Revenue Cycle Front Desk
Resume:
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
About Me
• Dynamic, resourceful, and highly motivated Revenue Cycle Management Professional with over 20 years of experience in the healthcare industry.
• Empathetic mentor with excellent communication skills, thriving in team environments.
• Eager to contribute to a company that values healthcare, with a focus on enhancing prosperity and achieving significant professional and personal development
milestones.
• Proven track record of multitasking and adapting to dynamic work environments.
• Meticulous and detail-oriented approach to projects, issues, and goals.
• Skilled in training and motivating teams through compassion and personal initiative.
My contact
********.********@*****.***
15-04 B Plaza Road, Fair Lawn NJ
07410
Professional Experience
Billing Manager Englewood Health
July 2024-present
Key responsibilities:
• Ensures all services rendered by the Physicians either in the Practice or at the Hospitals/Nursing Homes are billed timely and accurately against schedules, procedure logs and hospital census reports.
• Responsible for verifying and entering registrations, accurately and timely entering charges into the
professional billing system daily for all assigned Providers from either the Electronic Health Record system or from encounter forms or other documents provided for billing.
• Reviews all coding and charge edits and obtains
clarification from the Physicians or Medical Assistants as needed to ensure all claims are billed and work daily in Epic and Athena.
• Assist reviewing denial trends and overseeing projects with internal/external teams.
Software
• EPIC
• Athena
• ECW
• Idx
• Centricity
• Eagle
• Care Cloud,
• Advanced MD
• Cure MD
• Provation
Platforms
• Waystar
• Navicure
• Zirmed
• Change Healthcare
• TriZetto
• Viatrack
• SSI
• Emdeon
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
• Supervises direct reporting staff according to the policies of the Medical Center. Coaches, discipline staff and man- ages internal staff relations.
• Works with Revenue Cycle Director to help evaluate staff- ing requirements; recruiting, hiring and training new staff.
• Monitors, evaluates and manages staff performance in- cluding performance reviews and productivity. Appropri- ately delegates work duties to staff.
• Train new front desk staff on registration, insurance verifi- cation, co-pay collection and insurance when needed.
• Assists in creating performance standards and reports that evaluate all Front Desk staff at the time of service are com- pleting registrations, collecting co-pays, verifying insur- ance and obtaining necessary referrals and prior authori- zations necessary to get paid. Works with revenue Cycle Director on providing feedback and implement process im- provements.
• Acts as primary liaison for the practice between the physi- cians and office staff, the outside billing company, and the Director of Physician Network Revenue Cycle and Man- aged Care.
• Functions as the Practices primary security agent for Navinet, United Health care Online, Oxford and other web- sites needed for insurance verification, referrals or prior authorizations.
• Handles all payer correspondence received for the as- signed practices and researches and addresses any payer issues including claim denials as the practices payer spe- cialist.
• Ensures month end deadlines are met for all charge cap- ture functions including time-of-service payment applica- tion, discount/allowance posting and researches credit balances and refunds due.
• Performs other business services and revenue cycle duties as assigned/requested.
Core Competences
• Strategic Leadership and Consulting
• Certified Professional Coding and
Auditing
• Multi-Location Operations Management
• Client Relationship and Stakeholder
Engagement
• Revenue Cycle Optimization and
Compliance
• Team Leadership and Talent
Development
• Innovative Problem-Solving and
Decision-Making
• Quality Assurance and Process
Improvement
Languages
• English
• Armenian
• Russian
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
Revenue Cycle Coding Manager Ensemble Health
Partners
July 2022-June 2024
Key responsibilities:
• Overseeing coding operations across 12 different locations within the enterprise.
• Managing a global and local team of coders, ensuring accuracy and efficiency in coding activities.
• Coordinating and completing compliance audits within set timeframes.
• Creating and maintaining audit records, reports, and tracking trends in coding and compliance activities.
• Overseeing daily Key Performance Indicators (KPIs), analyzing data and running reports to ensure alignment with targeted goals; implemented strategies to enhance team performance and achieve objectives.
• Evaluating and enhancing internal controls to ensure regulatory compliance and operational efficiency.
• Spearheading payer-specific denial projects, analyzing patterns and implementing solutions to reduce denial rates and optimize revenue cycle efficiency.
• Monitoring team productivity, utilizing metrics to assess performance and identify opportunities for operational enhancements.
• Designing and delivering comprehensive training and educational programs for staff.
• Collaborating closely with IT to implement rule edits within the Epic system, aiming for a higher rate of clean claim submissions and reduced errors.
• Leading client delivery reviews, evaluating revenue performance and identifying key opportunities for growth and optimization; playing a pivotal role in strategizing client-specific solutions to enhance revenue cycle effectiveness.
Certifications
• Waystar
• Navicure
• Zirmed
• Change Healthcare
• TriZetto
• Viatrack
• SSI
• Emdeon
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
Revenue Cycle Coding Manager Hackensack
Meridian Health MPV New Jersey Billing Services
April,2020-July 2022
Key responsibilities:
• Supported organization's Mission, Vision, and Values.
• Promoted ideal patient experience and brand building basics.
• Managed a team of 300+ offshore Global partners and 12 domestic staff members.
• Acted as a resource to Administration, Practice
Consultant, managers, and staff on revenue cycle
performance.
• Managed activities to meet short-term strategic goals.
• Assessed risk areas and supports other departments within the organization.
• Partnered with Billing and Finance teams to ensure compli- ance with regulations. Maintains expert knowledge of CPT- 4, NCCI, and ICD-10 guidelines across specialties.
• Developed strategic plans and programs for the Revenue Cycle Coding team.
• Analyzed and updates coding for complex cases, providing billing coding direction.
• Performed data quality reviews, prepared reports, and per- formed related duties as assigned.
• Stayed informed about coding regulations and technology advancements.
• Monitored changing requirements and communicated to affected department management.
• Conducted audits for billing compliance and provides edu- cation based on audit results.
• Ensured compliance with regulations and evaluates billing procedures.
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
• Recommended accurate coding and billing reimburse- ment.
• captured appropriate revenue and identifies process im- provement strategies.
• Developed and implemented clean claim understanding and workflow to minimize denials.
• Conducted audits and quality assurance to ensure coding and compliance standards were met.
• Collaborated with IT analytics to customize and improve claim production based on pager requirements and poli- cies.
• Provided coding training and workflow education to groups and individuals based on specific needs
Director of Revenue Cycle Management
Sovereign Health System
July 2019- January 2020
Key responsibilities:
• Oversaw $3 million revenue and achieved significant AR reduction.
• Managed 130 employees across 35 Multispecialty
Physician Practices, 12 Ambulatory Surgical Centers, Oncology, and Radiation Centers.
• Presented metrics reports, KPI analysis, and
volume/profitability analysis to the board of owners.
• Implemented in-service training to improve revenue cycle.
• Conducted regular chart audits to identify common denials, providing education to staff and physicians for prevention.
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
Revenue Cycle Manager Vanguard Medical Group
June 2016 – July 2019
Key responsibilities:
• Supervised account management, competition analysis, communication with insurance providers, collections, billings etc.
• Implemented strategies to bill customers, process payments, focusing on minimizing bad debt, improving cash flow and managing the overall health of the
company’s receivables.
• Enhanced and standardized work – flow processes to maintain firm’s standardized success factors.
• Ensured revenue maximization by reworking and
resubmitting unprocessed claims and denials.
• Analyzed trends and made recommendations to Finance Director and Director of Operations.
• Worked closely with Human resource department to ensure the best fit was hired by the company.
Senior Reimbursement Auditor Analyst Mount
Sinai Health Systems St. Luke’s /Roosevelt, NY
July 2015-June 2016
Key responsibilities:
• Ensured accuracy and compliance of charge items by applying clinical and coding knowledge.
• Addressed updates to code sets and coordinated the setup of unique codes with practices.
• Evaluated operative reports and audited coding for appropriate establishment of hospital charge codes.
• Analyzed documentation and facilitated revisions for relevant departments.
• Educated facilities administrators and staff on proper coding and documentation practices.
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
• Conducted audits of government and commercial multi- specialty claims, providing findings and corrective actions.
• Implemented Smart claims following CMS, NCCI, LCD, MUE, and MLN guidelines.
• Monitored regulatory changes and payer requirements related to facility billing.
• Coordinated projects and audits to improve revenue cycle processes.
• Collaborated with the Director of Billing Integrity to identify relevant updates to the Charge Description Master (CDM).
• Addressed various denials, including Real-Time Protocol
(RTP), Local Medical Review Policy (LMRP), missing blood factor, device, high and low-cost skin products, Central Equipment Identity Register (CEIR), incidental, improper revenue code, wrong number of units, etc.
• Updated coding-related medical necessity policies.
• Resolved coding errors and denials identified by the hospital's billing system for revenue enhancement.
• Consulted with clinical staff to identify reimbursable errors.
• Conducted ongoing revenue cycle reviews with the Director of Billing Integrity and Director of Health Information Systems.
• Participated in education programs to maintain up-to-date coding skills
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
Billing Department Manager Phillips Eye Center
June 2008 - July 2015
Key responsibilities:
• Supervised daily coding and billing operations, generated productivity reports.
• Provided training sessions to staff for proper chart validation and accurate claims submission.
• Conducted quarterly internal audits, educated MDs and mid-level providers on proper documentation.
• Supplied staff and providers with medical policies and guidelines from CMS and major insurances.
• Collaborated with IT Department to enhance features and workflow, improving documentation and billing.
• Ensured accurate charge items and audited billing inconsistencies using clinical and coding knowledge.
• Prepared reports, analytics, and planning for future practice opportunities.
• Handled accounting reconciliation and reporting on a weekly and monthly basis.
Office Manager Internal Medicine and Geriatrics
2005 – 2008
Key responsibilities:
• Provided coding support for hospital home visits and office procedures, audited coding and offered training.
• Educated facilities administrators and staff on proper coding and documentation practices.
• Analyzed documentation and facilitated revisions for ap- propriate departments.
• Managed accounting functionalities and daily reconcilia- tion reports.
• Provided analysis and guidance for practice goals. Office Manager Ophthalmology Practice, New York
2000 – 2005
Key responsibilities:
• Established and implemented effective workplace
procedures.
• Ensured compliance with industry standards and
government regulations.
• Oversaw hiring, training, and monitoring of administrative staff.
• Managed patient records using electronic health records.
• Supervised daily practice operations, including billing and collections.
• Monitored inventory and facilitated resupply of
medications and equipment.
• Addressed patient complaints and maintained good communication.
• Coordinated staff meetings and conducted performance reviews.
• Collaborated with Physicians on business strategies and patient services.
• Demonstrated strong interpersonal, communication, and problem-solving skills.
• Proficient in relevant healthcare and administrative software.
• Skilled in leadership, motivation, training, and goal-setting.
• Knowledgeable in financial and accounting practices.
• Familiarity with health care finance best practices and standards.
• Effective organization and time management abilities.
• Understanding of health and safety standards in the medi- cal industry.
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
NAIRA MARGARYAN
BEE, BS, CPC, CPCO, CPMA, CPC-I, CPPM, CRC
NM Medical Coding and Consulting, LLC
January 2014-Present
Key responsibilities:
• Supporting new project development including system analysis, planning and preparation.
• Developing, supporting and maintaining documentation and procedures as needed, provide training to end users.
• Assisting varies organizations run efficiently, responsibly and ensuring staff has expertise needed for successful product implementation.
• Directing the recoveries of lost revenue for our clients, as it relates to underbilled and/or underfunded accounts by third party payers.
• Utilizing my expertise in policies and procedures, reviewing regulatory compliance, assessing staffing needs and providing guidance for daily operations.
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