Revenue Cycle Management

Dawn Roberts

*** ****** **., ******** ***** *****

Cell: 817-***-****

Summary

Reimbursement (Revenue Cycle Management) manager who provides leadership, guidance and support focusing on quality services and compliance with company standards. A team player who handles multiple projects simultaneously in a fast-paced environment. Possess a strong work ethic and a high level of professionalism with the ability to lead / direct others in meeting daily operational goals.

Skill Highlights

Management ICD 9/10 coding Credentialing/Contracting CPT/HCPCS

Electronic Medical Record Medical billing/collections Revenue Cycle Management Medical Terminology

Professional Experience

Billing Manager August 2023 to Current

Retina Center of TX Southlake, Texas

Revenue Cycle Management for Ophthalmology

Managing all functions of the billing process: charge entry, claims submissions and claim status, clearinghouse reporting, bank deposit and payment posting reconciliation, AR follow up, patient statements and collections.

Maintaining comprehensive knowledge of all contracted insurance plans and fee schedules

Collaborating with physicians to identify revenue cycle issues and participating in process improvement initiatives.

Hiring, supervising, and evaluating billing staff. Creating a positive work environment for staff through team building, coaching, constructive feedback, work delegation, personal example, and goal setting.

DS Billing Manager June 2023 to July 2023

MHMR of Tarrant County Fort Worth, Texas

Overseen DS Medicaid billing processes for efficiency, accuracy, and successful reimbursement

Collaborated with Patient Financial Services Department for reimbursement of provided services.

Monitored Medicaid Revenue Billing for multiple DS programs.

Supervised ICF Census entry and verification. Overseen GR Respite Family Paper claims entry

Managing DS Program-specific guarantors for billing and encounters

Monitored encounter reports for exceptions, duplicates, and rejected encounters, and participating in the DS Division's Data Workgroup

Dawn Roberts Page 2

Insurance/Medicare Reimbursement Supervisor April 2021 to April 2023

AngMar Medical Holdings Mansfield, Texas

Managed teams of billers, collectors, payment posters and contract specialist with daily processes for Home Health and Hospice providers. Performed coaching, write ups and annual reviews.

Worked with the director and other departments to resolve payor issues.

Audited team performances to detect inconsistencies and/or errors affecting production Analyzed and trend data, recommending solutions.

Reviewed outstanding balances to identify and resolve issues preventing finalization of claim

payment; including coordinating with payers, patients, and clients when appropriate.

Medical Receptionist July 2017 to March 2021

Questcare Medical Clinic Burleson, Texas

Verify patients’ insurance, authorizations, available labs, patient financial responsibility

Check patients in and out and collect applicable patient financial responsibility

Obtain all pertinent paperwork from patient needed from patient

Answer multi line phone calls, schedule appointment, answer financial questions

Prepare patient charts for appointments. Account Resolution, balance end of day and prepare deposit slips for manager.

Reimbursement Specialist III June 2016 to June 2017

Complete Emergency Care Southlake, Texas

Medical billing and collections

Account Resolution, completed appeals and filed and submitted claims.

Thoroughly investigated past-due invoices and minimized the number of unpaid accounts.

Reviewed outstanding insurance balances to identify and resolve issues preventing finalization of claim.

Payment

Practice Manager September 2011 to April 2016

Texas Health Medsynergies Irving, Texas

Managed the day to day Revenue Cycle Operational Process Coached, trained, and developed subordinate staff

Reviewed work and managed performance

Resolved escalated issues

Researched issues to detect inconsistencies and/or errors affecting production Analyzed and trend data, recommending solutions

Reviewed outstanding insurance balances to identify and resolve issues preventing finalization of claim

payment; including coordinating with payers, patients and clients when appropriate Supervised billing specialists

Dawn Roberts Page 3

A/R Supervisor December 2005 to September 2011

Medsynergies Irving, TX

Performed full cycle medical billing in a fast paced medical billing company Managed client revenue by analyzing and problem solving Provided administrative support for thirteen clients Liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy Appropriately and correctly identified errors and re filed denied/rejected claims

Evaluated the accuracy of provider charges, including dates of service, procedures, level of care,

locations, diagnoses, patient identification and provider signature Completed appeals and filed and submitted claims

Thoroughly investigated past due invoices and minimized number of unpaid accounts

Team Lead December 2000 to August 2005

Millwood Hospital Arlington, Texas

Supervised collectors with insurance calls/problems Billed psychiatric, chemical dependency and physician claims electronically and paper.

Posted contractual adjustments, wrote cash receipts for payments.

ICD 9 and CPT coding

Collections including but not limited to Medicare and Medicaid

Contact this candidate