Anita Perez, CPC
Aliso Viejo,CA
Summary
Experienced Revenue Cycle Director with 19+ years of expertise in leading administrative and clinical revenue integrity functions. Skilled in driving the enhancement of patient services and revenue management. Demonstrates deep understanding of process improvement, analytics, and regulatory guidelines. Proficient in EPIC and Certified Procedural Coding. Strategically applies data analysis and innovative revenue management practices to consistently achieve efficiency improvements and financial health enhancements. Sets new standards for operational excellence. Experienced with strategic planning and project management. Utilizes leadership skills to drive team performance and operational excellence. Track record of delivering high-impact results through innovative problem-solving and effective communication.
Overview
20
20
years of professional experience
Work History
Director of Specialty Coding and Charge Capture
R1 RCM
07.2024 - Current
- Transitioned to R1 through position at Providence St Joseph Health
- Oversee coding and charging for Cardiovascular Lab and Interventional Radiology services across 23 Providence Hospitals
- Lead a team responsible for high-volume, complicated procedures, ensuring accuracy and compliance
- Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
Director of Specialty Coding and Charge Capture
Providence St. Joseph Health
12.2021 - 07.2024
- Managed two charging departments with over 45 staff members
- Provided oversight for charge capture of ED levels, procedures, infusion/injections, and observation services
- Provided coding and charging support for Cardiovascular Lab and Interventional Radiology services across 23 Providence Hospitals
- Focused on consistent training, productivity metrics, and coding accuracy
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements.
Director of Revenue Cycle Management
Behavioral Health Works, Inc.
07.2020 - 12.2021
- Managed and trained a team of collection representatives, billers, authorization coordinators, and the credentialing department.
- Implemented new billing and collections practices, increasing collections and timeliness of claims submissions.
- Implemented bots for payment posting, claims creation, and statement generation.
- Improved cash flow management, reducing outstanding accounts receivable balances.
Charge Description Master Consultant
Kaiser Permanente
01.2020 - 07.2020
- Company Overview: through Mastech Digital.
- Assisted with pricing WQ for HB and PB charges.
- Managed client relationships through regular check-ins and updates on project progress.
- Verified coding, EAP development, and department training.
- Evaluated client needs and expectations, establishing clear goals for each consulting engagement.
Credentialing Manager
Forefront Telecare
04.2019 - 10.2019
- Implemented MDStaff credentialing software and created workflows for credentialing new mental health providers.
- Maintained up-to-date knowledge of industry regulations, ensuring ongoing adherence to best practices in provider credentialing.
- Reduced processing times for credential applications by optimizing workflow efficiency and staff allocation.
Manager - Charge Capture
Providence St. Joseph Health
11.2015 - 04.2019
- Developed a new department for charge capture for ED, Infusion, and Observation services.
- Managed and trained 23 employees, creating training programs for new and existing staff.
- Controlled costs to keep business operating within budget and increase profits.
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
Manager - Billing Operations
Health Essentials, LLC
04.2015 - 10.2015
- Managed billing operations and cash control for a medical group
- Developed processes for daily billing operations, overseeing six employees and over 60 physicians
- Accomplished multiple tasks within established timeframes.
Billing Manager
UCI-University Head & Neck Surgeons, Plastic Surgery Associates
05.2005 - 06.2014
- Managed all business functions for eight ENT physicians and five plastic surgeons
- Oversaw coding, revenue management, staff training, and compliance with university, federal, and state mandates
- Reviewed billing problems, researched issues, and resolved concerns.
- Managed seven employees: charge capture, payment posting, and five collections representatives
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Turned around a department that had to refund tens of thousands of dollars to Medicare due to improper billing and coding, passing audits every year
- Implemented policies that improved accounts receivable collections, resulting in reduced outstanding balances and increased cash flow.
- Reduced A/R days from an average of 120 to 53 and lag days from 15 to 3
- Managed average charge capture of $1,000,000 per month and average collections of $550,000
Education
Bachelor's Degree - Health Administration Management
National American University
02.2016
Certification - Lean Six Sigma Black Belt
SNHU
05.2024
Skills
- Revenue Cycle Management
- Process Improvement
- Data Analysis
- EPIC
- Certified Procedural Coding
- Healthcare Billing Systems
- Automation Implementation
- Cross-Functional Collaboration
- Training and Mentoring
- Relationship building
- Verbal and written communication
- Decision-making
Accomplishments
- Increased collections by 20% through new billing practices at Behavioral Health Works, Inc.
- Successfully transitioned coding and charging operations to R1 RCM, maintaining high accuracy and compliance.
- Implemented automation solutions that reduced payment posting time by 30%.
Timeline
Director of Specialty Coding and Charge Capture
R1 RCM
07.2024 - Current
Director of Specialty Coding and Charge Capture
Providence St. Joseph Health
12.2021 - 07.2024
Director of Revenue Cycle Management
Behavioral Health Works, Inc.
07.2020 - 12.2021
Charge Description Master Consultant
Kaiser Permanente
01.2020 - 07.2020
Credentialing Manager
Forefront Telecare
04.2019 - 10.2019
Manager - Charge Capture
Providence St. Joseph Health
11.2015 - 04.2019
Manager - Billing Operations
Health Essentials, LLC
04.2015 - 10.2015
Billing Manager
UCI-University Head & Neck Surgeons, Plastic Surgery Associates
05.2005 - 06.2014
Certification - Lean Six Sigma Black Belt
SNHU
Bachelor's Degree - Health Administration Management
National American University