Healthcare

Kim Riozzi

**B Justin Way

Jackson NJ *****

732-***-****

***.******@*****.***

Summary

Highly organized with a commitment to teamwork. Experience as a Sales Account Executive/Revenue Cycle Manager and Director of Physicians Billing Services. Knowledge of Medical claims, medical cost containment and care management solutions to payers of medical claims for automobile, workers’ compensation, self pay and disability insurance claims.

Work Experience

McKesson Provider Technology, Somerset NJ –2004- 2006

Revenue Cycle Operations/Account Manager for Brigham and Women’s Hospital Surgery Department.

 Responsible for multiple specialties within the Department of Surgery.

 Budgets, staffing, payroll and PTO.

 Improve and ensure increase of cash flow.

 Handling of hiring, training, job descriptions, yearly reviews and seminars for staff.

 Correct registration, charge entry and payment posting.

 Work with office’s to ensure correct front-end procedures

 . CPT, ICD-9 coding, collections, billing and working with insurance carriers.

Bayshore Community Health Services, Holmdel NJ 2003-2004

Director of Physician’s Billing Services

 Responsible for Medical Claims Billing and front end Offices for 11 practices specialties included: Orthopedics, General Surgeons, Plastic surgery, Ambulatory Facility, Internal Medicine, Physical therapy Rehabilitation and wellness centers, Wound Care Center, Mammography and Diagnostic centers In-patient and out-patient billing and Senior Nursing Facility.

 Development and Implementation of office and billing procedures

 Restructuring of department, hiring, training, job descriptions and workflow

 Responsible for day-to-day management

 QA

 Maintained and created budget

 Oversee front-end functions i.e.: registration, insurance verification, pre-certification and charge entry.

 Financial and operational responsibilities

 Direct contact with clients

 Electronic Billing

 Third party billing regulations

 UB92, HCFA and Medicare/Medicaid forms

 Increased revenues by 45%

 Set up new physicians that join practices

 Interface with CFO, Senior VP of management, Medical Director and Physicians

 Credentialing

 Budgets

 Contracted outside vendors and collection agencies

 Knowledge of HIPPA, JCHAO and OSHA compliance

 Responsible for staff personnel records, payroll, PTO and evaluations

 Involved with medical records in a Hospital setting

Concentra (Formerly National Healthcare Resources) Woodbridge NJ 1998-2003

National Account Executive

 Selling and Managing services such as Independent Medical Evaluations (IME), Medical Peer Reviews, Diagnostic testing and Radiology reviews, pre-certification, utilization, field and telephonic case management, DME, bill auditing to all provider network panels to payers of all medical claims.

 Recovered $350,000 in delinquent accounts receivables over 3-month period.

 Handled Requests for proposals (RFP)

Medical Diagnostics Associates, Springfield NJ

1995-1998

Billing and Collections Manager

 Oncology, Hematology and Infectious Disease. Responsible for all explanation of benefits (EOB) Posting payments with knowledge of fee schedule capitation, adjustments for Co-insurance, disallowed amount and deductibles.

 CPT and ICD-9 coding, Precertification for office and hospital procedures. Direct coordinator with insurance companies for reviewing of claims with detailed follow up. Knowledge of Medical Manager software, Practice Management systems and Execuflow.

Neptune Orthopedics

1990-1995

Billing and Collections Manager

 Managed Accounts receivables. Specializing in Workers’ Comp, PIP, HMO and Indemnity plans.

 Arranged financial plans with patients, attorneys and Insurance Companies.

 Handling all disability forms and legal correspondence.

 Scheduled surgery. Pre-admission testing and precertification.

 Coordinate the surgeon’s on Workers’ comp and PIP panels.

Citicorp Credit Services, Shrewsbury NJ

1988-1990

Credit Analyst

Administrate and direct credit and collection staff. Adjust MasterCard/Visa Accounts and customer credit ratings while reviewing credit procedures in the Customer Service and Collections Department.

Education

Brookdale Community College- Business 1987

Lincroft NJ

Software- IDX and Medical Manager

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