Cynthia Hall
Coweta,Oklahoma
Summary
Over 30 years of progressive experience in practice management/administration, compliance, collections, technology implementation and system development. Personable, Analytical, and Cost-Conscious Senior-Level Executive offering in-depth experience in improving cash flow and profits for physicians and physical therapists with a proven ability for keeping abreast of changes in medical billing requirements, implementing strategies and systems to ensure compliance and performing quality assurance functions. Expertise in performing financial analysis and interpreting relative value units to establish fee schedules for multi-specialty clinics. Highly effective in the identification of problems with Medicare, Medicaid and private insurance companies to minimize risk with a consistent record for recovering assets and enhancing bottom-line profits. Skilled in establishing priorities, delegating activities, defining goals and achieving objectives.
Articulate...Knowledgeable...Sound Judgment...Committed to high quality standards...Resourceful...Analytical...Business Savvy...Persuasive Communication, Interpersonal and leadership skills...Decisive...
Overview
26
26
years of professional experience
Work History
Operations Control Auditor
Confluent Health
10.2017 - Current
- Increased internal control effectiveness through diligent evaluation of processes and providing recommendations for improvement.
- Ensured compliance with regulatory requirements by performing regular audits and staying up-to-date on state and federal guidelines.
- Supported management decision making with accurate data analysis and insights from audit findings.
- Developed strong relationships with staff, building trust and ensuring a high level of confidence in the audit process.
- Collaborated closely with clinical auditors, providing them with information used to guide their clinical documentation audits.
- Conducted risk assessments to determine areas requiring increased focus during subsequent audits.
- Planned and executed follow-up audits at appropriate intervals.
Practice Manager/Compliance Officer
Redbud Physical Therapy
01.2005 - 01.2017
- Oversee all practice management functions for 17 practice locations including staffing (hiring, evaluating, terminating, motivating), administration, policies, procedures and controls
- Selected to re-organize an under-performing company with accountability for Top to Bottom operations, reestablishing policies, setting up infrastructure, implementing controls that resulted in improved bottom-line for company
- Analyzed practice and implemented processes to improve revenue stream (increased revenue by 65%)
- Successfully increased the size of the company from 4 to 17 clinics
- Selected and Implemented Electronic Medical Record Practice Management System
- Developed Training Manuals for Front Office and Billing Positions
- Negotiated company contracts with major insurance companies
- Perform and supervise Credentialing
- Serve as HIPAA Compliance Officer and perform yearly HIPAA training.
Site Supervisor/ Office Manager/ Practice Manager
Springer Clinic
01.2004 - 01.2005
- Oversaw all practice management functions including staffing (hiring, evaluating, terminating, motivating), administration, policies and procedures and controls
- Supervised 42 employees including one site coder and establish protocols; coder audits 450 charts per month to obtain billing integrity for services rendered
- Recovered $90,000 over 10 months through appropriate coding
- Proven record for increasing physician compensation
- Implemented Electronic Medical Record.
Documentation Control Auditor/ Medicare Compliance (Administrative position)
Springer Clinic
01.1998 - 01.2004
- Served as liaison with physicians and staff in coding to assure compliance with CMS regulations
- Trained physicians and staff in order to ensure accurate coding and optimum reimbursement as well as adherence to national coding guidelines
- Audited physician charts for compliance with CMS and state standards; annually audited all physician charts, developed audit reports and met with physicians
- Compared physician coding trends to national trends by specialty to identify outliers; responsible for physician coding and documentation education
- Identified/corrected aberrant coding patterns to adhere to policies and procedures
- Created tools for each specialty by meeting with physicians and staff
- Responsible for researching current codes, investigating problem areas and pin-pointing areas requiring improvement as well as developing memos and communicating with staff
- Audited and monitored CMS requests to identify risk areas before submission; implemented strategies to minimize risks
- Developed education and monitoring of coding auditors in multiple locations
- Worked with Compliance Officer to establish compliance plan for 70+ physicians
- Developed coding curriculum and taught courses on a wide range of issues to ensure compliance
- Worked with Attorney on response to a major Medicare Audit that initially requested $500,000 payback
- After audit no deficiencies were uncovered
- Served as resource person for attorney regarding other compliance issues.
Education
Associate of Science Degree -
Connors State College
Oklahoma, OKSkills
- Practice Management
- Contract Negotiations
- Regulatory Compliance
- Auditing/Quality Assurance
- Enhancing Profits
- Credentialing
- Expense Controls
- System Controls
Professional Highlights
- Analyzed practice and implemented processes to improve revenue stream by 65%.
- Recovered over $90,000 over 10 months through appropriate coding.
- Worked with Attorney on response to a major Medicare Audit that initially requested $500,000 payback. After audit no deficiencies were uncovered.
- Guest Lecturer at OSU School of Medicine, "How to Survive in Business".
Training
Numerous Technology, Collections, Risk Management and Operations workshops and seminars
Timeline
Operations Control Auditor
Confluent Health
10.2017 - Current
Practice Manager/Compliance Officer
Redbud Physical Therapy
01.2005 - 01.2017
Site Supervisor/ Office Manager/ Practice Manager
Springer Clinic
01.2004 - 01.2005
Documentation Control Auditor/ Medicare Compliance (Administrative position)
Springer Clinic
01.1998 - 01.2004
Associate of Science Degree -
Connors State College
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