Revenue Cycle Continuous Improvement

Kathy Philbert

Grayson, GA ***** • 678-***-**** • *************@*****.*** • WWW: Online Digital Resume Professional Summary

Revenue Cycle Professional with over 25 years of experience in Healthcare. Well-versed in billing cycle operations and with a strong background in continuous improvement and revenue performance analysis. Focused and organized with demonstrated success in achieving company goals. Identifying obstacles related to revenue generation and collaboration with departmental and site leadership. To identify and implement solutions and best practices related to the revenue cycle.

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Skills

Revenue Cycle Management

Financial Analysis

Coding and Billing Process and Guidelines

Insurance and vendor contracting

IT

Staff Management

EHR and PM Implementation

Relationship and Team building

Sound Decision Making

Critical Thinking proficiency

Personal and Professional Integrity

HIPPA Compliance

Work History

Director of Revenue Cycle, 07/2019 to Current

SENTA Partners – Sandy Springs, GA

Directed and oversaw overall policies, objectives, and initiatives of company's revenue cycle department.

Oversaw full revenue cycle for 3 affiliated companies, 8 clinics, 2 ASC's with 17 Providers, 25 Audiologist.

Managed all day to day RCM functions for a team 17 staff. Trained, coached and mentored staff to ensure smooth adoption of new processes. Hiring and Onboarding new staff

Created new revenue streams through follow up and appeals process. Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of Revenue Cycle Department Reviewed and implemented processes surrounding fee schedule, billing, third party payor relationships, collections and other financial analyzes to ensure that clinical revenue cycle was effective and properly utilized.

Analyzed and reported on weekly and monthly KPI's. Aging Reports discussed with RCM staff with focus on Highs and lows to give proper directives. Full Assessments of newly acquired RCM department and set new processes, structure and guidance to ensure success of RCM Implementation.

Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities. Worked with third party vendors the company used for front and back end processes. Reported and communicated on all payor compliance issues for the department. Oversaw any payor and third party audits for the department. Reported to Sr. Director and VP of Revenue Cycle

Business Office Manager, 02/2016 to 05/2019

Buckhead ENT – Buckhead,GA

Managed daily operations of front office, Billing Department and surgery scheduling Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of Billing Department Responsible for new employee training, hire and terminations Worked closely with physicians to develop seamless delivery of services and excellent experience for patients through end-to-end process Liaison between Piedmont Community Connect and the practice Supervised Meaningful Use for 3 physicians

Provide and interpret financial analysis to effectively increase front office collections. Set goals and deadlines for Billing Department

Oversaw all ERA's and EFT's set up and process

Reconciled all Recoupments

Daily aging and month end closing reports

Managed and worked with patient collection vendor

Recommend and implement procedural or policy changes to improve operations. Maximized cash flow through optimal billing and collection processes. Billing Manager, 06/2006 to 02/2016

Northeast Atlanta Ear Nose and Throat – Lawrenceville,GA Managed Billing and Collections for 2 clinics, 4 Providers, 1 PA and 2 Audiologist. Provided updates on different issues impacting collections. Reviewed billing problems, researched issues and resolved concerns Reported directly to Practice Administrator

Claims Specialist, 03/2000 to 11/2005

Cigna Healthcare – Atlanta,GA

Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.

Managed large volume of medical claims on daily basis. Paid or denied medical claims based upon established claims processing criteria. Claims Adjuster, 01/1994 to 09/1999

United Healthcare – Duluth,GA

Handled more complex claim issues, accounting, adjustments of underpayment and overpayment audits.

Provided customer service and processed claims for managed and non-managed care policies. Education

Psychology Applied Psychology

Georgia State University - Atlanta, GA

General General Psychology

DEKALB COLLEGE - Dunwoody, GA

Associate of Applied Science: Business Public Administration, 05/1990 MILWAUKEE COLLEGE of BUSINESS - Milwaukee, WI

Affiliations

American Academy Professional Coders

ASCENT - Administrative support Community for ENT

Ambulatory Surgery Center Group

Healthcare Billing and Coding Group

Certifications

CPC - Certified Professional Coder

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