Cynthia Guinn
Lexington,KY
Summary
Hospice revenue cycle professional with 10 years of experience leading billing operations, quality auditing, and team development in hospice care settings. Proven track record managing Medicare, Medicaid, and commercial payer billing end-to-end — from patient eligibility verification and authorization through claim submission, bill hold resolution, denial management, and appeals. Experienced in auditing for compliance with federal, state, and Medicare regulations, communicating revenue risk to site and operations leadership, and coaching billing staff to drive continuous improvement. Consistently stepped into coverage roles across all billing functions to maintain departmental standards. Deep hands-on expertise with the WellSky Hospice platform. Ready to bring this breadth of experience into a formal supervisory role in hospice revenue cycle management.
Overview
18
18
years of professional experience
Work History
Quality Assurance Analyst / Reimbursement Quality Auditor
WellSky (formerly Consolo Services Group)
Lexington, KY
09.2023 - 06.2026
- Audited hospice billing accounts on aging reports, reviewing biller notes and directing staff to escalate unresolved claims, clear bill holds, obtain additional documentation, or file payer appeals.
- Conducted payment audits by reconciling remittance advice (EOBs) against posted payments to verify posting accuracy and identify billing discrepancies.
- Tracked and analyzed denial patterns across the billing team, identifying root causes and payer trends, developing targeted corrective action to reduce recurrence.
- Compiled and maintained quality metrics reports; provided regular communication to site and operations leadership detailing outstanding documentation issues, unresolved bill holds, and items creating potential revenue risk.
- Audited billing activity for compliance with Medicare, Medicaid, and commercial payer requirements, as well as applicable federal, state, and company billing policies and procedures.
- Coached and trained billing staff on audit findings, delivering individualized feedback that measurably improved accuracy scores and overall team performance.
- Routinely covered for billing staff absences, performing all core billing functions to maintain departmental standards and ensure continuity of claims processing.
Billing Specialist
WellSky (formerly Consolo Services Group)
Lexington, KY
04.2016 - 09.2023
- Managed end-to-end hospice billing operations for Medicare, Medicaid, and commercial payers using the WellSky Hospice (formerly Consolo) platform.
- Verified patient eligibility and confirmed payer coverage guidelines to ensure all required information was secured prior to billing.
- Managed authorization and re-authorization requests in compliance with commercial payer and state Medicaid guidelines; ensured pre-certification, Medicare notification requirements, and level of care change documentation were completed accurately and on time.
- Processed and submitted hospice claims across all levels of care; resolved bill holds by coordinating with clinical staff to obtain missing documentation, and identified and corrected batch submission errors and rejections to minimize reimbursement delays.
- Utilized Medicare Direct Data Entry (DDE) for claim submission, claim status inquiries, and resolution of Medicare A billing issues; prepared Quarterly Medicare Credit Balance Reports in compliance with CMS requirements.
- Investigated and resolved claim denials through payer follow-up, corrected claim submissions, and formal appeals; maintained Medicare A logs and reported denial and non-payment status to leadership and clients.
- Worked accounts receivable aging reports to proactively identify and resolve outstanding claims, minimizing days in AR and ensuring accurate monthly billing and AR reporting.
- Consolo Services Group was acquired by WellSky in December 2018; title and responsibilities remained unchanged.
Auto Travel Counselor / Membership Sales
AAA Allied Group
Lexington, KY
08.2008 - 04.2016
- Delivered customer service across phone and in-person channels for travel planning, emergency road service, and membership sales.
- Promoted to district office role based on performance, transitioning from call center to direct client consultations for travel services and travel money products.
Education
Bachelor of Science - Middle Childhood Education
University of Dayton
Dayton, OH05.2005
Skills
- Hospice Revenue Cycle Management
- Payment Auditing & EOB Reconciliation
- Pre-Submission Claim Review & Error Correction
- Denial Tracking & Appeals Management
- Microsoft Excel & Reporting
- Patient Eligibility Verification
- Authorization & Pre-Authorization
- Quality Metrics Reporting & Analysis
- Billing Staff Coaching & Training
- Cross-Functional & Payer Communication
Accomplishments
- Selected as departmental representative to WellSky's Employee Advisory Council — met monthly with the Chief Clinical Officer, HR leadership, and cross-departmental peers to drive company culture and operational improvements.
- Participated in every WellSky-sponsored community volunteer event and actively recruited colleagues to join, reflecting a consistent commitment to service beyond the workplace.
Timeline
Quality Assurance Analyst / Reimbursement Quality Auditor
WellSky (formerly Consolo Services Group)
09.2023 - 06.2026
Billing Specialist
WellSky (formerly Consolo Services Group)
04.2016 - 09.2023
Auto Travel Counselor / Membership Sales
AAA Allied Group
08.2008 - 04.2016
Bachelor of Science - Middle Childhood Education
University of Dayton