Summary
Overview
Work History
Education
Skills
Professional Accomplishments
Timeline
Generic

Alvin Bacilio

Washington,DC

Summary

To join a reputed organization where I can utilize my two decades of medical billing and management experience by transitioning into the legal industry as the manager of billing. A strategic, problem-solver who envisions smart solutions and executes with urgency across all levels of the organization.

Manage, train, and develop a team of 20 direct reports and 3 team leads including hiring, and annual evaluations. Conducted staff development training, including orientation, in-service education, staff evaluation, directed and monitored organizational performance improvement activities, assisted in setting budgets, establishing reserves, approving, and maintaining expenditures. Optimized productivity within department processes by helping to establish goals, productivity metrics that best utilize personnel and by encouraging communications to maximize reimbursement. Developed departmental policies and procedures regarding, registration, cash posting, billing and collection practices to create structure and enforce uniform standards in the department. Reviewed and updated contracts to ensure billing compliance; negotiated and make sure reimbursement rates are current; recommended policy changes in additions to enhance service levels and cost savings. Conducted meetings with department leaders and outside venders via conference call or face to face to discuss on issues affecting the agency, negotiate and collect on payments resulting in reimbursement delays and ensured promptly payments. Responsible for fiscal planning, budgeting, and management of operations under established fiscal parameters, and ensuring the organization is following all applicable federal, state, and local laws. Software Experience: eClinical Works (eCW), All scripts, RealMed/Availity, GE/IDX, Cerner, EZ Invoices, Solution One, Dezine, Pro-Data, and CBSI. Computer Proficiency – developed and implemented Statistical Ad-hoc reports, Microsoft Office Suite, Quattro Pro, TSO/Mainframe, and Windows GUI Front End. Fluent in English and Spanish.

Overview

16
16
years of professional experience

Work History

MEDICAL BILLING SUPERVISOR

Unity Healthcare
02.2023 - Current
  • Lead and manage a team of 10 billing specialists, providing guidance, support, and training as needed
  • Oversee the entire billing process, from claim submission to payment collection, ensuring accuracy, timeliness, and compliance with relevant regulations
  • Monitor and analyze billing data to identify trends, issues, and areas for improvement, and implement necessary changes to optimize billing operations
  • Collaborate with other departments, such as coding and finance, to resolve billing-related inquiries, discrepancies, and issues
  • Develop and enforce billing policies and procedures to ensure adherence to industry standards and regulations
  • Stay updated with changes in medical billing regulations, coding guidelines, and insurance policies, and ensure that the team is trained accordingly
  • Conduct regular audits of billing processes and records to identify and rectify errors, discrepancies, and potential areas of non-compliance
  • Generate and analyze billing reports to assess team performance, identify areas for improvement, and provide recommendations for increased efficiency and productivity
  • Participate in meetings and communicate with management and stakeholders to provide updates on billing operations, challenges, and achievements
  • Maintain confidentiality of patient records and sensitive billing information, ensuring compliance with HIPAA regulations

REVENUE CYCLE MANAGER

CCI Health and Wellness Services
03.2021 - 11.2022
  • Manage the day-to-day Revenue Cycle operation of the Central Business Office (CBO) by maintaining working knowledge and compliance of relevant billing regulations from State and Federal programs
  • Review the revenue cycle process guidelines, created monthly financial reports of all outstanding charges summarizing accounts status to ensure all reimbursement opportunities are capture, and maintain compliance with local and federal regulations
  • Maintain fee schedule updated, captured all charges to make sure payments are obtain according to medical billing guidelines of state, federal, and local guidelines
  • Design and implemented billing processes, Quality Review (QR), staff productivity, and review Key Performance Indicators (KPI) metrics to track and maximize reimbursement

PATIENT ACCOUNT MANAGER

GW Medical Faculty Associates (MFA)
05.2017 - 11.2019
  • Company Overview: Addison Group
  • Manage the Accounts Receivable (A/R) for over 700 physicians and fifty-two (52) specialties with satellite offices in Prince George’s County, Montgomery County, and Northern Virginia, totaling over $60 million in charges each month, including credentialing, denial management, patient account follows up and supervise over 20 employee and 3 team leads
  • Analyze top denials for each specialty and identified solutions to increase cash and reduce A/R days
  • Coordinate efforts across departments to decrease billing errors and increased revenue, working closely with the billing & collections department to determine opportunities to improve revenue
  • Maintain a strong relationship with all department specialty managers, review trends monthly, and discuss the implementation of an action plan on how to correct the issues
  • Overhauled policies and procedures to eliminate gaps and standardize processes
  • Addison Group

PATIENT REVENUE MANAGER

Clinica del Pueblo (FQHC)
10.2015 - 04.2017
  • Managed the agency's daily revenue cycle operation through efficiently coordinating the billing and collections operations, charge entry, patient registration and effectively managing all accounts receivable and ensuring departmental goals are met
  • Maintained knowledge of reimbursement changes of the Center for Medicare and Medicaid Services (CMS), commercial and third-party insurance billing regulations, and distribute the information among the department staff
  • Developed, and implement all policies and payment methodologies related to the agency and manage care payers
  • Provided on-going feedback to providers concerning service performance, conducted patient chart reviews by maintaining quantifiable monitoring of providers coding, billing, and collection activities and providing information regarding production and accuracy to the agency Director every month
  • Created monthly financial reports of all outstanding account balances, month-end reconciliation reports, and maintained all billing software files update as needed
  • Assisted the Human Resources Department with the credentialing process of all new physicians

OPERATION DIRECTOR

Lillie’s in the Valley Private Duty Services, L.L.C.
04.2012 - 09.2015
  • Directed the company's day-to-day operations to achieve the mission of the agency and meet strategic and financial goals
  • Recruited, employed, and retained qualified personnel to maintain appropriate staffing levels and ensure staff development including orientation, in-service education, continuing education, staff evaluation, directed and monitored organizational performance improvement activities
  • Assured skilled nursing and other therapeutic services furnished are under the supervision and direction of a physician or an RN
  • Planned for future resources needed, estimated short- and long-range personnel, budgetary, space, and equipment needs, and assisting in the implementation and oversight over new resources
  • Supported the organizational goals by providing internal financial reporting that include, organizational revenue/expense and balance sheet reports, development, and monitoring of organizational and contract budgets
  • Responsible for fiscal planning, budgeting, and management of operations under established fiscal parameters, and ensuring the agency is following all applicable federal, state, and local laws and regulatory agencies

BILLING MANAGER

Total Care Services
02.2009 - 10.2013
  • Managed, coordinated, planned, and organized the Business Department daily revenue cycle operation, maintaining knowledge in the areas of billing, collections, reimbursement, processed invoices and follow-up on all delinquent accounts over 180 days
  • Supervised four (4) employees
  • Monitored employee performance and provides annual evaluations as prescribed by company policy; set performance goals and ensured staff are meeting agency goals; made recommendations on disciplinary actions, hiring, firing, and relocation of duties
  • Revamped the business department by implementing a new billing and collection process from billing paper invoices to electronic invoice submission, which reduce invoices processing time from sixty (60) days to fourteen (14) days, saving the agency 60.5 hours a week of employee overtime, maintained submission errors below 5%, and increased the agency annual revenue from seven (7) million to twelve (12) million
  • Served as an expert analyst in the assessment and improvement of program effectiveness, and the improvement of complex management processes

Education

Master of Human Services -

Lincoln University
Lincoln University, PA

Operation of Medisoft Patient Accounting Certificate -

Medisoft Graduate Training Course
Baltimore, MD

Medisoft Patient Accounting and Electronic Invoice Submission Certificate -

Medisoft
Baltimore, MD

Medical Billing Specialist Certificate -

Prince George’s Community College
Largo, Maryland

Patient Accounting and Electronic Medical Invoices Reimbursement Certificate -

Wheeler Communication
Washington, DC

Spanish Bilingual Certification/OPI Rating of Advance - High -

Language Testing International
Virginia Beach, VA

Diploma in Business with Major in Accounting -

Jose Guardia Vega

Skills

  • Team leadership and supervision
  • Revenue performance
  • Strong empathy
  • Budgeting and planning

Professional Accomplishments

  • Revamped the business department by implementing a new billing and collection process from billing paper invoices to electronic submission, which reduce the invoices processing time from 60 days to 14 days, saving the agency 60.5 hours a week of employee overtime, increasing collection to 90%, maintained submission errors below 5%, and increased the agency annual revenue from 7 million to 12 million.
  • Assisted in the implementation and integration of a new billing software which included the addition of the Electronic Medical Record (EMR) in the software; as part of the planning committee, assisted with scheduling meetings for various departments and participated in the day-to-day operation from start to the go live date. Served as the system administrator.
  • Conducted personnel analysis that led to the reduction of employee turnover from 60% to 5% by implementing a training and incentive program for staff, and increased department performance by 90%.
  • Reduced AR days from over 180 days to 45 days by simultaneously increasing AR collection by 80% and reduced patient complaints to 2% per month.

Timeline

MEDICAL BILLING SUPERVISOR

Unity Healthcare
02.2023 - Current

REVENUE CYCLE MANAGER

CCI Health and Wellness Services
03.2021 - 11.2022

PATIENT ACCOUNT MANAGER

GW Medical Faculty Associates (MFA)
05.2017 - 11.2019

PATIENT REVENUE MANAGER

Clinica del Pueblo (FQHC)
10.2015 - 04.2017

OPERATION DIRECTOR

Lillie’s in the Valley Private Duty Services, L.L.C.
04.2012 - 09.2015

BILLING MANAGER

Total Care Services
02.2009 - 10.2013

Operation of Medisoft Patient Accounting Certificate -

Medisoft Graduate Training Course

Medisoft Patient Accounting and Electronic Invoice Submission Certificate -

Medisoft

Medical Billing Specialist Certificate -

Prince George’s Community College

Patient Accounting and Electronic Medical Invoices Reimbursement Certificate -

Wheeler Communication

Diploma in Business with Major in Accounting -

Jose Guardia Vega

Master of Human Services -

Lincoln University

Spanish Bilingual Certification/OPI Rating of Advance - High -

Language Testing International
Alvin Bacilio