Cennedy Padilla
Wittmann, AZ
Summary
Detail-oriented Revenue Cycle Specialist skilled in billing compliance, revenue analysis, and coding accuracy. Proven ability to streamline processes and enhance communication with clinical teams for improved reimbursement outcomes.
Overview
7
7
years of professional experience
Work History
Revenue Cycle Specialist
VillageMD
Phoenix
07.2021 - Current
- Managed patient billing processes to ensure timely and accurate collections.
- Reviewed claims for compliance with regulatory guidelines and company policies.
- Coordinated with insurance providers to resolve billing discrepancies and issues.
- Analyzed revenue cycle performance metrics to identify areas for improvement.
- Collaborated with clinical teams to optimize documentation for reimbursement purposes.
- Processed appeals related to denied or rejected claims in a timely manner.
- Collaborated with other departments to resolve customer inquiries regarding billing issues.
- Contacted insurance providers to check patient coverage.
- Audited payments from third-party payers to ensure accuracy of reimbursement amounts.
- Researched discrepancies on unpaid invoices and reconciled them.
- Compiled data into weekly and monthly reports outlining performance metrics related to revenue cycle activities.
- Analyzed revenue discrepancies to ensure accurate billing and coding compliance.
- Prepared reports on revenue cycle performance for management review and strategic planning.
- Engaged with external auditors to facilitate timely financial reviews and compliance checks.
- Responded promptly to inquiries from external auditors concerning billing matters.
- Reviewed charge capture accuracy and identified opportunities for improvement.
- Provided support in the development and implementation of revenue integrity processes, policies, and procedures.
- Maintained current knowledge of Medicare and Medicaid reimbursement rules and regulations.
- Performed detailed analysis of financial statements to identify areas of potential revenue leakage or underpayment from third-party payers.
- Monitored changes in insurance coverage guidelines, industry best practices, and regulatory requirements related to revenue integrity.
Medical Coding Specialist
Hatfield Medical Group
Mesa
02.2019 - 07.2021
- Reviewed medical records for accurate coding and compliance with regulations.
- Utilized coding software to translate diagnoses and procedures into codes.
- Maintained up-to-date knowledge of coding guidelines and industry changes.
- Conducted audits of coded data to ensure accuracy and integrity of information.
- Communicated with insurance companies regarding claim submissions and rejections.
- Participated in continuing education programs related to medical coding procedures.
- Developed a thorough understanding of CPT and HCPCS codes and modifiers used in the healthcare industry.
- Utilized Level 1 HCPCS and Level 2 HCPCS systems to complete coding tasks.
- Ensured timely submission of all claim forms according to established deadlines.
- Researched and resolved coding issues identified by auditors.
- Collaborated with medical staff to clarify diagnoses or treatments when necessary.
Education
High School Diploma -
Youngker High School
Buckeye, AZ05-2012
Skills
- Revenue cycle management
- Claims processing
- Medical coding
- Compliance auditing
- Data analysis
- Healthcare regulations
- Charge capture accuracy
- Insurance coordination
- Customer service
- Team collaboration
References
References available upon request.
Timeline
Revenue Cycle Specialist
VillageMD
07.2021 - Current
Medical Coding Specialist
Hatfield Medical Group
02.2019 - 07.2021
High School Diploma -
Youngker High School