Alicia Woychik
Eau Claire,WI
Summary
I have 25-plus years of healthcare experience in various positions such as Leadership, Management, Medical Assisting, Billing, Auditing, Payment/Denial Trends, Authorizations, and Financial Counseling. I also have a combined total of 10 years of retail experience as a cashier, product promotions, customer service, financial booking, and HR duties such as resume reviews, interviews, onboarding, training, and time management. Methodical Revenue Cycle Specialist with strong attention to detail and in-depth understanding of billing procedures. Excellent planning and problem-solving abilities. Prepared to bring 26 years of related experience to a dynamic position with room for career growth. Demonstrated success in supporting and enhancing revenue cycles for medical and hospital facilities. Knowledgeable about debt management, collections policies and insurance payments. Good verbal and written communication skills.
Overview
11
11
years of professional experience
Work History
Revenue Cycle Specialist
Oakleaf Surgical Hospital
07.2023 - Current
- Insurance Biller – Commercial, Workman’s Compensation, and Federal
- Investigate denied claims: review clinical documentation, surgical notes, and laboratory results to prove medical necessity
- Review insurance carrier policies to confirm plan errors
- Appeal denials by submitting relevant supportive documentation to recover lost revenue
- Review denials with the authorization department to collaborate on preventing future denials and discuss resolutions
- Infusion Authorization Coordinator: Review Infusion orders, insurance eligibility, and authorization requirements and initiate prior authorization as required.
Financial Counselor
Sacred Heart Hospital
06.2019 - Current
- Investigate denied claims: review clinical documentation, surgical notes, and laboratory results to prove medical necessity
- Review insurance carrier policies to confirm plan errors
- Appeal denials by submitting relevant supportive documentation to recover lost revenue
- Review denials with the authorization department to collaborate on preventing future denials and discuss resolutions
- Review denial trends: Reviewed denials based on CPT codes to determine trends, or if the insurance carrier is denying outside of the facility contract
- Sort reports according to coding, coding errors, authorization errors, process errors, and revenue loss
- Presented trends to management while maintaining confidentiality
- Veteran review: Locate the Veteran’s eligibility and submit notifications with supportive documentation in order to have an episode of care approved quickly and efficiently
- Coordinate care with Veteran case worker to prevent gaps in treatment.
Kronos Clerk/Cashier
Festival Foods
06.2022 - 08.2023
- Cashier Wine & Spirits – June 2022 – Aug 2023
- Duties Include: Cashier
- Assist with Wine & Spirits complying with all policies, procedures, and laws
- Maintained appropriate inventory and ensured accurate pricing
- Provided customer service, answered the telephone, and assisted with special requests
- Addressed any and all concerns from guests and provided resolution
- Kronos Clerk – July 2022 – Aug 2023
- Duties Include: Payroll, applying attendance points, and tracking those in violation
- Prepared weekly reports from Business Intelligence
- Reviewed PTO hours and adjusted as necessary
- Reviewed schedules worked by Full Time Associates, Minor Violations, and Overtime
- Job Placement
- Training
- Employment Interviews.
- Utilized strong multitasking skills to manage multiple priorities and tasks, ensuring timely completion of each assignment.
- Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
Multiple Roles
United HealthGroup
01.2014 - 05.2019
- NEC Escalation Supervisor
- Specialist/Claims Representative Associate: Emphasis on Problem-Solving
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Claim and Clinical Research
- Critical Thinking
- Attention to detail
- Strong Communication Skills
- Ability to work independently
- Appeals and Grievances
- Deescalate Member/Provider/CMS/Insurance disputes
- Provide leadership to the customer service team as needed
- Research hospital, provider, and prescription claim inquiries such as denials, over/underpayments, and copay accuracy
- Reviewed benefits and eligibility for services by medical and hospital providers
- Well-versed with Medicare, Medicaid, Employer Group, and commercial insurance procedures
- Job Training
- Job Placement
- Interview those in line for promotions
- Collaboration
- Leadership
- Emphasis on Quality
- Analyze payment/pending/denial trends
- Collaborated with the implementation team in configuring the processing system for a newly acquired division through the creation of scenarios and procedural testing.
Education
M.B.A. - Healthcare Management
Capella University
Minneapolis12.2024
B.A. - Healthcare Leadership
Capella University
Minneapolis, MN02.2023
A.A. - Healthcare Administration
University of Phoenix
Dallas, TX08.2016
Skills
- Microsoft Outlook
- Operating Systems: Windows
Software:
- MS Word
- MS Access
- MS PowerPoint
- EPIC
- UKG
- Workday
- MS Excel (experience with charts, graphs, pivot tables, data analysis, and spreadsheets)
- Claims review
- Claims Processing Proficiency
- HIPAA Compliance
- Professionalism and Ethics
- Patient Registration
- Insurance Verification
- Paperwork management
- Verifying insurance
- Denial Management
- Medical Billing Expertise
- Analytical Problem Solving
- Accounts receivable management
- Managing records
- Financial Counseling
- Collecting payments
- Writing reports
- Medical Billing
- Insurance collaboration
- Analyzing claims
- Healthcare Finance Knowledge
Training
- HIPAA
- ADA & FMLA
- Conflict Resolution
- Benefits and Eligibility
- Social Security Benefit Enrollment
- Subrogation
- Workman’s Compensation
- Litigation
- CMS Guidelines
- Veteran Benefits and Eligibility
- Revenue Cycle Management
- Payment Negotiation
- Payroll
- Authorizations
- Claim Processing/Adjusting/Audits
- Recruitment
- Job placement
- Suicide De-escalation
- Data Analysis
- Trend Analysis
- Recruiting & Onboarding
- Time/PTO Adjustment
- Job Training
- Insurance Billing (UB04/HCFA1500)
Timeline
Revenue Cycle Specialist
Oakleaf Surgical Hospital
07.2023 - Current
Kronos Clerk/Cashier
Festival Foods
06.2022 - 08.2023
Financial Counselor
Sacred Heart Hospital
06.2019 - Current
Multiple Roles
United HealthGroup
01.2014 - 05.2019
M.B.A. - Healthcare Management
Capella University
B.A. - Healthcare Leadership
Capella University
A.A. - Healthcare Administration
University of Phoenix
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