Results-driven Revenue Cycle Management professional with expertise in optimizing billing workflows and overseeing accounts receivable operations. Experienced in cash flow monitoring, claim resolution, and process improvement while ensuring compliance with payer requirements. Proven ability to foster positive team dynamics and motivate teams to achieve organizational goals.
Overview
14
14
years of professional experience
Work History
Supervisor – AR and Billing
Accanto Health
Saint Paul, MN
2022.11 - Current
Supervised daily accounts receivable operations, ensuring timely and accurate billing functions across the RCM department.
Monitored A/R performance to identify and address account or claim issues affecting revenue and cash flow.
Escalated cash flow concerns to leadership for prompt attention.
Investigated and resolved escalated patient inquiries with professionalism and clear communication.
Assisted in communicating coding and documentation updates to providers and clinic staff.
Supported hiring, onboarding, training, and performance evaluations for RCM personnel.
Managed office functions including account aging, reimbursement analysis, denial appeals, and account reviews.
Participated in continuous process improvement initiatives, identifying issues and educating staff to enhance operational outcomes.
Collaborated with cross-functional departments to resolve workflow issues, improving process efficiency.
Reviewed payer contracts to ensure compliance with billing and reimbursement requirements.
Provided regular updates to management regarding workflow disruptions or operational concerns.
Conducted weekly or biweekly 1:1 meeting with staff and leadership to support performance and communication.
Successfully managed multiple tasks simultaneously while maintaining accuracy and efficiency.
Revenue Cycle Supervisor
Med-Metrix
Parsippany, NJ
2021.06 - 2022.11
Organizes, directs, and monitors daily activities of Account Representatives as it relates to Insurance Follow-up/Revenue Cycle Management.
Monitors and analyzes productivity of Account Representatives, completes employee evaluations.
Distributed workload to team, monitored performance to ensure alignment with goals.
Monitored department KPIs and employee performance, adjusted plans to align with daily and monthly goals.
Establishes procedures, prepares, and coordinates schedules, and expedites workflow.
Conducted staff meetings to review performance metrics, address challenges, and promote continuous improvement.
Interviews, trains, motivates, and rewards Account Representatives.
Strengthened team relationships and effectiveness with hands-on and motivational approach.
Manages disciplinary personnel issues and escalates accordingly.
Assists with the implementation of policies and procedures necessary to comply with federal, state, and third-party regulations which govern billing and collection activities for physician services.
Performed root cause analysis to identify issues affecting revenue cycle performance, implementing corrective actions to drive improvement.
Provided subject matter expertise on reimbursement regulations, staying informed about industry best practices and compliance requirements.
Possesses and maintains thorough knowledge of the medical billing industry.
Revenue Cycle Supervisor
Pinnacle Revenue Management
Londonderry, NH
2015.08 - 2021.01
Oversee the billing and collections of claims for specialty billing for home infusion, suite infusion and DME.
Enhanced revenue cycle efficiency by implementing strategic process improvements and workflow optimizations.
Streamlined billing procedures for increased accuracy, reducing errors and improving overall collections.
Reduced accounts receivable days outstanding by streamlining collection efforts and collaborating closely with customers for prompt payments.
Performed root cause analysis to identify issues affecting revenue cycle performance, implementing corrective actions to drive improvement.
Managed team of up to 15 employees.
Appropriately delegate work to each employee based on skill set and capabilities.
Established processes based on client/team specific needs to ensure accuracy of workflow.
Developed training materials on home infusion, company expectations, and HIPAA compliance, enhancing employee understanding and adherence.
Regularly attend to team questions, reporting, and auditing of accounts receivable.
Monitored adherence to HIPAA standards to protect patient information.
Oversaw the yearly Risk Assessment for HIPAA compliance for the company.
Maintained employee HIPAA training records to ensure completion and currency, including onboarding training.
Reconciling month end reporting and accounting periods.
Developed office policies which included but were not limited to standard of conduct, bereavement, internet use.
A/R Representative
Southern New Hampshire Medical Center
Nashua, NH
2012.12 - 2015.07
Reduced outstanding A/R balances by promptly resolving billing disputes and discrepancies.
Managed follow-up on claims for inpatient and outpatient services, ensuring timely resolution.
Analyze insurance reimbursement or denials and adjust or appeal accordingly.
Uphold a high level of accuracy through regular review of aging reports, identifying errors or inconsistencies for immediate correction.
Maintained operational efficiency by adhering to established policies and procedures.
Serve and protect sensitive information by adhering to professional standards, company policies and procedures, federal, state, and local requirements and standards including HIPAA compliance.
Maintained client confidentiality while handling sensitive financial information and adhering to privacy regulations.
Participated in monthly educational activities to enhance professional skills and knowledge.
Billing Consultant – Project Lead
Sharon Hospital
Sharon, CT
2012.02 - 2012.12
Managed follow-up on Medicare claims to ensure timely resolution and payment.
Handling accounts 60 days and older for inpatient and outpatient claims.
Reduced errors in billing data entry through implementing automated validation checks.
Supported optimal revenue cycle management by analyzing trends within payer mix data and collaborating with leadership to develop strategic plans for improvement.
Increased cash flow by promptly submitting accurate claims to insurance companies for timely payment.
Reviewed contracts to identify revenue opportunities and inaccuracies affecting future billing cycles.
Enhanced revenue collection rates with proactive follow-up on overdue invoices and timely communication with insurance companies.
Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
Audited patient accounts to identify discrepancies in billed services, correcting errors to ensure proper reimbursement.
Advised senior management on improvements to Medicare billing process, enhancing efficiency and minimizing errors.
Established a remote home office to facilitate efficient workflow and communication.