Revenue Cycle Customer Service
Resume:
DEBBIE PALUMBO
Seattle, WA 714-***-****/ ***************@*****.***
Experienced Revenue Cycle Leader with over 20+years’ experience in Hospital and Clinic Healthcare Business Operations.Dedicatedtocontinuousprocessimprovementinthefaceofrapidlyevolvingandchanginghealthcareneeds. Results-oriented,proactive,and successful atmeetingandexceedingoperationalKPIsincludingA/RDays,aginggoals per payers,etc.;created and maintained leadership task force to reduce initial denials for both commercial and government payers;participated incontractnegotiationswithpayers.Successfullyimplementednewoperationsoftware systems.InvolvedinallaspectsofPayroll,HumanResources,Personnelactivities,andissueresolutionsforthebusiness office.
Experience
Seamar
Supervisor, Revenue Cycle November 2024-Current
● Provided direction and oversight of concurrent denial prevention findings and solutions for the organization
● Identification of strategies for prevention and initiate processes for denial avoidance
● Maintain working knowledge of non-government and government payers and contract language
● Develop and implement denial action plans with interventions as needed with all facility departments
● Identify education opportunities within facility and assist with communication of such
● Identify health plan or medical group issues then work with health plans provider rep to resolve CFS Agency
Accounting Support July 2024-October 2024
● Posting payments
● Researching invoice discrepancies
● Customer service on phones
● Managing the Accounting inbox-responding to the numerous customer questions, complaints and miscellaneous projects
CONIFER HEALTH SOLUTIONS – 9 years
Manager, Billing and Credits September2022-2023
● Monitor and evaluate management KPI’s daily, weekly, and monthly. Report results with revenue cycle leadership team
● Collaborate with management team to provide strategic goals to the Revenue Cycle Department
● Maintain effective working relationships with co-workers, management and respective internal and external resources to standardize processes, policies and vendor relations to reduce costs and improve performance
● Provide oversight and monitoring of Billing and Credits
● Coach and mentor staff. Foster an innovative and team-oriented work environment Director, Denials Management and Prevention(CentralMarket)January 2017-September 2018
● Provided direction and oversight of concurrent denial prevention findings and solutions for a 850 bed hospital.
● Identification of strategies for prevention and initiate processes for denial avoidance
● Maintain working knowledge of non-government and government payers and contract language
● Develop and implement denial action plans with interventions as needed with all facility departments
● Identify education opportunities within facility and assist with communication of such
● Identify health plan or medical group issues then work with health plans provider rep to resolve
● FacilitateweeklyDenialPreventionmeeting.Provideandpresentdetailanalysisofdenialstrendsandrootcauses to the Denial Prevention team and Sr. Leadership
● Maintain facility Denial Action plan. Ensure action items were moving forward and within targeted periods
● Work closely with facility CFO,Case Management Director,A/R Team,and various other leadership teams throughout the organization
Sr.Manager,A/R(CaliforniaMarket)November2013-January 2017
● Managed day-to-day A/R operations of 11 hospitals including clinics for the business office with staff of 35
● Monitor and evaluate management KPI’s daily, weekly and monthly. Report results with revenue cycle leadership team
● Collaborate with management team to provide strategic goals to the Revenue Cycle Department
● Maintain effective working relationships with co-workers, management and respective internal and external resources to standardize processes, policies and vendor relations to reduce costs and improve performance
● Provide oversight and monitoring of Billing, Collections, Cash Posting and Customer Service areas
● Coach and mentor staff. Foster an innovative and team-oriented work environment Sr. Manager Patient Financial Services(NW Region)October 2011-November 2013
● Manage day-to-day operations of hospital billing office with staff of 30.
● Monitor billing of patient claims to government and non-government payers.Oversight of electronic billing system including building and maintaining specific payer bill edits. Management of Unbilled report.
● Manage the charge master to ensure charges were updated per contracts and that the revenue cycle team was charging and services were in line with organizational goals and policies
● Accountsreceivablecollectionsforgovernmentandnon-governmenthealthplansincludingworkercompensation and self-pay. Ensure A/R days exceeded expectations
● All cashiering and banking duties including monthly general ledger balancing
● Research and resolving credit balance report,insurance/patient refund requests,insurance payment take-backs, underpayments and denied claims
● HRdutiesincludinginterviewandhiringstaff,stafftraining,yearlyevaluations,goalsandobjectives,disciplinary actions
● Develop departmental goals, objectives, standards of performance, policies and procedures PROVIDENCE HEALTH SERVICES - 8 years
SWEDISH MEDICAL CENTER
Sr. Manager, Business Office June2020-Sept 2021
● Managed day-to-day operations of 9 hospitals including clinics for the business office with staff of 51.
● Monitor and evaluate management KPI’s daily, weekly, and monthly. Report results with revenue cycle leadership team
● Collaborate with management team to provide strategic goals to the Revenue Cycle Department
● Maintain effective working relationships with co-workers, management and respective internal and external resources to standardize processes, policies and vendor relations to reduce costs and improve performance
● Provide oversight and monitoring of Billing, Collections, Cash Posting and Customer Service areas
● Coach and mentor staff. Foster an innovative and team-oriented work environment PACIFIC MEDICAL CENTER
Manager, Business Office March 2019-June2020
● Managed day-to-day operations of the business office responsible for 11 clinics with staff of 25.
● Monitor and evaluate management KPI’s daily, weekly and monthly. Report results with revenue cycle leadership team
● Collaborate with management team to provide strategic goals to the Revenue Cycle Department
● Maintain effective working relationships with co-workers, management and respective internal and external resources to standardize processes, policies and vendor relations to reduce costs and improve performance
● Provide oversight and monitoring of Billing, Collections, Cash Posting and Customer Service areas
● Coach and mentor staff. Foster an innovative and team-oriented work environment PROVIDENCE HEALTH AND SERVICES
A/R Manager, Government Payers April 2010-January 2013
● Responsible for all aspects of Medicare and Medicaid collection and billingactivitiesforeleven(11)hospitals with an average of 150-400 beds with 50 caregivers
● Manage collections, cash applications and clerical staff using SSI, CCSM and MedeAnalytics
● Implement several improvements through weekly and monthly trend analysis
● Provide monthly collection updates to Leadership
● ResponsibleforallaspectsofmyteamtransitioningtoEPICincludingtraining,communication,documentation, and daily report out to Leadership highlighting go live issues, possible resolutions, and follow up activities PHNS – consultant
Patient Financial Service System Analyst January 2008-January 2010
● Perform ongoing quality assurance to ensure accuracy and consistency of output in system
● Conduct user acceptance testing and data validation of web applications
● Load and maintained CMS claims processing edits and payment transactions
● Participate on the build from McKesson Star to EPIC Hospital For Sick Children - consultant
Clinical Applications Analyst May 2006-December 2007
● Technical support utilizing critical thinking to evaluate and resolve customer issues in a timely manner.
● Conduct user acceptance testing and data validation of web applications
● Load and maintain CMS claims processing edits and payment transactions.
● Participate on the build from McKesson Star to EPIC
● Conduct end user training for the patient account representatives Perot Systems - consultant
Manager, Patient Financial Services(Valley MedicalCenter)May 2005-May 2006 Manage day-to-day operations of hospital billing office with staff of 45.
● Monitor Billing of patient claims to government and non-government payers.Oversight of electronic billing system including building and maintaining specific payer bill edits. Management of Unbilled report
● Accountsreceivablecollectionsforgovernmentandnon-governmenthealthplansincludingworkercompensation and self-pay. Ensure A/R days exceeded expectations
● All cashiering and banking duties including monthly general ledger balancing
● Research and resolving,credit balance report,insurance/patient refundrequests,insurancepaymenttake-backs, underpayments and denied claims
● HRdutiesincludinginterviewandhiringstaff,stafftraining,yearlyevaluations,goalsandobjectives,disciplinary actions
● Develop departmental goals, objectives, standards of performance, policies and procedures Premera Blue Cross – 6 years
Medicare System Analyst September1999-May 2005
● Perform ongoing quality assurance to ensure accuracy and consistency of output in Medicare system
● Project team member for Medicare FI on CMS’s initiatives to combine a local and nationalclaimsprocessing system into one single platform
● Conduct user acceptance testing and data validation of web applications used to present benefit information
● Load and maintain CMS claims processing edits and payment transactions.
● Participate on the build from APASS CMS application to FISS CMS application
● Travel to hospitals in Washington,Alaska and Oregon representing CMS to provide education to facilitiesfor changes and or new CMS transmittals that were issued on quarterly basis Hospital Associations
− Former AAHAM Second Vice President of Evergreen Chapter (2 years)
− Former active participant HFMA, Washington Chapter (2 years)
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