Revenue Cycle Medical Billing

Mrs. Tequila M. Samuel (she/her)

Revenue Cycle Analyst

Chesterfield, VA (p) 804-***-**** (e) ***********@***.*** Professional Summary

Experienced Revenue Cycle Analyst with 20+ years in healthcare finance, medical billing, and revenue cycle management. Adept at reimbursement optimization, compliance, and data analytics, with a strong foundation in AI-powered automation tools. Proven success in reducing receivables, improving financial reporting accuracy, and streamlining claims management. Seeking a remote or hybrid role in a dynamic organization.

Core Skills & Competencies

● Revenue Cycle Management & Optimization

● Medical Billing & Coding (ICD-10, CPT, HCPCS)

● Accounts Receivable & Claims Processing

● Healthcare Financial Compliance & Auditing

● AI-Driven Data Analysis & Process Automation

● Healthcare ERP & EHR Systems (Epic, Cerner, Meditech)

● SQL, Microsoft Excel (Pivot Tables, VLOOKUP), Access, Power BI

● HIPAA, CMS, and State Regulatory Compliance

● Cross-functional Team Leadership & Training

● AI-Based Talent Acquisition & Workforce Planning Professional Experience

Prime Therapeutics (Formerly Magellan Rx) Remote Pharmacy Rebate Analyst May 2021 – Jan 2024

● Managed the $1.2 billion Government Pharmacy Rebate Program, ensuring 100% compliance with regulations.

● Led claims analysis, reimbursement reconciliation, and revenue forecasting, reducing outstanding payments by 10%.

● Developed AI-driven reporting tools, improving Medicaid/Medicare revenue tracking efficiency.

● Handled invoice dispute resolution and payer contract analysis, optimizing collections.

● Delivered monthly, quarterly, and annual financial reports for state contracts. Pediatrix Medical Group Glen Allen, VA

Infant Auditory Screening Coordinator Aug 2018 – Feb 2020

● Supervised a 10-member revenue cycle team across 4 hospital facilities, ensuring OSHA, HIPAA, and Joint Commission compliance.

● Conducted insurance eligibility verification, claims audits, and reimbursement analysis, reducing denied claims by 15%.

● Implemented AI-based billing systems, streamlining charge capture and improving collections. Parallon Business Solutions (Formerly HCA Shared Services) Remote Charity/Logging Analyst & Unbilled/HIMS Coordinator Oct 2011 – Mar 2018

● Managed and maintained charity care and bad debt logs, ensuring Medicaid/Medicare compliance.

● Performed data analysis using RPAS, HOST, OnBase, and Artiva to support revenue cycle operations.

● Partnered with finance teams to enhance cash flow forecasting and reimbursement strategies. Education & Certifications

● AAPC Medical Coding Certificate – Chesterfield County Technical Center, VA (2016)

● AS - Undergraduate, Health Sciences – Georgia Perimeter College, GA (2011)

● AS - Undergraduate, Business Administration – J. Sargeant Reynolds College, VA (2003)

● Commissioned Notary Public – State of Virginia

Technical Proficiencies

● Revenue Cycle & Billing Systems: Epic, Cerner, Meditech, eClinicalWorks, Availity

● Data Analysis & Reporting: SQL, Power BI, Tableau, Microsoft Excel (Advanced)

● AI & Automation Tools: Workday, ChatGPT, Salesforce Health Cloud, RPA (Robotic Process Automation)

● Collaboration Tools: Microsoft Teams, Google Meet, Zoom, SharePoint Professional Affiliations

● American Academy of Professional Coders (AAPC - non certified)

● Healthcare Financial Management Association (HFMA) Salary History & References

Available Upon Request

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