Versatile Professional

Tamara Parks

Atlanta, GA *****

**********@*****.*** 678-***-**** https://www.linkedin.com/in/tamara-p-728458a

Senior Revenue Cycle Consultant

Seasoned, goal-focused Revenue Cycle Versatile Professional with years of extensive Healthcare administration and Accounting experience. Results-oriented and solution-focused. Accounting Professional skilled in problem solving and maintaining accuracy. Dedicated, diligent, and responsible professional that can formulate appropriate strategies while helping to meet organizational goals. Detailed oriented with well-organized practice. Offer professionalism with an excellent work ethic.

Proven expertise in driving efficiency and productivity through evaluation of ERP systems and implementation of process improvements. Strong leadership skills with success directing highly skilled financial management teams in supporting and achieving objectives. Established credibility and developed relationships with all levels of client management. Managed process improvement effectively, leveraging existing implemented solutions to achieve better performance and outcomes. Evaluated business processes, identify opportunities for improvement and made recommendations to clients.

Career Achievements

●Slashed the total amount of 91+ COMM/MVA/WC accounts from 56% to 100%.

●Successfully resolved 85% of collection-related issues.

●Recovered $1.8M from FL Medicaid by recognizing a trend and billing corrected claims.

●Resolved Medicare bill edit issue and reduced AR by 90% of high dollar RTP claims.

●Trained 30 employees on the Medhost (HMS) system, 154 employees on Epic (HB), and multiple staff members on GA Medicaid and Winasap Claims systems.

●Achieved hospital collections and billing for four state hospitals on accounts with $100K and higher.

●Generated $5.5M in revenue on BCBS and Medicare claims combined.

●Utilized creative problem solving and critical thinking to resolve product issue’s through system testing.

●Reported, documented and resolved Pre-billed claims which led to hundreds of clean claims to be processed for payment.

●Implemented missing claims report to identify claims never billed for revenue cycle purposes

Career Experience

D-Med Corporation, Revenue Cycle Consultant 01/2020 - 03/2020

Engagement: Baptiste Health - Little Rock, AR

●Researched VA and Medicare Managed care claim denials related to referral, pre-authorization, medical necessity, case management, non-covered services, and billing resulting in denials and delays in payment. Initiate appeals with insurers appropriately.

●Submitted detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines as well as Baptiste Health policies and procedures

●Initiate Peer to Peer reviews as appropriate and communicate thoroughly and accurately with payers and Peer reviews.

●Made recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency and reduce denials organizations to resolve denials.

Financial Corporation of America (FCOA), Healthcare Consultant (PT-Remote) 03/2019 - 01/2020

Engagement: Premier Laboratory Solutions

●Researched all Lab charges on CMS1500, worked denied claims utilizing NexGen and Etactics.

●Rebilled all primary insurance.

●Resolved all commercial and medicare claims that denied for missing CLIA numbers and Rendering provider names.

●Worked claims that were returned to client as unprocessable due to incorrect modifiers and tax identification numbers on claim. Transferred claims to Self Pay as applicable.

Frasier Healthcare Consulting, Senior Healthcare Consultant (Remote) 06/2018 – 09/2019

Engagement: Trinity Health – Kentwood, MI

●Streamlined the completion of commercial, MVA and Worker Compensation billing and follow-up.

● Held responsibility for bill editing, adjustments, and refund preparation. Worked closely with DCM on denied claims.

●Prepared reconsideration and first level Appeal letters and filed appeals for authorization, timely and medical necessity denials via online or fax.

●Worked with Integrity Revenue team analyzing charges are being billed with correct modifiers. Resolved VA denials.

Management Solutions Group, Senior Revenue Cycle Consultant, 2018

Engagement: Fairfield Medical Center – Lancaster, OH

●Supported the Fairfield Medical Center and affiliates in Medicare RTP claims and Medicaid bill edits, hospital scheduling department, and surgical procedures.

●Educated patients on pre and post procedure clinical preparations.

●Utilized compliance checking software and maintained paperless order files.

●Successfully processed written orders through Cerner scheduling electronic software.

Apex Solutions, Senior Biller/AR Specialist, 2017 - 2018

Engagement: Optum360 – Atlanta, GA

●Resolved all-payer claim edits for billing and processing.

●Trained full-time employees on the HMS medhost system. Collected high dollar Medicare claims. Resolved collection issues on managed care and other government claims.

●Worked BCBS rejected claims due to billed with the incorrect member ID prefix's, corrected these by volume and resubmitted corrected bill.

●Resolved over 200 accounts for Medicare and BCBS accounts weekly.

HCI Group, Epic-Go Live Trainer, 2017

Engagement: Vanderbilt University – Nashville, TN

●Worked with training team to develop application specific training curriculum's and materials for Vanderbilt University and maintained models and documentation of operations.

●Administered pre / post-training proficiency assessments and class evaluations.

●Orchestrated end-user needs, assessments and evaluation of results.

●Responsible for developing strategies for change management, business process improvement, and providing application optimization suggestions for Epic (HB) curriculum.

SafeGuard Products International – Atlanta, GA

Account Receivable/Account Payable Specialist II, 2012 - 2014

●Managed a portfolio of 900 accounts on Great Plains system.

●Performed journal entries on AR/AP general ledgers.

●Established special collection service to a selected range of customers entailing corporate to corporate collections.

●Identified any process issues which may be contributing to debt position.

●Negotiated and completed contracts for executive sign off.

●Generated missing payment reports and managed those accounts.

●Initiated customer contact to manage the collection process, including the resolution of invoice reinstatement/re-bills.

●Successfully reconciled pricing issues on products for dealerships, finance, regional, and insurance managers.

●Champion collection and billing for over 800 high-dollar accounts.

Additional Experience:

Senior Revenue Cycle Consultant (2017), Frasier Healthcare Consulting, Dekalb Medical Center – Atlanta, GA

Healthcare Consultant (2017), Frasier Healthcare Consulting, Medical Center Health System, Odessa, TX

Senior Revenue Cycle Consultant (2015 - 2016), Frasier Healthcare Consulting, Munroe Regional Medical Center, Ocala, FL

Revenue Cycle Consultant (2016), Advanced Bottom Line Management, Cooper University Healthcare, Remote

Senior Healthcare Consultant(2014 - 2015), Frasier Healthcare Consulting, Seton Hospitals, PFS, Arlington, TX

Revenue Cycle Consultant (2014), Frasier Healthcare Consulting, CHS/Shared Services Center, Bethlehem, PA

Account Receivable Specialist II (2011-2012), Reed Construction Data, Duluth, GA

Healthcare Consultant (2011) D-Med Corporation, Mitchell Co. Hospital, Colorado City, TX

Healthcare Consultant (2010-2011), D-Med Corporation, Anderson Regional Medical Center, Meridian, MS

Account Receivable Specialist (2004-2010) Premiere Global Services, Alpharetta, GA

Education

Associate of Science in Healthcare Management

Ultimate Medical Academy – Graduated 2014

Clearwater Lake, FL

Computer Networking

Advanced Career Training (ACT) - 2000

Atlanta, GA

Certifications

Lean Six Sigma White Belt Certified (LSSWB)

Management and Strategy Institute- 05/2020

Project Management Essentials Certified (PMEC)

Management and Strategy Institution- 05/2020

Present- CMS Form 1500, Medicare Fraud and Abuse, Prevention, Detection and Reporting, Medicare Billing Certificate Program for Part B Providers, Skilled Nursing Facility Consolidated Billing, Uniform Billing (UB)-04.

Present- HIPAA (Health Insurance Portability and Accountability Act) EDI Standards.

Affiliations

2011 – Present, Member of the National Society of Collegiate Scholars (NSCS)

Present, Healthcare Financial Management Association (HFMA)

Present, Member of the National Association of Professional Women (NAPW)

Computer Proficiency

Medical Software (Advanced)- Epic (HB) (end-user), Epic (ecweb), Cerner/NThrive, HMS, SMS, Healthquest/RWS, NextGen, Etactics, PreBill Edit (PBE) module, SSI, FISS (DDE-web base), Cerner/Chartmaxx, Epic/Powerchart, Healthland/Dairyland, Emdeon, Envision(MS-Medicaid ), GHP(GA-Medicaid), Medifax (FL Medicaid), TMHP Web (TX Medicaid), Epremis, MedAsset, AllScript, HIM, EMDS, Invision (SMS), Healthware, (McKesson) STAR, Medisoft, Medical Manager, Meditec, Ensure, IDX, Mosaic, FACS, MHN (Multi-Health Network), Boost, Prism, Event Tracker, GUI (web-base), Claims Net, CRT 4.0,QVT Term, Art2000, PCAT, Batch Tracker, Clientele (CA& ATL), Dan soft HCFA Mapper, MS SQL, Specbuilder 5.5, IRCS, MHC (Claims), Maccess, Compass RCC and all Payer web-portals.

Accounting/Finance Software (Advanced) - Peoplesoft 8.0-9.9, NetSuite, Oracle 11i (financials, Collector/AR workbench super-user access), ViaKlix, Crystal Reports, Great Plains (Dynamics), Salesforce, Zuora, Compass Accountant, SQL Reporting Server,, IPP, CCIS (invoicing), Lawson, Cybersource, Care Zone 1.0 and 2.0, Oscar, DPS, Quickens,Tesla, Metra Net, Aladdin, Contract Management (CMS), Dun & Bradstreet (D&B) and Microsoft Office Suite.

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