Revenue Manager
Duke Health
Hi, I’m
Danielle Davis
Revenue Manager
Holly Springs,NC
Summary
Seasoned Financial Manager with over 10 years of healthcare revenue cycle management experience, specializing in patient financial services, hospital billing, A/R management, and strategic revenue initiatives. Proven success in optimizing back-end revenue cycle operations, reducing denials, and improving collections through process improvement and collaboration. Expert in leveraging digital and analytics tools to drive efficiencies, aligning financial operations with patient satisfaction. Adept at leading multidisciplinary teams and partnering with senior leadership to implement system-wide revenue cycle programs.
Work History
Duke Health
Revenue Manager
Job overview
- Manage Revenue and Analyze trends of professional and technical charges and receipts for the specialty and primary care divisions of the Department of Pediatrics and Duke Children's Hospital
- Oversee Revenue of over 120 MD's, DO's, APP's and other providers
- Monitor activities of and mentor staff responsible for charge capture, coding, charge entry, insurance follow up and reimbursement analysis
- Educate providers and staff about coding, revenue cycle, and payer regulations and guidelines
- Develop and prepare reports to track financial and operational performance across the entire spectrum of the revenue cycle
- Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solutions for improvement
- Act as a liaison to management and staff in the designated clinical area, DHIP, PRMO, DUHS Hospitals, and third-party payers on revenue cycle activities including charge capture, denials, prior authorizations, and others
- Matrix reporting relationship with Pediatric Coders and Clinical Financial and Front Desk Staff
- Collaborate with department leadership and finance with budget projections
- Data Analytics used to identify trends
- Review departmental services to determine any new services we could capture in our billing
- NC Ink Kindergarten Readiness Collaborative liaison for all departments
- NC Medicaid subject matter expert
- Pediatric Primary Care consultative expert
Duke Health
Compliance Specialist
Job overview
- Write training plans and timelines for providers-hospital and ambulatory, coding staff - HIM and Professional, CDI program, and all non-clinical staff
- Present plans to leadership and maintain on SharePoint
- Create and maintain SharePoint site for Revenue Integrity and Quality audit
- Collaborate with all Revenue Cycle departments to create a centralized location for training and references in relationship to correct billing and business practices
- Research topics as assigned by the CMO to build training materials for medical and coding staff
- Assistant Editor for PRMO Practice Perspectives newsletter
- Ensure an effective data collection and processing system by reviewing and analyzing data input, and processing and data output activities
- Perform audits to evaluate the quality and timeliness of coding and abstracting completion to ensure optimum reimbursement to the hospital
- Train new coding employees and monitor performance
- Create and maintain SharePoint site for Revenue Integrity and Quality audit
- Collaborate with all Revenue Cycle departments to create a centralized location for training and references in relationship to correct billing and business practices
- Project Management for Charge Validation During EPIC Implementation
- Oversaw team of 40 nurses to facilitate charge validation
- Coordinated all testing related to charge validation
- Project Management for Implementation of ICD-10CM Coding
- Write training plans and timelines for project for all relevant staff
- Facilitate creation of a Duke University Health System ICD-9 to ICD-10 map and crosswalk
- Consult with Insurance Team for ICD-10 CM claims testing
- Develop and present timely, relevant educational programs to hospital and medical staff members regarding coding, diagnosis related groups (DRG's), APR-DRG's, MS-DRG's, APCs, RBRVS or other Coding related documentation, and billing and reimbursement systems
- Prepare reports and analyses setting forth progress, adverse trends and appropriate recommendations or conclusions
Internal Medicine Office
Coding and Compliance Officer
Job overview
- Reviews and educates on all information published by HCFA and the OIG via the Federal Register, fraud alerts, OIG advisory opinions, and other publications relative to coding, billing and reimbursement compliance
- Manage Revenue and Analyze trends of professional and technical charges and receipts
- Reviews and educates on all information from third party payers relative to claims filing, coding, and the adjudication process
- Stays up to date with changes through reviewing various publications both in written form and through the Internet relative to coding, billing and reimbursement compliance
- Educate providers and staff about coding, revenue cycle, and payer regulations and guidelines
- Develop and prepare reports to track financial and operational performance across the entire spectrum of the revenue cycle
- Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solutions for improvement
- Work with Medicaid, Medicare, and other payer representatives to find solutions to coding and other denials
- Reviews, assesses, studies, and analyzes the overall coding, billing, documentation and reimbursement system for potential compliance problems and noncompliant activities
- Uses a systematic approach for the identification and resolution of complex compliance problems
- Uses knowledge obtained to perform Provider Chart Audits and education on both an individual basis as well as through monthly compliance meetings
- Hold educational sessions for clinical staff in order to keep up to date on all regulations and rules
- Work Insurance denials, inquiries, payments and other issues as well as address patient billing issues resulting from these issues
- Post charges and payments as needed to assist business office activities
- Work with providers and administrator to contract with insurance companies and keep all licensures up to date
- Provide consulting services to Pediatrics, Orthopedics, and General Surgery
- Report on Charges, Receipts, and Denials
- Educate and train Providers on coding and billing activities
American Greetings
Assistant Store Manager
Job overview
- Assist in all aspects of running a store including but not limited to: Staffing, Scheduling, Ordering, Display creation, and Customer service
Fence Post
Store Manager
Job overview
- All aspects of running a store including but not limited to: Staffing, Scheduling, Ordering, Display creation, and Customer service
American Greetings
Store Manager
Job overview
- All aspects of running a store including but not limited to: Staffing, Scheduling, Ordering, Display creation, and Customer service
Education
Lenoir-Rhyne University
MASTERS OF PUBLIC HEALTH
University of Wisconsin
BS from SOCIOLOGY
Herzing University
DIPLOMA OF INSURANCE AND MEDICAL BILLING
Skills
- Forecasting
- Advanced Problem Solving
- Financial Reporting and Analysis
- Budgeting
- Microsoft Office
- APC and DRG Reimbursement Knowledge
- Third Party Reimbursement Expertise
- Financial Resources Management
- Strategy Development
- Business Relationship Management
- Risk Assessment
- Proactive Problem Solving
- Strategic Planning Skills
- Remote Communication Expertise
- Revenue reporting
- Business Intelligence
- Analytical Thinking
- Process Improvement
Projects
NC InCK Kindergarten Readiness Promotion Bundle Implementation
- Planning for Duke Pediatric Departments - lead build and implementation plan for reporting and training of providers and coders., 2022-2024
Collaborative Care Management
- Helped to develop a working report to reduce the burden of coding the service
ICD-10 Training team, 2015
EPIC Physician Trainer with HB and PB Certifications, 2012-2013
References
- Marie Thomas, VP Revenue Cycle Operations, ECLAT Health Solutions, Inc, Durham, NC, (919) 398-2314, marie.thomas@eclathealth.com, Past Manager
- John Sleasman, MD, Dr. Glenn A. Kiser and Eltha Muriel Kiser Professor of Pediatrics, Duke University School of Medicine, Durham, NC, 919-681-2949, john.sleasman@duke.edu, Provider I work with
- Gina Lombardo, Revenue Manager, Duke Health, Durham, NC, (919) 271-9627, gina.lombardo@duke.edu, Coworker
Certification
- Certified Professional Compliance Officer (CPCO)
- Certified Professional Coder (CPC)
- Certified Internal Medicine Coder (CIMC)
Timeline
Compliance Specialist
Duke Health
Coding and Compliance Officer
Internal Medicine Office
Assistant Store Manager
American Greetings
Store Manager
Fence Post
Store Manager
American Greetings
Lenoir-Rhyne University
MASTERS OF PUBLIC HEALTH
University of Wisconsin
BS from SOCIOLOGY
Herzing University
DIPLOMA OF INSURANCE AND MEDICAL BILLING
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