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.
Chantilly, Virginia
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.
Chantilly, Virginia
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
Falls Church, Virginia
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
Falls Church, Virginia
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
Falls Church, Virginia
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.
Fairfax, VA
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