Coding Manager Receivable
Resume:
JYOTSNA SOIN
Email: *********@*****.***
www.linkedin.com/in/jyotsna-soin
**** ***** **. *******, ** 94518 510-***-****
PROFESSIONAL STRENGTHS
Over 17 years of healthcare revenue cycle financial, operational and business process management experience
Proven ability to lead teams successfully through change management process, analyzing and optimizing workflows to align business outcomes with organizational strategy
Strategic leader with strong program management skills, experienced with project implementations across multiple markets leading to national standardization
Strong communication, interpersonal and presentation skills; skilled in building effective teams to maximize results
Extensive knowledge of MediCal, Medicare, Medicare Risk, Managed Care plans, Commercial and Workers Comp, billing and reimbursement guidelines
EDUCATION
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL Chapel Hill, NC
Master of Healthcare Administration, May 2003
Major: Finance & Management Information Systems
INDIAN INSTITUTE OF HEALTH MANAGEMENT RESEARCH Jaipur, India
Post Graduate Diploma in Health and Hospital Management (MHA Equiv.), June 2000
ALL INDIA INSTITUTE OF MEDICAL SCIENCES, New Delhi, India
Bachelor of Science in Optometry, August 1998
'Best Student of 1997' Award
CERTIFICATION
CERTIFIED PROFESSIONAL CODER (CPC) # 01061868
American Academy of Professional Coders (AAPC)
CERTIFIED INSTRUCTOR – ICD-10 CM/PCS
American Health Information Management Association (AHIMA)
CREDENTIALED REVENUE CYCLE REPRESENTATIVE (CRCR)
Healthcare Financial Management Association (HFMA)
EXPERIENCE
KAISER PERMANENTE Walnut Creek & Oakland, CA
11 years and 8 months
Director, Regional Billing Operations, NCAL Oct 2016 – Present
Responsible for oversight and management of regional billing department with 5 managers and 90 union employees, processing claims for 39 hospitals and 700 medical offices in Northern California.
Leading national project to conduct end to end analysis of revenue cycle edit infrastructure and deploy solutions to ensure standardization and claims generated are clean and compliant across all KP market regions.
Developed and led strategic initiatives for work force management to align job functions and streamline business workflows between cross functional teams, creating consolidation and efficiencies for the organization.
Actively monitor operational performance by tracking KPI’s, benchmarks, quality and productivity standards. Design and implement dashboard reporting.
Operational responsibility of all departmental budgets including monitoring, cost approval, reconciliation of expenditures and discrepancies
Pro-fee Coding Manager August 2011 – Sept 2016
Revenue Cycle Leadership Award 2015
Served as a coding manager for the professional fee coding department at Kaiser Permanente. Supervise and mange 40+ onsite and remote coders.
Developed and negotiated with union productivity and quality standards. Workqueue reconfiguration solution and implemented Specialty WQ’s to maximize productivity and efficiency in the department as a UBT initiative.
Conducted training for coders in the new Specialty workflow and ICD-10 training.
Led the newly formed PCSS Bridge UBT from inception level 1 to a highly functional level 5 promoting labor management partnership in the dept.
Assisted with coding questions and presented coding educational services and seminars to the regional employees
Assured compliance with regional and national coding policies and procedures
Pre-Billing Manager - CSS Dec2009 – Aug 2011
Served as an operations manager in the pre-billing unit of CSS, responsible for management and oversight of professional fee work-queues in KPHC and TPL(Third Party Liability) line of business.
On boarded and trained 25 union employees, establishing guidelines on productivity and setting up monthly team goals & functional UBTs in union-labor partnership environment.
Created ‘Edit Resolution Guide’ for each line of business PB WQs and documented a training manual for the TPL billing process
Actively collaborated in transition of pre-billing work from facilities to Central Support Services department and involved in process improved to significantly reduce WQ inventory and CSS accountability AR days.
Created Inventory tracking reports to monitor volume and revenue and to access backlog, worked with DMR to create productivity and In-Out Activity reports.
UNIV OF CALIFORNIA SAN FRANCISCO (UCSF) MEDICAL CENTER San Francisco, CA
5 years and 7 months
Revenue & Coding Manager Nov 2008 – Dec 2009
Served as a revenue and coding manager for the department of Ophthalmology- responsible for overseeing the billing operations for multi-specialty clinics.
Rolled-out new revenue enhancement projects such as implementation of coding editing system - Ingenix Claim Manager (ICM) for the department.
Oversight and management of the charge entry, charge master, TES, eligibility, authorization, auditing and coding process.
Developed quarterly standard dashboard reports for faculty reflecting charge, payment, AR trend along with other financial indicators – using COGNOS data warehouse and Excel.
Conduct regular reimbursement audits and analysis per provider/ specialty/ division. Analyze denials, aged Accounts Receivables (AR) and late charges to identify areas of improvement in the revenue cycle.
Coordinate and manage faculty /residents/fellow credentialing process with the Medical Staff Office.
Accounts Receivable Manager Sept 2004-Nov 2008
Served as an accounts receivable manager for Transplant billing department- responsible for overseeing the administrative and operational activities pertaining to management of professional fee revenue cycle.
Developed and implemented policies and procedures for billing such as payor follow-up, payment posting, credits and refunds to streamline and effectively manage accounts receivable.
Re-engineered billing process flow to maximize team effort, individual performance and enhance financial results.
Performed monthly financial analysis of billing performance, identifying variances and communicated to clinical departments.
Supervised 6 full time clerical staff, created tools to measure productivity and quality on tasks performed by staff.
Extensively coordinated with diverse group of people such as physicians, department managers and other UCSF depts. such as Contracting, Accounting, IT and case management staff.
Client Services Manager, July 2003- Sept 2004
Served independently as a liaison between MGBS and five UCSF clinical departments for routine pro-fee billing and coordination of projects and activities with front end staff as well as management.
Reviewed physician charge patterns by procedure, denial, insurance type and other insurance groupings as identified.
Analyzed and reported variances using IDX functions such as BAR, ADT, AES etc.
Assisted departments with set-up of new billing areas and identification and development of appropriate coding for new services and procedures provided by clinicians
Reviewed & analyzed selected EOB information by specialty to determine expected reimbursement levels from various carriers. Developed recommendations to improve reimbursement levels based on various insurance pro-fee contracts.
Developed a rejection code reference guide for all government and commercial carrier rejections for professional fee claims.
SKILLS Proficiency and knowledge of EPIC Resolute (HealthConnect) – PB & HB Modules
Proficiency and knowledge of IDX system– TES, AES, BAR, SCHED, ADT, PCS, STOR, CASE
PDS Data Warehouse COGNOS Applications – PowerPlay and Impromptu
Certified CPC coder with knowledge of medical terminology, CPT and ICD-9 coding
OR Management Software - PICIS
Statistical Package for Social Science (SPSS); Win QSB, EPI INFO
Microsoft Office: Word, Excel, Access, PowerPoint and Power BI
Desktop Publisher; Photoshop; MS VISIO
PROFESSIONAL
AFFILIATION
Member- American Academy of Professional Coders (AAPC)
Member - American Academy of Ophthalmic Executives (AAOE)
Member – California Association Healthcare Admissions Management
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