MS Office
Cynthia Avila
Revenue Cycle SME
Woodbridge,VA
Summary
Results-driven professional with ten years of experience in revenue cycle. Proven track record in process improvement, training program development, and project management. Committed to delivering high-quality services and achieving operational excellence.
Overview
10
10
years of professional experience
3
3
years of post-secondary education
5
5
Certifications
2
2
Languages
Work History
Revenue Cycle Support Contract Lead
Western Door Federal LLC.
12.2024 - Current
- Conducted ongoing performance analysis and transformed client metadata into actionable insights by designing dynamic, decision-support dashboards using Power BI.
- Prepared comprehensive documentation, including Corrective Action Plans (CAPs) and Business Case Analyses (BCAs), to drive operational improvements and inform strategic decisions.
- Reduced workflow errors by delivering targeted resolution strategies and educational material, resulting in 46% of DQM Statement standards surpassing peer performance benchmarks.
- Led cross-functional initiatives with various clinics, leaders and departments, launching and managing multiple strategic projects that achieved a 25% increase in collectible revenue (FY25) and a sustained 2.3% monthly DNFB reduction.
- Facilitated regular Knowledge Transfer Meetings to promote timely issue resolution, enhance team alignment, and ensure a favorable return on investment.
- Performed weekly quality assurance reviews to maintain accuracy and ensure compliance with regulatory standards.
Revenue Cycle Solution Support Specialist
Western Door Federal LLC.
11.2022 - 12.2024
- Supported DHA-HI project by leveraging extensive Revenue Cycle SME knowledge.
- Developed weekly pre-deployment, deployment and post-deployment content for all revenue cycle process areas, ensuring smooth workflow adherence for favorable outcomes.
- Produced daily and weekly reports/dashboards using data visualization tools to effectively communicate business insights and resource allocation.
- Successfully reduced errors by 80% and elevated facility to top performer in terms of metrics, showcasing outstanding performance.
- Strategizing with the client to reduce their DNFB in order to increase workload credit and third-party collections.
- Monthly on-site support in knowledge gaps within the revenue cycle.
Quality Assurance Lead
Inova Health System
11.2020 - 11.2022
- Developed and implemented comprehensive training program for Hospital Billing Office, which included the creation of 183 training manuals.
- Conducted ongoing analysis, held weekly meetings with senior leadership, incorporated feedback and conducted mock trainings to refine learning strategies and curriculum.
- Supported Go-Lives and ensured smooth integration of new acquisitions by assisting with system conversions, workflow optimization, and advocating for quality improvement.
- Managed multiple special projects concurrently, meeting deadlines while maintaining core responsibilities.
- Developed and designed databases tailored to specific needs of Patient Access Services, Patient Contact Office, Patient Financial Services, and Revenue Integrity areas along with corresponding executive summaries.
- Implemented and established quality standards and metrics for Revenue Integrity, with a primary focus on workflow quality. This involved evaluating the existing workflow and developing grading parameters to ensure adherence to the established standards.
Patient Financial Service Supervisor
Inova Health System
11.2019 - 11.2020
- Trained, supported, and guided a team of 25 members to ensure alignment of productivity and quality expectations.
- Monitored, analyzed, and strategically addressed account trends for a portfolio of over $3 billion in accounts receivable across five parent hospitals, resulting in surpassing the targeted goal of $220 million in December 2019.
- Analyzed and audited quality assurance outcomes for over 400 accounts to optimize account handling, reduce aging, and maximize cash yield.
- Successfully facilitated Cigna, Aetna, United Healthcare and Veterans Administration monthly escalation calls to effectively address issues.
- Provided senior leadership with comprehensive reports on trends, escalations, and resolutions on a weekly basis.
- Developed and implemented escalation protocols/policies to streamline follow-up process and enhance effectiveness.
Patient Financial Service Representative
Inova Health System
02.2018 - 11.2019
- Ensured timely and accurate editing, submission, and follow-up of assigned claims, maintaining compliance with payer guidelines and regulations.
- Processed claims for multiple payer types, including Commercial, Managed Care, Blue Cross, Medicare, and Medicaid, leveraging in-depth knowledge of each payer's requirements.
- Proactively identified issues with claims process and provided potential resolutions to Supervisor/Manager, contributing to process optimization and efficiency.
- Supported, educated, and guided team members, fostering collaborative and supportive work environment.
- Actively participated in departmental process improvement initiatives, offering valuable feedback and contributing to enhancing workflows and operational effectiveness.
Financial Coordinator
Stynchula Chiropractic Care LLC.
05.2015 - 01.2018
- Trained team members on organizational policies and procedures, promoting adherence to best practices and enhancing productivity.
- Corrected clearinghouse rejects to eliminate billing errors and enhance claim submission accuracy.
- Appealed denials and underpayments, advocating for full reimbursement and optimizing revenue capture.
- Reconciled Explanation of Benefits (EOB) and Remittance Advice (RA) to ensure accurate payment posting and resolve discrepancies.
- Developed and implemented protocols to ensure appropriate charge capture and billing accuracy, minimizing revenue leakage.
- Reviewed financial reports and consulted with provider monthly, offering insights and suggestions for improving accounts receivable performance.
- Successfully resolved all patient inquiries and concerns, fostering positive relationships and ensuring patient satisfaction.
- Managed system conversion from Eclipse to Rapid, overseeing seamless transition and minimizing disruptions.
Education
High School Diploma -
James Monroe High School
Fredericksburg, VA 09.2010 - 01.2014
Skills
- AR Management
- Process improvement
- Training program development
- Data analysis and validation
- System Conversions
Certification
Epic ARCR: Resolute Hospital Billing and Single Office Self-Pay Follow-Up Proficiency
Software
Eclipse EHR
RAPID EHR
Epic EHR
Cerner EHR
SAP BusinessObjects
Power BI
Timeline
Revenue Cycle Support Contract Lead
Western Door Federal LLC.
12.2024 - Current
Revenue Cycle Solution Support Specialist
Western Door Federal LLC.
11.2022 - 12.2024
Quality Assurance Lead
Inova Health System
11.2020 - 11.2022
Patient Financial Service Supervisor
Inova Health System
11.2019 - 11.2020
Patient Financial Service Representative
Inova Health System
02.2018 - 11.2019
Financial Coordinator
Stynchula Chiropractic Care LLC.
05.2015 - 01.2018
High School Diploma -
James Monroe High School
09.2010 - 01.2014
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