Constance Price
Forney,Texas
Summary
Revenue management professional prepared to drive success in this role. Proven track record in optimizing revenue cycles, improving financial performance, and implementing efficient processes. Strong focus on team collaboration and achieving results. Adept at adapting to changing needs and fostering reliable work environment. Skilled in financial analysis, strategic planning, and regulatory compliance with keen eye for improving operational efficiencies.
Overview
15
15
years of professional experience
Work History
Senior Revenue Cycle Manager
Behavioral Health Group
Dallas, Texas
02.2020 - Current
- Manage the day-to-day Revenue Cycle Operational process to increase effectiveness, efficiency, and compliance with Service Level Agreements (SLA’s)
- Drives departmental initiatives to ensure long term operational excellence
- Serves as the primary liaison between Revenue Cycle Operations internal and external customers
- Manage staff including: Performance management, Training development, Workflow planning, Hiring, placement, and Disciplinary actions
- Monitor and report on key metrics, including but not limited to cash collections, net A/R days, aging’s, DNFB, initial denial rates, underpayments, clean claims %, administrative write offs, payment-to-charge percentage (PCR), and cost-to-collect. Proactively perform root cause analyses and develop action plans when metrics do not meet internal goals or industry best practices. Complete monthly trending analyses and present findings at monthly operational review meetings to senior revenue cycle leadership.
- Administer adjustments, reconciliations, in efforts to provide proper maintenance, accuracy and integrity of client receivables accounts
- Responsible for researching, managing, coordinating, and implementing Charge Description Master (CDM) set-up and charge generation initiative and processes to ensure revenue management and revenue protection
- Develop and maintain financial models to support performance optimization
- Managing functions including: Collections, Billing, and Cash Posting Departments
Senior Manager Revenue Integrity
Adeptus Healthcare
Lewisville, Texas
06.2017 - 02.2020
- Monitor and report on key metrics, including but not limited to: cash collections, net A/R days, aging, DNFB, initial denial rates, underpayments, clean claims %, administrative write offs, payment-to-charge percentage (PCR), and cost-to-collect. Proactively perform root cause analyses and develop action plans when metrics do not meet internal goals or industry best practices. Complete monthly trending analyses and present findings at monthly operational review meetings to senior revenue cycle leadership.
- Develop and monitor adherence to specific goals, performance standards, and policies & procedures for each area of responsibility. Define, implement, and manage clear quality and productivity standards across all areas of responsibility.
- Assume a lead role for innovation, knowledge sharing and leading practice identification within hospital billing and collections. Identify and assess new technology and process improvements that reduce cost-to-collect. Perform ROI analysis and provide recommendations to senior revenue cycle leadership.
- Maintain departmental budget and perform all human resource functions. Develop and implement strategies to improve employee engagement. Actively participate in succession planning and developing career advancement opportunities for employees within department.
- Assists in the development and maintenance of system wide Chargemaster program, policies and procedures.
- Coordinates a system-wide auditing and monitoring program to ensure consistent application of charges in the CDM as well as compliance with established charging methodologies.
- Ensures accuracy and appropriateness of charge master coding and relative value units ensuring that information in the charge master conforms with overall organizational billing practices and is compliant with coding and billing laws including but not limited to use of correct modifiers, proper treatment of equipment and nursing services, proper identification of self-administered drugs, proper categorization of supplies, non-covered supplies and services, non-billable or overhead supplies, ancillary supplies, and specialty billable supplies.
- Establish goals and develop training processes to ensure maximization of the revenue cycle
- Manage: Billing Department, Payment Posting Department , Coding Department, Customer Service Department and Revenue Cycle Department
Revenue Cycle Manager
United Surgical Partners
Addison, Texas
02.2016 - 05.2017
- Manage the day-to-day Revenue Cycle Operational process to increase effectiveness, efficiency, and compliance with Service Level Agreements (SLA’s)
- Regular reporting of Revenue Cycle metrics and KPI’s
- Drives departmental initiatives to ensure long term operational excellence
- Maintaining the CDM to include its integrity and consistency between other integrated systems
- Servers as the primary liaison between Revenue Cycle Operations internal and external customers
- Management of 24 Collections Team associates that reported directly to me
- Manage staff including: Performance management, Training development, Workflow planning, Hiring, placement, and Disciplinary actions
- Monitor and report on key metrics, including but not limited to cash collections, net A/R days, aging’s, DNFB, initial denial rates, underpayments, clean claims %, administrative write offs, payment-to-charge percentage (PCR), and cost-to-collect. Proactively perform root cause analyses and develop action plans when metrics do not meet internal goals or industry best practices. Complete monthly trending analyses and present findings at monthly operational review meetings to senior revenue cycle leadership.
- Administer adjustments, reconciliations, in efforts to provide proper maintenance, accuracy and integrity of client receivables accounts
- Preparation and analysis of monthly reports and metrics for DSO, Aging, in efforts to reduce Bad Debt
- Managing functions including: Collections, Billing, and Cash Posting Departments
Reimbursement Manager
Option Care –Walgreens Home Infusion
Irving, TX
09.2014 - 02.2016
- Manage the daily administrative and business operations for the Collections Team
- Manage the administrative staff including hiring, salary, and performance evaluations
- Manage Collections department on best practice processes for adjudications of Accounts Receivables
- Ensure all policies, licenses, compliance, and accreditations are met according to current guidelines
- Reconcile and monitor reimbursement patterns of contracted and non-contracted carriers
- Assign and verify patient insurance information, assign CPT and ICD-10 codes to procedures and diagnosis from progress notes
- Verify and post contractual obligations and payments from various payers
- Assist in the implementation and assessment of the billing system’s upgrades and software change
Revenue Cycle Manager
Christus Healthcare
Irving, TX
10.2011 - 08.2014
- Oversee and Manage 3 departments, accountable for 48 total employees. (Collections, Refunds, Contracts)
- Plan, direct and supervise staff to ensure timely, and accurate adjudication of accounts, while ensuring quality and production goal are met
- Perform QA of accounts worked to identify critical claims/payor issues for the adjudication of Accounts Receivables
- Reviewed and approve refund request submitted to payors and or patients
- Attend and participate in daily team briefings, metrics tracking to promote prompt resolution of issues and opportunities
- Establish and maintain contracts reporting and analytics to tract payor efficiency
- Create collaborative team environment to achieve volume expected to meet operational requirements
Education
High School Diploma -
Potomac High School
Oxon Hill, MDSkills
- Revenue performance
- Denial resolution
- Billing cycle expertise
- Account monitoring
- Cash flow management
- Data analytics
- Clinical team guidance
- Budget monitoring
- Revenue metrics analysis
- EHR management
Timeline
Senior Revenue Cycle Manager
Behavioral Health Group
02.2020 - Current
Senior Manager Revenue Integrity
Adeptus Healthcare
06.2017 - 02.2020
Revenue Cycle Manager
United Surgical Partners
02.2016 - 05.2017
Reimbursement Manager
Option Care –Walgreens Home Infusion
09.2014 - 02.2016
Revenue Cycle Manager
Christus Healthcare
10.2011 - 08.2014
High School Diploma -
Potomac High School