Microsoft Office, Sharepoint, Smartsheet
Resume:
Sheryl A. Clark, CPC
***** ******** ****, ********* **, 44095
*********@*****.***
Objective: I am seeking a new position that makes use of the knowledge and skills that I have previously acquired, along with offering an intellectual challenge and opportunities for advancement in new career opportunities. Qualifications: Extensive financial medical billing background. Proficient in the following areas: CPT / ICD-10 Coding, Resolute/EAPM, Epremis, EPIC, Microsoft Word/Excel/PowerPoint, Outlook, Financial Dashboards, Softmed. Compliance Database, PowerPoint, Craneware, 3M, Encoder. Possess excellent verbal and written skills.
Positive skills in presenting and educating.
Education: Graduate of Midview High School 1990 – High School Diploma Employment: April 22, 2019 to October 29, 2025 – Cloudmed R1
* Physician Rules Architect Lead / Manager
*Leading Meetings and Projects
*Vendor Relations
*Reporting
*Training New Hires
*High Volume Report Review
*Rule/Category Reviews
*Rule Clean Up Review
*Trending of Rule Hit Rates
* Review New Yearly CPTs/HCPCS/Anesthesia
*Quarterly (HCPCS)
*New Rule Build
*Category/Rule Edit Completion
*Category Mapping
*Other Assigned Requests/Projects
November 5, 2018 to April 9, 2019 Metrohealth Medical Center
*Senior Financial Clearance Specialist
*All Surgical Specialties
*Coding All Surgical Specialties
* Authorizations Surgical Cases
January 16, 2018 to September 7, 2018 Cleveland Clinic Health System
*Revenue Cycle Business Partner
*Glickman Urology & Kidney Institute
*Endocrinology & Metabolic Institute
*Pathology/Laboratory/Molecular Institute
*Regional Operations
*Digestive Disease & Surgical Institute
*Head & Neck Institute (including Dental)
• Leading Meetings and Projects
• Reporting
• Lead Compliance Support
• Denial Management
• Coding/Billing
Professional
Technical in Provider based setting
• Provider Credentialing / Enrollment
• Onboard New Practice Acquisitions
• Physician Education and Training
o New Policies
o Coding Compliance
o Documentation
o Charge Capture
• Trending of Denials
• Implementing new processes
• Other Assigned Requests and Projects
August 10, 2015 to January 15, 2018, Cleveland Clinic Health System (Head & Neck Institute) August 12, 2012 to January 15, 2018, Cleveland Clinic System (Digestive Disease and Surgical Institute)
*Institute Reimbursement Manager / Compliance Officer
• Reimbursement Management
o Charge Capture
o Denial Management
o Coding / Billing (Office / Provider Based)
Coding Surgical Specialties
o Surgical Optime
o CASS Charge Entry
o Manual Entry Charge Entry
o Epremis HB/PB Claims
o Resolute/EAPM
Surgical
Charge Capture
Follow up / Edits
Revenue Integrity
• Institute Compliance Officer
• Leading Meetings and Projects
o Institute Town Hall
o PMDsoft Charge Capture
o Committees
Compliance
FPPR (First Pass Payment Rate)
Denial Management
o Engagement Advisor
o EAPM Support
• Physician Education and Training
o New Policies
o Coding Compliance
o Documentation
o Charge Capture
• ICD 10 Admin Support
• Provider Credentialing / Enrollment
• Onboard New Practice Acquisitions
• Other Assigned Requests and Projects
July 1, 2009 to August 12, 2012, Cleveland Clinic Health System (The Lorain Institute)
*Divisional Reimbursement Manager / Compliance Officer / Multi Specialty
• Managing Clerical / Financial Employees
• Reimbursement Management
• Corporate Compliance
• Physician Education
• Leading Meetings and Projects
• Managing Provider Based Billing
• PMDsoft (Electronic Charge Capture via iPhone/Android)
• Denial Management
• Other Assigned Requests and Projects
September 2007 to July 2009, Cleveland Clinic Health System (The Lorain Institute)
*Revenue Cycle Specialist
• Reporting
• New Provider Education
o New Policies
o Coding Compliance
o Documentation
o Charge Capture
• Auditing
• Review of all Specialty Charge Tickets
• ICD9 / CPT / HCPCs coding
• Insurance Follow up on all payors
• Coding of Inpatient Charges
• Other Assigned Requests and Projects
December 2005 to September 2007, Cleveland Clinic Foundation,
(Financial Reporting, Systems & Quality)
*Work Leader
• Coordinating Meetings and Projects
Pt / Insurance Refund Downloading/Processing/Posting/Reviewing Reviewing Reports
1. Episode Assignment Daily Detail
2. HBO Error Master
3. Refund Tracking
Registration Issues
1. Discharge Dates
2. Duplicate ID’s
3. Pt information
HBO / SMS Balancing
Signature Semi-Annual Testing
Time / Attendance Updating
Olie Posting (Refunds/Adjustments)
HBO Automated posting (Refunds/Adjustments)
Clinical Research Memo Account Resolutions
Implementing new processes
1. Clinical Research Adjustment Form
2. HBO Charge Correction Database
Other: Assigned Requests or Projects
August 2004 to December 2005 the Cleveland Clinic Foundation (RMP, Physician Billing Department)
• Insurance follow up – all payors
• Customer service
• Other: Assigned Special Projects, Trending
March 2000 – January 2004, Kase & Speelman M.D.s Inc (Family Practice)
* Medical Billing Manager
January 2003 – April 2004, Mukesh C. Bhatt M.D. (Oncology/Hematology)
*Medical Billing Manager
• Updating / Implementing policies
• ICD9 / CPT / HCPCs coding
• HCFA / EMC insurance billing all payors
• Payment Posting
• Insurance follow up all payors
• Handling all Workers Compensation Claims
• Referrals
• Patient statements
• Inpt / Outpt charge entry
• Front Desk / Check out desk
• Customer service
January 1998 – March 2000, Elyria Professional Services
(Internal Medicine, Pediatrics, OB/Gyn, Family Practice, BWC, Orthopedics)
• ICD9 / CPT / HCPCs coding
• HCFA / EMC Insurance billing all payors
• Insurance follow up all payors
• Payment posting
• Patient statements
• Collections
• Customer service
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