Revenue Cycle Personal Injury

Resume of Misti D. Ervin

Professional Healthcare Administrator

Specializing in Revenue Cycle

email: ***************@*****.***

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Professional Summary

Experienced, knowledgeable revenue cycle director with a strong background in personal injury with emphasis on accurate billing, auditing and collections. Talented and proficient in daily accounts receivable operations; specializing in goals driven collections and increased revenue. Knowledgeable and proficient in personal injury and managed care billing/collections, medical records and chart auditing; demonstrating high levels of accuracy through years of experience and knowledge of ICD-10 and CPT codes associated with personal injury care. Outstanding servant leadership with motivational and organizational skills. Open and clear communicator with a consistent approach to developing and improving processes and procedures. Adept at maximizing productivity with a gift of bringing out the best in employees; offering a 30+ year track record of success in revenue cycle and healthcare management.

Career Overview

I have achieved a great level of success in increasing company revenue and furthering business by proven methods of accurate and timely billing, effective payment negotiations, and goals driven collections while emphasizing excellence in customer service and patient care. I have used my expertise in this field to teach and train numerous employees in the areas of billing, coding, collections and case management. My servant leadership and organizational skills, as well as my sincere love for the work I do have been instrumental in increasing employee productivity, increasing company revenue and contributing to overall company success.

Work History

Director of Revenue Cycle-Neurology Provider (03/06/2023 to present)

As the director I am responsible for the overall cohesiveness of the personal injury revenue cycle department. I manage the revenue cycle processes including coding of charges, billing, collections and medical records. My department is also responsible for verification of personal injury auto insurance and third-party direct claims, as well as filing 3rd party liens when applicable. Through servant leadership, I lead, manage, teach and cross train a team of 10 direct reports ensuring their proficiency, productivity and confidence in their work abilites while fostering a culture of teamwork with an emphasis on excellence in customer service. Some of my specific duties include the following:

•Develop, monitor and update the billing and collections processes, utilizing measurable metrics and KPIs to ensure optimal collections, project future revenue, ensure compliance with HIPAA, and departmental procedures; quickly identifying trends which could adversely affect monthly revenue and collections

•ensure the proper use of ICD-10 and CPT codes associated with personal injury treatment so that charges are entered into the EHR system correctly and in a timely manner

•the proper and detailed auditing of patient charts ensuring medical records, casebooks and finals are sent to attorneys and third-party requestors with a high level of accuracy, and in a timely manner

•the proper and timely return of medical records for subpoenas, affidavits and DWQs, including billing and collection of payments for these types of requests

•payment posting and deposit balancing ensuring all checks are posted properly with appropriate write-offs and resolution of problematic accounts including processing of refunds for overpayments

•Goals driven collections with case and payment follow up through written and verbal communications ensuring consistency with payments, meeting and exceeding monthly collection goals

•negotiations and reductions with attorneys and third-party payors optimizing maximum reimbursement ensuring collections are consistent and increasing each month

• analyze and submit daily charges reports to external funding companies for financing of specific accounts

•Compilation of charges and payment reports, including data collections and analysis, to submit to CPA and C-Suite officers for weekly finance meetings

•Collaborate with the front desk and clinical departments ensuring excellent communication and fluidity with overlapping responsibilities to achieve the overall goal of quality patient care and the advancement of the company

Corporate Office Manager-Accident Centers of Texas (03/21/2022 to 12/30/2022)

I was responsible for the daily operations in the corporate office, overseeing a team of 9 billers and 3 collectors. My duties included developing processes, teaching and training employees to ensure the following:

•correct and appropriate use of ICD-10 and CPT codes associated with personal injury treatment

• reviewing and properly auditing charts ensuring patient records are being sent to attorneys and third-party requestors with accuracy and in a timely manner

• time management techniques to optimize daily productivity with billing, auditing and collections

•medical records keeping including HIPAA, patient records requests, 3rd party requests, attorney finals, subpoenas and affidavits

•create and maintain an easy view system of auditing and tracking released charts which also served as a reference for follow up case status and collection calls to attorneys and 3rd party payers

•implement policies and procedures to ensure LOPs and LORs are procured for treatment and release of billing and records

•create and maintain processes to streamline the collections department with structural procedures ensuring consistent and increased revenue

•closely working with the collectors ensuring their knowledge of personal injury settlement breakdowns, pro rata payment shares and negotiation of reductions resulting in increased collections and employee morale

•maintaining and improving processes for patient case managers and referral coordinators increasing the quality of patient care, customer satisfaction as well as improved communications and relationships with attorneys and referring providers

•promote excellence in customer service and teamwork, ensuring enhanced patient experience representing the company’s core values

•interviewing and hiring motivated candidates with skill sets and personalities conducive to a healthy workplace environment

Director of Operations-NorthStar Injury and Pain clinic/Silver Care Management

(10/01/2020-03/01/2022)

My ability to set up, organize and promote this medical clinic from the ground up, including creating patient and treatment forms, policies, and procedures, allowed me to lead this brand-new facility to success in its initial year of practice, ensuring longevity for the future. I accomplished this by:

•Surpassing collections expectations by ensuring the smooth day-to-day operations of the clinic including scheduling, billing, and collections, as well as coordination of patient care with attorneys and outside providers

•Solidifying and strengthening relationships with referral sources and attorneys by providing excellent customer service and extended after-hours access

•Increasing revenue, accurate projection of future revenue and collections by negotiating payments and reductions with attorney 3rd party payers

•Maintaining medical records, as the records custodian, including completing medical and billing records affidavits, subpoenas and DWQ requests

•Maintaining accuracy and integrity of the accounts receivable through line-item payment posting and account reconciliation including overpayments and refunds

•Ensuring clinic compliance on state and federal levels by Introducing and implementing protocols for HIPAA, creating the company compliance program, writing, and maintaining the company compliance policy manual, organizing, and directing the clinic’s monthly HIPAA and Compliance meetings as the HIPAA Compliance officer

• Promoting growth and stability for the company by interviewing, hiring and onboarding qualified, motivated healthcare providers and support staff.

Silver Care Management (a division of NorthStar Injury and Pain) duties- I sustained the growth and progression of this pharmaceutical company, maintained accurate records and reconciled the AR resulting in better projection of future revenue and increased monthly collections. My duties included:

•effectively overseeing the daily operations of the accounts receivable department for Trinity Apothecary and People First Pharmacy by maintaining accuracy and integrity in billing and records.

•Increasing collections through timely resolution of accounts with patients, hospice and assisted living facilities

•effectively communicating with patients, attorneys, and facility customers regarding prescriptions, records and payments

•Promoting and maintaining a positive company image by handling escalated account matters and customer service issues in a timely and professional manner

•accurately performing month end duties including collection calls, freezing accounts for non-payment, payment posting, charging credit card payments for ACH accounts using the IPS pharmacy system software, and timely mailing of billing statements to patients, attorneys and customer facilities

• Increasing revenue by successful collections of accounts over 90 days.

•Increasing productivity by streamlining the accounts receivable processing uncollectable accounts for escalated collections and bad debt write offs

Collections Manager-MDN Injury Care (03/06/2019 – 09/01/2020)

I immediately increased collections by 30% utilizing my knowledge, skills and passion for personal injury collections by analyzing and organizing the accounts receivables department and increasing employee productivity by:

•creating and maintaining easy to use policies and procedures for goals driven collections

•creating and maintaining a system for case status and payment follow up with collection calls and emails

•increasing collection payments substantially by cleaning up the receivables focusing on collectable accounts

•creating a process of in-person attorney payment collections

•successfully negotiating payments and bill reductions increasing monthly collections

•solidified business relationships, increasing revenue, through effective communication, excellent customer service and projecting a professional image assisting with marketing of Attorneys, referral sources and other healthcare providers

Business Administrator-All Injury Rehab & Chiropractic Clinics (03/2004– 02/08/2019)

I was instrumental and directly involved in the overwhelming success of this personal injury chiropractic company by strategically planning and maintaining company profitability, increasing growth from 4 clinics to 8 clinics through out the D/FW Metroplex. I opened the company business office, laying the foundation and groundwork by creating systems for Human Resources, HIPPA compliance, provider credentialing, as well as centralized billing, collections, accounts receivable/accounts payable and medical records. I worked directly with the CEO, CFO and CMO to catapult this young company into leading the industry by providing next level, high quality personal injury care incorporating chiropractic, physical rehab, diagnostic testing and medicine.

Administrative and Human resources duties-With my professional and organized handling of admin and HR duties, I was able to increase the profitability of this company and save revenue, by leading, motivating, teaching and training employees with the objectives to give excellent patient care, ensure state and federal compliance, promote healthy work environments and overall cohesiveness with the goal of consistent and increasing revenue and collections and an enhanced patient experience. I implemented structural policies and procedures for billing and collections which are still in place with this company today. I achieved goals and directives through long hours of work, dedication, loyalty and the proper and ethical handling of company business by:

•skillfully managing daily operations as a dedicated and proficient health care administrator for 8 clinics and a business office employing over 65 employees in the organization

•presenting business plans and ideas to the company owners focusing on all aspects of facility operations, including setting priorities and job assignments of personnel, marketing, advertising, collections, and budget projections.

•assessing the need for, writing and updating the company Policy Manual, including the company mission statement, as well as the core values of the company

•reviewing and renegotiating vendor contracts, insurance plans and employee benefits for more competitive pricing and rates for the company

•replacing outdated machinery and computer systems with more cost effective and efficient products

•creating and maintaining protocols to ensure compliance with HIPAA by co-creating the company compliance program with the CMO, writing, and maintaining the company compliance manuals for each clinic, organizing and presenting the bi-annual companywide HIPAA and Compliance seminar for all employees

•Interviewing and hiring qualified candidates, administering hiring tests, completing the onboarding process including new hire paperwork, company policy manual, credentialing, and HIPAA and OSHA video training

•Credentialing doctors for Insurance network participation including CAQH profiles; tracking license renewals and CE hours

•Constructively handling disciplinary issues including verbal and written warnings, counseling, re-training, and disciplinary action including termination

•Proficiently handling the timely response of all correspondence of unemployment claims

•Accurately handling all aspects of bi-monthly payroll with precision including calculation of employee time sheets/timecards, calculation and tracking of employee bonuses, employee time off and vacation use, and deductions of payroll for benefits

•Conducting informative monthly meetings with doctors and office managers to educate them on changes in health care laws and reimbursement trends

•Saving the company money by ensuring accuracy and prompt payment of vendor invoices, continuously checking competitive pricing for products and services

•Creating customer satisfaction surveys and reviewing information to identify areas of concern or in need of improvement.

Billing and Collections duties- I was able to bring in high dollars of collections elevating the company to new levels of growth, expansion and financial success using my extensive knowledge and years of experience in healthcare and personal injury billing and collections. I achieved this by assembling, managing, and training a team of billers, collectors and support personnel with duties including:

•Accurate verification and billing of major med insurance, workers comp, auto (PIP), 3rd party and premises liability claims, as well as filing and follow up on 3rd party liens

•Effective and organized goal driven collections of accounts receivable always meeting and exceeding the minimum collection goal of $350k per month

•In person collections for attorney payments

•Accurate account reconciliations including written and oral insurance denial appeals and accounts variances including refunds of overpayments

•Effective, professional communications with attorneys negotiating the highest payment reimbursements on personal injury accounts

•implementing month end closing procedures, using a system of checks and balances, ensuring the accurate entry of all charges and payments, including review and analyzation of month end data reports

•Maintaining good communication between clinic directors and office managers on corrective measures of documentation, billing, and coding errors

•Encouraging creative thinking, problem solving, and empowerment of employees to facilitate smooth operations and goal achievements by instilling confidence, promoting teamwork and excellence in customer service

Medical Records duties-My attention to detail and extensive knowledge and experience as a medical records custodian enabled me to protect the company by ensuring the accuracy of ICD and CPT coding, adherence to rules and regulations regarding patient records, leading to company growth and expansion, by managing, training, and teaching the business office staff on the proper handling and maintenance of records including:

•Proper patient authorization in accordance with HIPAA for release of records

•Subpoena requests for medical, billing and x-ray records, coordinating with a 3rd party copy service for invoicing, payment, and submission of records to requestors, as well as direct submission of records to attorneys and insurance companies

•Preparation of the final narrative reports, bills, records and affidavits for attorneys, outside health care providers, disability companies, Social Security, and work comp designated doctors, as well as patient requests for bills and records

•Court and video deposition appearance to testify to the authenticity of the billing and medical records, as well as reasonableness of fees and charges

Skills

•Proficient Manager and Director with the ability to lead and motivate with positivity

•Excellent Servant Leadership Skills

•Expert Collector increasing revenue and profits

•Creative and innovative with the ability to bring out the best in employees

• Next step thinking and problem-solving skills

•Multi-tasker with attention to detail

•Project Management skills reaching time sensitive goals with success

•HIPAA Compliance

•Proficient Medical Biller with knowledge of ICD 10/CPT coding for personal injury treatment

•Proficient typist 75 wpm

•Effective written and oral communication Skills

•Ability to articulate in a clear, concise and professional manner

Professional References:

Mark Bean, owner of All Injury Rehab Clinics-972/746-7188

Charles DeMarque, MD, CEO/CMO of MDN Injury Clinic-682/444-0576

Edward DeHoyos- 817/455-1969

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