching and, communication skills, and technology to unify a diverse team in Revenue Cycle Best Practice. Certified revenue cycle professional leveraging strengths, in planning and executing projects in order to meet established revenue capture, strategic operations, and improved third-party payor-communications as a Revenue Cycle Optimization Compliance Consultant. Well-versed in the implementation design and development of processed focus training, overseeing client implementation and system improvement workflow and cash goals as well as products and solutions that support customers current and future prospect in charge reimbursement models. Identify gaps in service level/processes to identify potential areas for improvement in contract reviews.

Additional Strengths and Competencies

Revenue cycle management and A/R solutions -- RevSpring PatientKeeper Charge Capture OnBase QuickBooks

Practice management -- Lytec 2001 TSO (EHR & Practice Management software) Medical Manager Alchemy DOM Healthcare Healthland Athena ADT Medhost Integrated Scheduling Business Office Epic HB & PB Resolute Epic ADT/Prelude Meditech C/S 5.6 HP Application Lifecycle Management Cerner MethodM, FirstNet, PowerChart PAI CR-link MS Office Suite Prism Powertrak Medic Passport Compass Mobius LA McKesson OneContent eClaims (EPS) Centricity

Professional Consulting Experience

Healthcare IT System Analyst – Apex Systems/Privia-Health First (July. 2019 – Dec. 2019)

Managed Integrated testing in Athena Health System to ensure patient demographics, orders and charges crossed to downstream applications (for over $2.5 million project).

Identified, documented, and implemented system design standards and facilitated the development of process-focused training materials to complement go-live system training in collaboration with the client’s IT project management team to ensure go-live readiness.

oCreated Integrated Test Scripts

oReviewed and identified discrepancy’s in workflow documents

oCreated Signoff Document

oConducted User Acceptance Testing

oInvolved in Dress Rehearsals Sessions

Identified, discrepancy in patient demographics, orders, scheduling and doctor notes as well as charges in Athena Health System during testing.

oLogged issues on tracker.

oRe-tested failed issues to identify system issues (functionality, test script issues or gap in workflow).

oContinue modifying schedule build as needed.

Project Lead Revenue Cycle Compliance – Healthcare IT Leaders/Wyoming Medical Center (Nov. 2018 – June. 2019)

Managed project of clinical, billing and charge review audit analysis team in Meditech C/S 5.6 to ensure accuracy post acquisition to resolve $14 million in outstanding claims within 2 months.

Working knowledge of policies, standards and methodologies pertaining to charge capture and reconciliation, reporting documentation and general compliance.

Identified, medication, anesthesia, and R&B charge discrepancy on itemize bill before reaching insurance company. This consist of auditing EMR for operative notes, clinical orders, surgery operative notes, lab, and x-ray etc.

Completed bill audit analysis and implemented new process for submission on over 500 hundred Wyoming Work-Comp claims exceeding $5 million in outstanding AR.

oCompleted claims near timely filing deadline.

oCompleted claims requiring supporting documentations for claim adjudication.

Worked high dollar Commercial, Government and MVA payors totaling $2 million in outstanding AR.

oFinalized claims near timely filing deadline.

oFinalized claims requiring supporting documentation, such as appeal letters or medical records for claim adjudication.

Special projects focused in analysis and optimization in underperforming areas, including:

oProcessed 835 file

oPerformed payment analysis duties, such as posting and balancing self-pay accounts.

oAnalyzed overpaid accounts and distributed to patient open balances

oIdentified credit balances, issued refunds to patients and insurance companies.

Senior Cerner Design & Patient Access Analyst – Ettain Group/LifePoint Healthcare (Oct. 2018 – Nov. 2018)

Managed service request investigation and resolution (supporting internal and external clients), developing educational materials for associates and clients, defining user needs, and solutions-specific testing

Investigate, analyze, and provide comprehensive solutions for service requests utilizing applicable monitoring and troubleshooting tools.

oGenerated documents related to investigation and issue resolution to ensure compliance with operational policy.

Responsible for updating DCW’s for payor plans, R&B and Accommodations Codes.

oMaintained awareness of current solutions functionality and its relationship to solution specific database tables.

Utilized Cerner experience and workflow knowledge as well as test script creating procedures and was accountable for communicating concepts and workflow.

Gained specific experience with Cerner Registration and Scheduling in both acute and ambulatory environments (ERSM & CPM).

Client Integration Manager -- Conifer Health Solutions/Remote (Jun. 2016 – May. 2018)

Managed the implementation efforts to bring hospitals live on Epic System (HB & PB Resolute, ADT/ Prelude), and Cerner System. Build relationships and trust with key stakeholders to support program delivery and adoption of integration standards.

Identified, documented, and implemented system design standards and facilitated the development of process-focused training materials to complement go-live system training in collaboration with the client’s IT project management team. Provided inpatient, outpatient, scheduled patient backload.

Partnered with IS Project Management to fulfill all revenue cycle participation needs, as well as ensuring successful integration of systems.

oCompleted revenue cycle task items.

oFacilitated implementation of system modifications.

Participated in go-live planning and tracking calls.

oDesigned operational processes and ensured the updating of operational procedures to match the new system’s technical flow.

oAnalyzed current workflows and synchronize the design and delivery of future state processes to stakeholders.

oReporting of the realization progresses (technical functions, approval, customer acceptance0

Led the following implementations:

oRevenue Management -- CHI/EPIC Work-Queue’s, Tenet Point-of-Service Improvement, WellStar EPIC Vendor Management, CHI/EPIC 2015 Upgrade.

Key Projects and Achievements

Managed a Revenue Point-of-Service project (Team of 4) to drive the increase of POS collections for 12 facilities.

Assessed the POS operations for the Emergency Department, Scheduling Department, Financial Counselors, and Registration staff. Determined the areas of opportunity and offered recommendations for improving POS collections to the senior team.

oImplemented the recommendations and within 6 Months POS initiatives project realized an uplift of $15M through 2017.

Epic 2015 upgrade for the CHI Tacoma, Washington Market.

oConducted unit testing for 2015 Epic upgrade, to ensure system design readiness for Epic upgrade. Familiarized end-users with new features in Epic platform.

oCompleted a successful go-live with zero delays in meeting the go-live target date.

Implementation Consultant -- Ettain Group/Community Health Systems/Remote (Sept. 2015-Mar. 2016)

Lead analyst responsible for bringing hospitals live on Medhost and Cerner workflows and system development life cycle methodologies. Provided on-site Medhost/Cerner training and support, reviewed internal processes of CHS facilities and ensured CHS compliance.

System Conversion -- Conducted system conversion from McKesson Paragon, Meditech, and Healthland to Medhost and Cerner.

oDeveloped plans for business processes, ADT, and scheduling, including revenue cycle components.

oDetermined compliance levels in Hospital and Ambulatory settings.

oCompleted Cerner Data Collection Worksheet (DCW).

oConducted unit, integrated and parallel testing and system validation, identified shortcomings and discrepancies, and modified system configurations to achieve compliance with quality assurance standards. Assisted with HL7 processes and EDI transactions.

oReviewed fee schedule, Diagnostic-related Groups (DRGs), Per-Diem, Case Rates, and charge reimbursement.

oWorking knowledge of policies, standards and methodologies pertaining to charge capture and reconciliation, reporting documentation and general compliance.

oProvide support for assigned cost centers within service lines and in collaboration with Revenue Integrity team, perform reviews related to Charge Description Master (CDM).

Key Project and Achievements

Reviewed and created test scripts with the Cerner Lead, to test and validate the scripts process and workflow.

oEntered updated test scripts in Cerner MethodM project plan for testing prep-work. (total 40 scripts).

Assumed the project manager responsibilities of a critical project in mid-cycle. Determined that the following mission-critical departments did not receive training: Case Management, Registration Department and Financial Counseling. Resolved these deficiencies by scheduling nights and weekend training for those key areas.

The successful project implementation met the Go-live target date with zero delays.

Charge Capture Implementation Team Lead -- Provisions Group/HCA PatientKeeper (May. 2015 – Sept. 2015)

Managed Implementation team of Consultants for an HCA/Patient Keeper Charge Capture Rollout. Mentored and coached staff to manage client implementations independently.

oLed the charge capture system delivery, including application configuration, workflow and data analysis, and training during product deployment.

oTrained Physician Support Coordinators at the facility on the build of Charge Capture patient list, user profile, CPT codes, diagnosis codes and functionality of the system.

oTrained billers and coders on correcting charges and finalizing charges in the Charge Capture system.

oTrained physicians on Charge Capture system via desktop and mobile devices.

Key Project and Achievements

Discovered a significant build-issue with a PatientKeeper implementation; the system contained outdated information entered during a PatientKeeper pilot project. Worked closely with the stakeholders to verify the findings and initiate a revision. Completed the changes and rolled out the program to 10 physicians with no problems or delays.

Epic Team Lead -- ABLM/Reading Health Systems/Remote (Feb. 2015 – May 2015)

Managed the SBO cash acceleration collection follow-up project.

Trained and mentored staff on Epic HB & PB Resolute, ADT/Prelude, On-Base, and Rev Spring payment system through distance Join Me sessions.

Analyzed the collections process and provided innovative recommendations, productivity spreadsheets, and AR percentages to the revenue cycle Vice President.

Key Project and Achievements

Coached and developed a highly functioning team, each member working 60 accounts per day.

Improved communications through weekly team calls and exceptional communication skills.

Implementation Consultant -- HCTEC/Community Health Systems (Mar. 2012 – Sept. 2014)

Managed the implementation team that brought four hospitals live on Medhost/Cerner within a year. Provided on-site Medhost/Cerner training and support, reviewed internal processes of CHS facilities and ensured CHS compliance.

Conducted system conversion from McKesson Paragon, Meditech, and Healthland to Medhost and Cerner.

oDeveloped plans for business processes, ADT, and scheduling, including revenue cycle components.

oDetermined compliance levels in Hospital and Ambulatory settings.

oWorking knowledge of policies, standards and methodologies pertaining to charge capture and reconciliation, reporting documentation and general compliance.

oProvide support for assigned cost centers within service lines and in collaboration with Revenue Integrity team, perform reviews related to Charge Description Master (CDM).

Conducted unit, integrated and parallel testing and system validation, identified shortfalls and discrepancies. Modified system configurations to meet quality assurance standards.

Completed Cerner DCW. Assisted with HL7 processes and EDI transactions.

Revenue Cycle Billing Integrity Manager -- Cogent Hospitalist Management Group (Mar. 2011 – Mar. 2012)

Managed and directed a revenue cycle department of 20 and administrated the receipt of $20M in annual revenue.

Managed 26 markets covering the Central and Northeast region utilizing different system platforms (Epic, Athena, McKesson, Paragon, Meditech, and On-Base).

Created and presented pivot tables on outstanding AR for each market to Vice President and Market Director.

Reviewed CPT, ICD9, HCPCS and Revenue Codes and ensured clean claim submission.

oDiscussed claim errors, EDI transactions, and CDM. Ensured compliance with HIPAA guidelines.

Worked Closely with Revenue Integrity team to ensure reviews related to Charge Description Master (CDM) integrity.

Implementations Consultant II -- Medhost Systems (Dec. 2009 – Mar. 2011)

Trained the staff in Medhost policies, procedures, and processes at remote sites. Provided administrative and post-implementation support.

Conducted Medhost System build for facilities.

oAssessed revenue cycle needs, implemented and configured scheduling, batch scanning, eArchiving, patient registration and Business Office.

Implementations Account Analyst II -- CHS Physician Practice Support (Sept. 2007 – Dec. 2009)

Provided administrative support and direction for 123 physicians located in 13 clinics in multiple regions. Directed training programs for new and established facilities on the Athena system.

Provided direction to staff on implementation of program processes for 30 – 60 days after execution.

Diagnosed clinic and system problems; identified root causes and implemented solutions promptly.

Education and Professional Development

Master of Science, Health Informatics, Walden University, Minneapolis, MN

Bachelor of Science, Health Administration/Information Systems, University of Phoenix, Phoenix, AZ

Associate of Arts, Business Administration, Western International University, Phoenix, AZ

Healthcare Information and Management Systems Society (HIMSS) (2014 - Present)

Outstanding Employee, Community Health Systems 2014

Six Sigma Lean/DFSS Green Belt, Aveta Business Institute (2016 – Present)

Certified Revenue Cycle Representative (HFMA) (2017 – Present)

The National Society of Leadership and Success, Walden University (2019 – Present)

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