Revenue Cycle Financial Services
Resume:
Tara Sowell Hames
Charlotte, NC ***** 704-***-**** ***********@*****.***
Patient Financial Services Director
Results-driven and resourceful professional with experience in health care financial services. Comprehensive knowledge of Center of Medicare and Medicaid services, Commercial and other payers, including requirement for physician billing. Proven track record in achieving and exceeding KPIs, implementing process improvements, and leading cross-functional teams to optimize revenue cycle operations. Proficient in Epic and Microsoft Office Suite.
Areas of Expertise
Revenue Cycle Management KPI Tracking & Achievement Team Leadership & Training Cross-Functional Collaboration Process Improvement Payer Negotiation & Compliance Budget Development & Management Strategic Vision Implementation
Experience
Advocate Health aka. Atrium Health (formally Carolinas HealthCare System-CHS), Charlotte, NC May 2017 – June 2024
Patient Financial Services Director, Professional Business Office (PBO)
Promoted the Advocate Health vision and mission while remotely leading several departments including AR management for government payers (Medicare/Medicare Advantage, Medicaid/Managed Medicaid, VA and Tricare) and government/non-government payers for Behavioral Health and the Credit Processing team and Cash posting team for professional/physician billing remotely.
●Established and maintained internal procedures to ensure the achievement of monthly corporate KPIs, including AR reduction and denial management.
●Achieved and tracked reduction of key performance indicators (KPIs), such as AR greater than 90 days by 10%, initial denial rates by 5% and denial write-off percentages by 5%, to evaluate revenue cycle efficiency, identify areas for enhancements and drive operational excellence.
●Directed high-level management, including Managers and Directors, in resolving AR issues efficiently, improving revenue cycle performance.
●Led a cross-functional team in successfully integrating several acquired organizations, streamlining operations, and aligning corporate cultures, resulting in an increase in operational efficiency.
●Identified and negotiated patterned payer issues, maintaining stable performance under pressure and fostering strong relationships with stakeholders.
●Developed and maintained collaborative relationships with payer partners to ensure continuous dialogue and partnership around claim processing, payer updates and data exchange.
●Reviewed monthly adjustments and internal processes to ensure accuracy and minimal disruption to net revenue.
●Monitored statistical reports to identify trends, resolve deficiencies, and develop action plans for continuous improvement.
●Led and collaborated with all stakeholders in the revenue cycle within organization, such as patient registration, compliance, coding support and claims processing including workflows for eligibility/ prior authorization, enrollment/credentialing, coding guidelines/requirements, claims submission, etc., to ensure cross-functional process improvements impacting denial prevention, AR reduction, credit reduction and efficiency of posting cash.
●Collaborated with the CFO and other executive leaders to align facility performance with organizational goals and actively communicated issues for resolution.
●Developed and managed departmental budgets, prepared monthly reports, and established departmental goals to optimize performance and meet financial targets.
●Directed training and development of revenue cycle associates, coordinating training guidelines and materials to ensure compliance with billing regulations and payer policies.
●Built and led a high-performing teams of billing and revenue cycle professionals, provided mentorship, training and performance evaluations to enhance optimal efficiency.
Atrium Health (formally Carolinas Healthcare System), Charlotte, NC March 2011 – April 2017
Patient Financial Services Medicaid/Specialty Team Manager, Professional Business Office
Promoted the PBO vision and mission through strategic direction and leadership, ensuring KPIs were met or exceeded.
●Monitored the accounts receivable monthly tomaximize impact, developing focused strategies for government and commercial payers.
●Collaborated with internal departments to enhance process efficiency in response to payer regulation changes.
●Facilitated supervisors in monitoring the daily work activities of team members.
●Led recruitment, hiring, training, and performance reviews to build a high-performing team.
●Provided mentorship and guidance to peers, supervisors, and team members to ensure optimal efficiency.
Carolinas Healthcare System (CHS) Central Business Office, Charlotte, NC September 2008 - February 2011
Patient Financial Services Specialty/Cardiology Team Supervisor
Supervised daily work activities and performance of the team, ensuring monthly standards were met.
●Assisted in the implementation of strategies to achieve performance goals and impact AR for government and commercial payers.
●Led recruitment, training, and performance evaluations for new staff, fostering a culture of continuous improvement.
Additional Relevant Experience
Charlotte Cardiology Associates, Charlotte, NC, Business Services Supervisor
Led a team that performed all revenue cycle functions including claims submission, charge entry, coding, customer service, payment posting, refunds and insurance follow-up. Performed insurance follow-up for all Medicaid AR.
Certification
Certified Professional Coder, AAPC, July 2022
Education
Master of Business Administration (MBA), Healthcare Management
Liberty University
Master of Business Administration (MBA), Leadership
Liberty University
Bachelor of Arts (BA), Biology
The University of North Carolina at Greensboro
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