DANA WHITESIDE
Revenue Cycle Specialist
Sharon Hill,PA
Summary
Accomplished in developing strategies to improve workflows and processes, and enhancing revenue generation. Demonstrated leadership skills with a team-oriented personality.
Experienced with revenue cycle processes, including billing and claims management. Utilizes analytical skills to identify and resolve discrepancies efficiently. Track record of effective communication and collaboration to enhance financial performance.
Overview
21
21
years of professional experience
Work History
Revenue Cycle Specialist
Resources for Human Development
03.2022 - 02.2025
- Pre-Billing, Processing Claims, Creating Bills, Uploading Claims, Monitoring Reports, AR Follow-Up
- Initiate the write-off of claims
- Confirm successful transmission to payers and timely resolve any transmission errors
- Resolve all rejections, denials, re-submissions and appeals
- Work open claims systematically giving priority to aged claims to resolve balances in a timely manner
- Communicate any processing issues to the Manager
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
- Balanced and reconciled accounts.
- Contacted responsible parties for past due debts.
- Provided regular updates on billing status to upper management through detailed reports.
- Run daily billing reports from billing system.
- Reduced outstanding account balances by implementing effective collection strategies.
- Extract billing data from billing system.
- Increased revenue by identifying and resolving billing errors in a timely manner.
Certified Home Health Aide
Reliant Home Health Agency
02.2015 - 12.2022
- Assisted patients with handling daily chores and errands by transporting to appointments, cleaning personal spaces, and purchasing supplies.
- Monitored progress and documented patient health status changes to keep care team updated.
- Provided mobility assistance such as walking and regular exercising.
- Administered prescribed medications under direction of physician.
- Maintained records of patient care, condition, progress, or problems to report and discussed observations with supervisor or case manager.
Billing/Collections Specialist
Belmont Behavioral Health Hospital
02.2016 - 03.2020
- Conducted thorough credit analyses for potential customers, minimizing the risk of bad debt exposure for the company.
- Assisted in the development of departmental policies and procedures aimed at improving overall collections efficiency and effectiveness.
- Developed customized payment plans for clients facing financial hardships, resulting in improved long-term account retention.
- Maintained detailed records of collection activities, ensuring compliance with industry regulations and company policies.
- Regularly monitored accounts receivable aging reports, identifying trends that informed future collections strategies.
- Elevated the company''s overall cash flow management by closely monitoring account balances and initiating proactive measures to collect outstanding receivables.
- Improved cash flow with consistent follow-up on outstanding invoices and payments.
- Processed payments and applied to customer balances.
- Negotiated to collect balance in full.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Trained new team members on scripts, company services, and collection strategies.
Practice Manager
Crozer Chester Medical Center
07.2006 - 09.2015
- Supervised day-to-day operations of facility, complying with strict corporate policies and guidelines.
- Maintained all Medical License, Drug Administration and Malpractice Insurance for physician and mid-level employees.
- Addressed any patient or team member concerns immediately.
- Supported entire practice's staff, which boosted efficiency and improved overall process flow.
- Employed active listening and interpersonal talents to effectively interact with various individuals, including physicians, patients, and fellow employees.
- Created and implemented policies and procedures for effective practice management.
- Communicated with patients with compassion while keeping medical information private.
- Ordered all supplies needed and kept tabs on inventory levels.
- Complied with OSHA and HIPAA regulations.
- Coordinated and organized patient records for maximum efficiency.
- Coordinated financial operations, including budgeting, accounting, expenses, and financial reporting.
- Mentored and coached interns and newly hired team members on office procedures and computer systems.
- Developed and implemented policies and procedures for both hospital and office setting.
- Supervised daily operations of 3 physician practice, overseeing 20 staff members across all departments.
- Cultivated close working relationships with the entire staff, including 3 physicians, front desk receptionists, ultrasound technicians, genetic counselor, dietician, registered nurses, licensed practical nurses.
- Checked entire office and waiting areas regularly to provide clean and organized surroundings.
- Created and maintained electronic record management (EMR) systems to store data and develop reports.
- Consulted with clinicians to develop business strategy.
- Created onboarding program for new staff members, training in customer service and billing procedures.
- Coordinated monthly health events, increasing patient participation to improve health and wellness.
- Implemented methods to reduce overhead and increase productivity and cutting monthly costs.
Medical Billing and Collection Specialist
Crozer Chester medical Center
11.2003 - 07.2006
- Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
- Answered phone calls, responding to basic questions regarding appointments and clinic operations and directing calls within clinic as appropriate.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Applied HIPAA privacy and security regulations while handling patient information.
- Posted charges, payments, adjustments.
- Filed and submitted insurance claims.
- Prepared and submitted claims to insurance companies electronically and manually.
- Completed and submitted appeals for denied claims.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Completed appeals and filed and submitted claims.
- Posted and adjusted payments from insurance companies.
- Collaborated with all relevant parties to resolve billing issues, insurance claims and patient payments.
- Reviewed and verified benefits and eligibility with speed and precision.
- Verified proper coding, sequencing of diagnoses and procedures.
- Determined customer eligibility for benefit programs and services.
- Tracked and recorded status of delinquent accounts and sent follow-up letters to request payment.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols, and third-party billing requirements.
- Reviewed all claims for accurateness and appropriateness.
- Applied payments, adjustments, and denials into medical manager system.
- Investigated denials and collaborated with internal team members and third-party representatives to identify solutions.
- Prepared billing statements for patients, ensuring correct diagnostic coding.
- Reviewed received payments for accuracy and applied to intended patient accounts.
- Added modifiers, coded narrative diagnosis, and verified diagnoses.
- Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.
- Submitted refund requests for claims paid in error.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Researched and rectified account discrepancies.
- Collaborated closely with other departments to resolve claims issues.
- Entered procedure codes, diagnosis codes and patient information into Medic software and Epic EMR
- Remained up to date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
Education
Some College (No Degree) - Healthcare Management
Delaware County Community College
Sharon Hill, PACertificate in Medical Billing/Coding - Medical Insurance Billing
BETA
Swarthmore, PA12.2000
Certificate - New Supervisor/Manager Orientation Program
Crozer Chester Medical Center
Chester12-2008
Skills
- Full Knowledge of Billing and Coding
- Pre-Billing
- Processing Claims
- AR Follow-Up
- Customer relations
- Write Offs/Adjustments
- Claims review
- Claims processing proficiency
- HIPAA compliance
- Professionalism and ethics
- Teamwork
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking Abilities
- Excellent communication
- Reliability
- Organizational skills
- Team collaboration
Accomplishments
- Promoted from Medical Billing Specialist to Manager of High-Risk Maternity office for 2 office locations. in less than 2 years at Crozer Chester Medical Center.
- Promoted from Medical Billing/Coding Specialist to Hospital Admissions Counselor at Belmont Behavioral Hospital.
- Consistently maintained high customer satisfaction ratings.
Timeline
Revenue Cycle Specialist
Resources for Human Development
03.2022 - 02.2025
Billing/Collections Specialist
Belmont Behavioral Health Hospital
02.2016 - 03.2020
Certified Home Health Aide
Reliant Home Health Agency
02.2015 - 12.2022
Practice Manager
Crozer Chester Medical Center
07.2006 - 09.2015
Medical Billing and Collection Specialist
Crozer Chester medical Center
11.2003 - 07.2006
Certificate in Medical Billing/Coding - Medical Insurance Billing
BETA
Some College (No Degree) - Healthcare Management
Delaware County Community College
Certificate - New Supervisor/Manager Orientation Program
Crozer Chester Medical Center
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