Revenue Cycle Business Office

Kelly Smallwood

*** ******** **

Dawsonville, GA 30534

*****************@*****.*** C: 706-***-****

Central Business Office Director

I have 20+ year experience in the Revenue Cycle filed. Managed the CBO and Payor Enrollment Department. Ensured all the interfaces came across each morning for charges/demographics. Managed the day to day HOLDS in Athena and assigned out the AR Aging reports. Met weekly with weekly with CFO on Payor Enrollment applications on which providers were submitted and the ones that were pending information. Tracked application status from time applications submitted to the time the approval came in. Uploaded all Fee Schedules into Athena, Met monthly with physicians, CFO and VP of the company to go over all Revenue Cycle denials.

CORE COMPETENCIES

Accurate & Timely Filing Revenue Cycle Management

Revenue Cycle Denials Revenue Cycle Appeals on Denials

Monthly month end reports Quarterly Credit Balance Reporting

Daily Deposit Reconciliation Financial Reports for CFO

Patient Access Specialist PE Certified (Presumptive Medicaid)

EXPERIENCE

INCOMPASS HEALTH, CBO/PAYOR ENROLLMENT MANAGER, Alpharetta, GA 2022-Current

Managed team of 15+ employees for a physician billing company. We done all the billing for 15 hospitals and 4 Clinics in 8 different states. Responsible for all hiring and training of new employees. Managed the day-to-day functions of the CBO and ran all monthly reports and met with the physicians, CFO and VP to address denials and trends. Just currently got CPC certification and over see all the coding within in our office. Manage the coding denials for diagnosis and not medically necessary denials. Educate physicians on their denials due to their documentation. Administered policy and procedures for the CBO/Enrollment department. Set KPI for CBO and Enrollment department.

ARGOS, VA & GOVERNMENAL INSURANCE MANAGER, Agusta GA 2021-2022

Managed a team of 50 employees for Veterans Administration, Tricare and Governmental billing and AR Follow-Up. Acted as a client liaison between the company and clients. Ran weekly, monthly and year end reports. Distributed workflow according to client workflow. Monitored, tracked all trends within each location assigned to my team. Met bi-weekly with each client to go over denials and trends.

STEPHENS COUNTY HOSPITAL, REVENUE CYCLE MANAGER, Toccoa GA 2020-2021

Manage the day to day functions of the Business Office, Registration, HIM and Central Scheduling staff. Make sure that the claims are transmitted and billed on a daily basis. Responsible for monitoring the outstanding Accounts Receivable (A/R) as well as monitor the day to day mail/payments that come in from the insurance companies. Assisted staff with their A/R and ensure that every team member that reports to me stays on top of their continuation in education (we currently use Home Town Health online education) for staying up to date with the current changes in healthcare and insurances. Perform month-end close activities and ensure that any and all reports needed by the CFO are completed by day 1 after month end has closed. I monitor and submit all time for payroll. Stay up to date on all reconciliation balance sheets for the Business Office. Make sure the coding reports are done daily, weekly and monthly to ensure no breakdown in cash flow. Succeeded getting staff trained on the electronic billing system, posting and reconciling daily cash on a daily basis. AR days for unbilled were at 45 and was able to succeed in training department managers on getting charges entered in system timely and coding department coding within 3-4 days of discharge. AR was at $38 million and was able to get it down to $33 million within in the first 90 days. Implemented contract management and educated staff on how to read and understand insurance contracts.

HOLLIS COBB ASSOCIATE, Insurance Follow Up Manager, DULUTH GA 2019-2020

Responsible of the call floor center of 45+ employees working with 4 different clients on insurance follow up claims with appeals. Assisted with all staff training on insurance follow up as well as assisted with new client set up on vendor systems. During my employment led the team to get AR days down for buckets 120 and older. Got all claims for 2 clients reviewed and worked with resolutions within my first 90 days of employment. Due to this success this vendor gave us more AR to work. There was $5.8 million in collections of which we were able to collect and recover $2.4 million within 90 days of placement. Appeal rate success was at 96%.

NorthEast GA Medical Center, Variance Analyst Manager, Oakwood, GA 2017-2020

Responsible for management of 3 employees who worked Variance reports and appealed any claims that were underpaid according to the contracts.

CHESTATEE REGIONAL HOSPITAL, Business Office Director, Dahlonega GA 2004-2017

Business Office Director (Revenue Cycle Manager), 2008-Present

Manage the day to day functions of the Business Office, Registration and Central Scheduling staff. Made sure that all the claims are transmitted and billed on a daily basis. Monitored the outstanding Accounts Receivable (A/R) as well as monitor the day to day mail/payments that come in from the insurance companies. Assisted staff with their A/R and ensure that every team member that reports to me stays on top of their continuation in education (we currently use Home Town Health online education) for staying up to date with the current changes in healthcare and insurances. Perform month-end close activities and ensure that any and all reports needed by the CFO are completed by day 1 after month end has closed. Monitored and submit all time for payroll. Stay up to date on all reconciliation balance sheets for the Business Office.

Currently in transition to a new HIS System –Super user for the new system and am responsible for making sure all staff have been trained efficiently and effectively.

Supervised, trained and developed Business Office, Registration and Central Scheduling policy and procedures and made sure all staff is educated on them.

Revenue Cycle Manager Consultant, Envision USA, Atlanta GA 2014-2016

Offered a position with the corporate office for Chestatee Regional Hospital where I was outsourced to other hospitals who needed dire assistance. Assisted in reviewing their A/R and putting policy and procedures into place to assist with consistency with the flow of the Business Office to ensure the accounts were being billing accurately and in a timely manner. Trained new staff members on the billing systems and HIS system.

Business Office Account Representative (Business Office Cash Poster & Medical Biller) 2004-2008

Posted all the remit payments and contractual adjustments to the patients’ accounts on a daily basis as well as I had my own Account Receivable reports that I worked on a daily basis. Currently am experienced in billing for all payers including Medicare, Medicaid, Commercial and all Government. Worked my way up from Cash Poster to Billing Specialist of which I do have a certificate from Home Town Health University showing where I completed their billing and registration specialist classes and passed them both. Also started assisting in the Admissions/Registration area and became a top staff member for their area before being offered the Business Office Director position.

Implemented the policy and procedure for our Refund’s to the patient and insurance companies.

Trained all the new oncoming staff in Business Office and Registration

AR was at 85% of collections that had insurance payments on them within 30 days of billing claim. Upon my departure, there were only 14 claims in 120+ days AR aging that was due to back surgery procedures that were being reviewed by Medicare. Appeals were done and were pending payment .

Gateway Health & Rehab, Certified Nursing Assistant, Cleveland GA 2002-2005

Nursing Home setting where I would assist disabled and elderly patients with their ADL’s. mainly worked 11p to 7a shift.

Friendship Health & Rehab, Certified Nursing Assistant, Cleveland GA 2001-2002

Nursing Home setting of where I would assist disabled and elderly patients with their ADL’s, mainly worked 11p to 7a.

EDUCATION

CORNER STONE CHRISTIAN ACADEMY, Atlanta, GA

High School Diploma

CPC-A – (Certified Professional Coder) 2024

Home Town Health University, Cumming GA

Patient Access Certification

Patient Access Specialist

Age Specific Care

New Hire Employee Orientation (for all new hires within dept)

Managed Care History & Basics

Billing Pre-requisite

Health Insurance Basics

STRATFORD CAREER INSTITUTE, Atlanta, GA

Business Management Degree – Graduated 1/28/2017

COMPUTER COMPETENCIES

Excel, CPSI, EPIC, ADP Payroll, Power Point, Microsoft Word 2010, HMS, Razor & M Systems (Morris Systems), Quadax, SSI, Ability & Availity (All insurance web portals)

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