Medical Billing Revenue Cycle

Robin Tyler

Phoenix, AZ ***** 623-***-****

*****.*******@*****.*** • LinkedIn URL

Summary

Hospital Revenue Cycle Management

Dynamic Hospital Revenue Cycle Management with a progressive history of facilitating operational efficiencies and cost reduction strategies.

Forward-thinking and intuitive Revenue Cycle Manager and coach with over 15 years of proven achievement. Reputation for excellent leadership, interpersonal, client needs assessment, and problem-solving skills. Proven ability to lead seamless implementations and deliver technical solutions to improve practice revenue and workplace productivity. Possess intensive knowledge in various specialties of revenue cycle management and comprehensive knowledge of RCM, including medical claim rejections, denials, medical coding, cash posting, and patient collection. Demonstrated ability to communicate effectively with all levels of professionals from diverse backgrounds.

AREAS OF EXPERTISE

●Revenue Cycle Processes

●Quality Assurance

●Regulatory & Compliance Standards

●Project & Program Management

●Relationship Development

●Risk & Quality Management

●Process Improvements

●Revenue Growth Strategies

●HIPAA Guidelines & Regulations

●KPI Analysis & Review

●Operations Management

●System & Process Optimization

●Office Management

●Leadership & Mentoring

●Staff Management

SELECTED HIGHLIGHTS

●Successful history of facilitating revenue growth through the use of compliance filings.

●Extensive working knowledge of revenue cycle management principles and practices such as cash collection, financial reporting, refund compliance, medical billing, payer credentialing, Medicare and Medicaid reimbursements, coding, as well as denials and appeals.

●Possess strong financial management skills, including financial analysis, budgeting, benchmarking, trending, and forecasting.

●Verifiable success in the creation and implementation of company-wide policies and regulations that generate process improvements.

PROFESSIONAL EXPERIENCE

Lifeline Ambulance – Montebello CA. July 2014 – Present

Project Compliance Manager

Lead Revenue Cycle operations and consistent improvement of projects and programs. Cultivate strategic plans and programs for the RCM team, guaranteeing all objectives are clear and concise. Supervise billing staff in work allocation, problem resolution, accuracy, training, and compliance. Collaborate with key partners, including vendors, operations, and IT professionals. Examine requirements and institute the request for authorization of admission, testing, transplants, and follow-up appointments. Devise and institute policies and processes and proper systems to safeguard operations and maximize revenue. Formulate performance measures and standards necessary for the team’s annual performance review. Identify and examine challenges and breakdowns within the revenue cycle process. Monitor activity efficiency to certify outstanding authorizations, collections, billings, accounts receivables, and postings are established in time limits, and bad debt remains in industry standards.

●Bolster profits by 50% over the course of one year through the revitalization of the lab department.

●Conserve more than $120K in refunds through regulations in untimely requests for refunds.

●Secure a 23% increase in billing and collections by creating and implementing the departments’ first incentive for performance and production go

●Exceed company goals and objectives by achieving a reduction in outstanding work queues that delivered revenue increases.

Cedar Sinai Medical Center –Los Angeles CA February 2005 – June 2014

Supervisor Revenue Cycle

Facilitated the development of an internal expert focused on all areas of revenue cycles, including training, communication, standards, operations, and policies and procedures. Oversaw staff conformity with policies and procedures in addition to individual staff productivity. Generated accurate reporting dashboards, assessed trends, delivered information, and identified opportunities for enhancement. Assessed ongoing service delivery quality and monitored key RCM metrics. Formulated a positive working environment to drive operations and identify areas of professional growth opportunities. Fostered solid relationships with clients, administrators, providers, operations, executives, and clinical staff. Held responsibility for the management of daily operations, including delegating duties and reviewing employee performance.

Successfully mentored and coached team members to deliver a 23% increase in billing and collections.

Spearheaded the development and implementation of strategic policies and procedures within the Medical Center claims billing and collections units.

Surpassed company goals and objectives through the decrease in work queues that further generated added revenue.

Instrumental in the management of revenue cycle areas, including policies, communication, training, standards, procedures, and operations.

ERN/National Council of Reimbursement Advocacy – March 2002– January 2005

Manager Consultant

Cultivated new policies and procedures within government units, claims billing, and collections commercial. Identified opportunities to drive process improvements and challenge best practices. Fostered open communication and collaboration with internal and external teams. Supervised and mentored staff members to guarantee the adoption of new state and federal regulations related to each state and jurisdiction. Expertly filled complaints with DMHC, DOJ, CMS, DOD, and DHCS concerning unfair payment practices and improper denials. Partnered with multiple hospitals in an effort to advocate for patient rights through state and federal law regulations.

●Established innovative revenue streams, which accelerated revenue streams by over 60% in some hospitals through the institution of state and federal laws and appeal processes.

●Spearheaded the development of new policies and procedures by motivating and training staff at significant facilities such as UC San Diego.

EDUCATION

Bachelor of Art in Business/Healthcare Administration

Argosy University Los Angeles CA -2018

Associate of Arts in Liberal Arts/Communications

University of Cincinnati Cincinnati, OH

LICENSES & CERTIFICATIONS

Certificate of Compliance, Certified Ambulance Compliance Officer (2019)

Certificate in professional Medical Coding, American Academy of Professional Coders

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