Chelsea Moore
Levelland,USA
Summary
Dynamic and detail-oriented Director of Revenue Cycle Management with over 12 years of experience in healthcare finance and operations. Proven expertise in leading high-performing teams, optimizing billing processes, and ensuring regulatory compliance, complemented by a strong command of ICD-10 and CPT coding, insurance verification, authorizations, referrals, and comprehensive revenue cycle management. Demonstrated ability to spearhead initiatives that enhance operational efficiency and minimize denials while fostering collaboration across departments to drive quality improvement in hospital settings. Open to relocation and authorized to work in the U.S. for any employer, committed to excellence and a results-driven approach to every challenge.
Overview
12
12
years of professional experience
Work History
Director of Billing
24 Karate Health Solutions
Lubbock, TX
02.2025 - Current
- Managed billing operations to ensure timely and accurate invoicing for patients.
- Analyzed billing data to identify trends, enhancing overall accuracy and efficiency in operations.
- Streamlined payment processing procedures, enhancing cash flow efficiency.
- Developed training programs for staff on billing software and compliance standards.
- Oversaw reconciliation of accounts, ensuring accuracy in financial reporting.
- Oversaw financial reporting, streamlining month-end closing procedures for efficiency.
- Managed insurance billing processes, ensuring timely and accurate claims submissions.
- Collaborated with healthcare providers to resolve billing discrepancies and improve claim approvals.
- Mentored junior staff on billing procedures and compliance standards, fostering team development.
- Reviewed insurance policies for coverage determinations, providing guidance on claims eligibility.
- Increased revenue collection by diligently pursuing outstanding claims and negotiating with insurance companies.
- Monitored accounts receivable to identify trends and implemented strategies for improved collections.
- Ensured strict adherence to HIPAA guidelines while handling sensitive patient information during the billing process.
- Assisted patients in understanding their coverage benefits, providing clear explanations and addressing any concerns or questions.
- Managed authorization processes for healthcare services to ensure compliance and accuracy.
- Trained junior staff on authorization protocols and best practices to enhance team performance.
- Coordinated referral processes to optimize patient access and improve service delivery.
- Collaborated with healthcare providers to ensure accurate and timely referrals.
- Implemented tracking systems for monitoring referral status and outcomes.
Director, Revenue Cycle Management
Lynn County Hospital District
Tahoka, TX
11.2020 - 02.2025
- Oversaw team performance to enhance productivity and achieve project goals.
- Assisted in processing payroll for employees on a bi-weekly basis. Supported the maintenance of accurate payroll records and documentation. Helped resolve payroll discrepancies and inquiries from staff.
- Reviewed and confirmed insurance details to support efficient claims processing and minimize billing discrepancies.
- Oversaw pre-authorization processes to drive operational efficiency. Coordinated with cross-functional teams to optimize approval workflows. Formulated strategies to enhance turnaround times for pre-authorization requests.
- Achieved timely processing of insurance claims, resulting in improved cash flow for the organization. Enhanced client satisfaction through effective resolution of billing issues. Implemented best practices in billing procedures, leading to increased operational efficiency.
- Conducted thorough follow-ups with insurance providers to facilitate efficient resolution of claims.
- Reviewed medical documentation and accurately assigned CPT codes to reflect patient services provided.
- Reviewed patient records and assigned appropriate ICD-10 codes to facilitate proper healthcare documentation.
- Achieved timely payment postings, contributing to improved cash flow management. Enhanced accuracy of financial records through diligent oversight of payment processes. Improved operational efficiency by implementing best practices in payment posting.
- Achieved high levels of billing accuracy through effective management of ambulance coding operations. Enhanced compliance with healthcare regulations by refining documentation processes. Improved team performance by providing targeted training and support in coding practices.
- Achieved timely admissions and discharges, contributing to overall resident satisfaction. Improved operational workflows by collaborating with interdisciplinary teams. Strengthened family engagement through effective communication strategies.
- Facilitated preparation of detailed cost reports to support budget management and financial analysis.
- Compiled comprehensive charity report detailing exhausted benefits.
- Generated detailed reports on uncompensated care to facilitate auditor assessments.
- Compiled and maintained aged trial balance reports to facilitate timely financial assessments and decision-making.
- Revenue and usage report
- Oversaw the generation of medicare-medicaid bad debt reports to enhance financial accuracy. Coordinated with finance teams to streamline reporting processes. Facilitated training sessions on report interpretation for staff.
- Other reports as assigned
- Led quality improvement initiatives to enhance operational efficiency. Oversaw team collaboration to achieve project milestones. Championed best practices to foster a culture of continuous improvement.
- Led conflict resolution initiatives to enhance team dynamics and productivity. Guided team members through conflict management processes to promote a culture of collaboration. Developed strategies to mitigate disputes and improve overall team performance.
- Achieved compliance with regulatory standards through effective team collaboration. Improved audit processes, resulting in enhanced operational efficiency. Strengthened documentation practices, contributing to overall compliance integrity.
Business Office Manager
Shannon Memorial Hospital
San Angelo, TX
02.2017 - 11.2020
- Oversaw team performance to enhance productivity and achieve project goals.
- Developed and upheld comprehensive schedules to facilitate effective time management and resource allocation.
- Oversaw payroll operations to ensure timely and accurate compensation for all employees. Managed payroll systems and processes to enhance efficiency and compliance. Collaborated with HR to align payroll practices with organizational policies.
- Executed front desk responsibilities, including greeting guests, handling inquiries, and managing appointment schedules.
- Oversaw patient registration, verifying information for accuracy and completeness.
- Facilitated patient care to enhance recovery and ensure comfort during treatment processes.
- Achieved improved operational efficiency by effectively managing DNB revenue work queues. Resolved issues collaboratively with teams to enhance process effectiveness. Monitored revenue tasks to ensure timely and accurate completion.
- Reviewed and analyzed insurance claims to identify and address denial issues effectively.
- Conducted thorough follow-ups on all denied claims to facilitate timely responses.
- Evaluated and prioritized charge review work queues to optimize workflow and enhance service delivery.
- Reviewed clinical documentation and assigned relevant ICD-10 and CPT codes to inpatient and outpatient accounts, enhancing coding accuracy and efficiency.
- Collaborated with physicians to clarify and rectify conflicting or incomplete diagnostic codes to enhance coding precision.
- Engaged with revenue cycle team to address account discrepancies and enhance reconciliation efforts.
- Facilitated interdepartmental communication to streamline processes and improve service delivery.
- Managed data entry operations, maintaining high standards of accuracy and attention to detail.
Billing Administrative Specialist Lead
MicroGen DX
Lubbock, TX
01.2014 - 02.2017
- Achieved timely billing for clients and facilities through effective oversight of processes. Improved classification accuracy of billing information, resulting in enhanced operational efficiency. Maintained comprehensive records to support billing accuracy and accountability.
- Processed client invoicing by preparing and sending detailed invoices using QuickBooks software.
- Achieved timely collections through effective management of accounts receivable. Improved cash flow by implementing streamlined invoicing processes. Enhanced client satisfaction by addressing payment inquiries promptly.
- Conducted outreach to clients via phone and email to address outstanding invoices and reinforce payment timelines.
- Achieved compliance through thorough client account audits that identified key areas for improvement. Enhanced operational efficiency by implementing best practices in audit processes. Strengthened client relationships by delivering actionable insights from audit findings.
- Reviewed and authorized credit memos to maintain compliance with accounting standards.
- Managed client payment processing operations via Authorize.Net, ensuring accuracy and timeliness in transactions.
- Performed scanning of checks and facilitated deposits to maintain efficient banking operations.
- Close and balance batches
- Assisted in processing ICD-10 billing claims accurately. Supported team members in resolving billing discrepancies. Contributed to maintaining compliance with coding standards.
- Assisted in processing covid-19 billing inquiries. Supported team members in resolving billing discrepancies. Helped maintain accurate records of billing transactions.
- Managed provider files and ensured up-to-date information for governmental and commercial payer credentialing applications.
- Ensured provider licenses remained current and compliant with regulatory standards.
- Executed comprehensive revalidation processes mandated by payers.
- Collaborated with Revenue Cycle Director and billing staff to identify and resolve denial issues.
- Executed accurate data entry processes to ensure information integrity.
- Processed payments accurately and efficiently to support financial operations. Assisted in maintaining accurate records of transactions to ensure compliance. Collaborated with team members to resolve discrepancies in payment postings.
- Assisted various departments through cross-training initiatives. Supported requisition sorting by reviewing submissions from doctors for accuracy. Facilitated proper billing processes by verifying necessary information for insurance claims.
- Assisted denials department by making calls to insurance companies regarding denied claims. Reviewed explanation of benefits and remittance advice to process payment adjustments in the system.
Education
Bachelor's degree - Business Administration
Wayland Baptist University
Plainview, TX05-2013
Associate's degree - Administration
South Plains College
Levelland, TX01-2009
Skills
- Chronic care coordination
- Implementing HIPAA regulations
- Business administration
- Medicaid billing compliance
- Network configuration
- ICD-10 proficiency
- Computer proficiency
- Group cooperation
- Efficient claims management
- Continuous process refinement
- Reconciliation of medical billing accounts
- Expense tracking
- Prioritization and scheduling
- Efficient financial processing
- EHR system administration
- Epic system expertise
- Work experience within hospital environments
- Proficient in Microsoft PowerPoint
- Skilled in Microsoft Office tools
- Healthcare receptionist
- Understanding of financial principles
- KPI analysis
- Cross-functional teamwork
- Effective problem resolution
- Patient insurance confirmation
- Critical analysis abilities
- Healthcare clinic experience
- Clinical coding proficiency
- Financial record management
- Management of patient accounts
- Experience in financial management
- CPT code proficiency
- Overseeing medical billing teams
- Management of healthcare teams
- Experienced with Mondaycom project management
- HIPAA regulations knowledge
- Expertise in Medicare and Medicaid billing regulations
- Daily journaling practice
- Detail-oriented data management
- Expense tracking
- Compliance management in healthcare
- General ledger management
- Knowledge of surgical billing processes
- Experience in managing teams
- Data retention management
- Experience with computer applications
- Administrative support experience
- Customer engagement
- Medicare billing compliance
- Healthcare collections
- Dependable performance
- Effective communication
- Insurance claim processing
- Healthcare facility management
- Reception management
- Coordinate efforts with healthcare providers
- Accounts receivable analysis
- Acute care expertise
- Healthcare billing proficiency
- Financial management in healthcare
- Data analysis and reporting
- Coordination of medical insurance appeals
- Adaptability to change
- Maintaining patient confidentiality
- Nursing facility billing expertise
- Nursing home billing experience
- Administrative experience
- Health services management
- Invoice payment processing
- Medical Office Experience
- 10 key typing
- Experience with EMR platforms
- Cross-functional team management
- HIPAA compliance
- QuickBooks
- Accurate posting of payments in billing systems
- Payroll management
- Account reconciliation
- Quality improvement strategies
- Analysis of performance metrics
- General ledger account review
- Financial account reconciliation
- Cash management
Languages
English
Timeline
Director of Billing
24 Karate Health Solutions
02.2025 - Current
Director, Revenue Cycle Management
Lynn County Hospital District
11.2020 - 02.2025
Business Office Manager
Shannon Memorial Hospital
02.2017 - 11.2020
Billing Administrative Specialist Lead
MicroGen DX
01.2014 - 02.2017
Associate's degree - Administration
South Plains College
Bachelor's degree - Business Administration
Wayland Baptist University