RCM

DESIREE HAWKINS

Columbia, SC • Remote Ready

803-***-**** • ️ *********@*******.***

PROFESSIONAL SUMMARY

Revenue Cycle Manager with 10+ years of experience driving denials reduction, payer strategy, and financial performance in remote healthcare environments. Proven ability to recover revenue, strengthen documentation integrity, and lead high performing teams through data driven decision making. Skilled in appeals, root cause analysis, coding accuracy, workflow automation, and payer collaboration. Recognized for building scalable QA programs, implementing KPI dashboards, and improving operational efficiency. Currently pursuing CPC certification to deepen coding and reimbursement expertise.

KEY ACHIEVEMENTS

Reduced denials by 25%, generating $1.2M in annual savings and recovering $3M in receivables.

Achieved 98% coding accuracy, minimizing payer disputes and improving documentation quality.

Increased team retention by 20% through coaching, training, and performance development.

Implemented KPI dashboards and workflow automation, reducing turnaround times by 15%.

Built a QA program that improved compliance by 30% across billing and documentation workflows.

CORE COMPETENCIES

Revenue Cycle Optimization • Denials & Appeals Strategy • Payer Relations • Contract Negotiation • ICD 10/CPT Coding Accuracy • Documentation Integrity • A/R Recovery • Root Cause Analysis • KPI Reporting • Workflow Automation • Remote Team Leadership • Compliance & HIPAA • Training & Staff Development

LEADERSHIP HIGHLIGHTS

Led distributed billing, coding, and compliance teams with a focus on accuracy, accountability, and continuous improvement.

Developed training programs that strengthened denial prevention, documentation quality, and coding accuracy.

Fostered cross department collaboration with clinical, billing, and payer teams to resolve complex issues.

Built a culture of transparency, performance ownership, and operational excellence.

PROFESSIONAL EXPERIENCE

Medix (Contract for Providers Resources, Inc – PRI) – Remote

Health Insurance Specialist – IDRE (No Surprises Act)

02/2026 – Present

Supporting compliance and resolution processes under the No Surprises Act for health insurance claims.

Managing IDRE (Independent Dispute Resolution Entity) workflows to ensure timely and accurate dispute handling.

Collaborating with payer and provider teams to resolve complex insurance issues and maintain regulatory compliance.

Utilizing strong knowledge of health insurance regulations and dispute resolution strategies to improve operational efficiency.

Ensemble Health Partners – Remote

Spec 1, Customer Services

07/2023 – 09/2024

Provided high quality support for complex billing, claims, and account inquiries across multiple EMR/EHR systems.

Collaborated with cross functional teams to streamline workflows and improve operational efficiency.

Ensured strict adherence to HIPAA and organizational compliance standards.

Marsh Counseling & Consulting, LLC – Remote

Program Manager, Dual Diagnosis Program (Revenue Cycle & Denials Operations)

03/2014 – 11/2025

Reduced claim denials by 25% through targeted appeals, payer escalation, and root cause analysis.

Recovered $3M in aged receivables and generated $1.2M in annual savings by optimizing denial workflows.

Achieved 98% coding accuracy, improving documentation integrity and reducing payer disputes.

Directed and coached a remote team, increasing retention by 20% and elevating performance across RCM functions.

Designed and implemented automated KPI dashboards, reducing turnaround times by 15%.

Established a comprehensive QA program that improved compliance by 30%.

Negotiated payer contracts to reduce disputes, accelerate reimbursement, and improve financial outcomes.

Developed and delivered virtual training sessions on denial management, compliance, and workflow optimization.

SYSTEMS & TOOLS

Epic • Cerner • Meditech • Athenahealth • Availity • Waystar • SharePoint • Teams • Zoom • Excel (Pivot Tables, VLOOKUP) • KPI Dashboards • Workflow Automation Tools

SPECIALTIES

Denials Prevention • Appeals Strategy • Payer Escalations • Coding Accuracy • Documentation Review • Revenue Leakage Reduction • A/R Recovery • Compliance Monitoring • Process Improvement

CERTIFICATIONS

CRCR – Certified Revenue Cycle Representative (HFMA), 2024

Diploma in Medical Billing & Coding, 2024

CPC Certification – In Progress

Medical Assistant Diploma, 2022

PROFESSIONAL DEVELOPMENT

HFMA Revenue Cycle Training • Ongoing payer policy education • Coding guideline updates • RCM automation and analytics training

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