Rivawn Butler
Kingwood,TX
Summary
Passionate healthcare professional dedicated to achieving exceptional patient outcomes by integrating financial clearance expertise and clinical excellence. Proficient in clinical documentation improvement, stakeholder relations, customer service, and problem-solving. Skilled in articulating complex ideas and fostering clear communication to drive optimal results. With a demonstrated track record of effectively acquiring and applying new skills.
Overview
18
18
years of professional experience
Work History
Benefit Support Specialist
Conifer Health Solutions/St. Luke’s Hospital
01.2020 - 02.2024
- Provided information on insurance benefits, payment options, outstanding balances, and patient billing or financial concerns
- Assisted patients in understanding eligibility for financial aid and navigating the application process, while obtaining essential financial details.
- Worked alongside various vendors to identify potential payment sources and assist in securing hospital funds.
- Ensured timely discharge planning and financial clearance by providing regular financial updates, and attending meetings with case management and finance for in-house patients.
- Ensured accurate completion of financial assistance calculation worksheets and submitted them for necessary approval.
- Managed and optimized various financial counseling services including extended payment arrangements, discounts, single case agreements, and case rates.
Managed Care Analyst
Texas Children’s Hospital
01.2014 - 01.2016
- Skilled in the coordination of benefits (COB), healthcare facility management, and professional healthcare processing.
- Advanced understanding of contract interpretation, fee schedules, and reimbursement methods
- Ensured accurate and compliant processing of Medicaid, Medicare, and Commercial High-Cost Outliner claims for a diverse client base.
- Analyzed and assessed a variety of carrier EOB statements and appeal statuses daily.
- Handled a daily workload of 50 claims, verifying accuracy and adjudication.
- Applied sound understanding of CPT, ICD-10, and HCPCS coding guidelines while utilizing comprehensive medical terminology expertise.
Provider Liaison Specialist
Our Lady of the Lake
01.2011 - 01.2014
- Worked closely with BRPH to identify areas for improvement in their outreach programs and recommended effective strategies.
- Engaged in collaborative efforts with various system functions involving physician offices, outbound referral systems, provider recruitment, and provider resources.
- Established and maintained positive ongoing communications with referring providers, their office staff, local community organizations, and businesses.
- Utilized evidence-based methods to achieve objectives in raising awareness, meeting targets, and fostering trust.
- Managed conversion of patient's medical records from paper to electronic format.
Patient Access Representative
Our Lady Of The Lake Hospital
01.2009 - 01.2011
- Implemented new intake procedure to streamline the admissions process, reducing staff time.
- Performed consistent EMR audits to maintain precise billing records.
- Collected 90% of copayments/deductibles.
- Documented clear, concise, and completed activities in EHR system for each account.
- Provided support to scheduling and insurance department by addressing referral inquiries and billing questions.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
Medical Records Clerk
Our Lady Of The Lake Hospital
01.2006 - 01.2009
- Retrieved, collected, and analyzed 70% of medical records made through the organization, patients, and affiliates.
- Ensured prompt reporting of breaches, non-compliance issues, patient complaints, and problems to supervisor to protect patient PHI.
- Verified legitimacy, accuracy, and authority of all requests and processed them for invoicing.
- Reviewed, developed, and implemented standards and procedures for processing medical records requests with administrative support.
- Responded to patient inquiries to provide information and details of medical records.
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Processed medical records requests from outside providers according to facility, state, and federal law.
Skills
- Clinical Documentation Improvement
- Stakeholder Relations
- Customer Service
- Problem-Solving
- Organizational Skills
- Analytical and Methodical
- Active Listening
Computers
- Microsoft Office 365
- Epic
- Citrix
- RTE
- Cerner
- Oracle
Professional Development
- Certified Community Health Worker, Texas Department of Health Services, 2020
- Certified Scrum Master, Scrum Alliance, 2020
Timeline
Benefit Support Specialist
Conifer Health Solutions/St. Luke’s Hospital
01.2020 - 02.2024
Managed Care Analyst
Texas Children’s Hospital
01.2014 - 01.2016
Provider Liaison Specialist
Our Lady of the Lake
01.2011 - 01.2014
Patient Access Representative
Our Lady Of The Lake Hospital
01.2009 - 01.2011
Medical Records Clerk
Our Lady Of The Lake Hospital
01.2006 - 01.2009
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