Dawn Coleman
Gilbert,AZ
Summary
An effective communicator, team builder, and certified professional coder with two decades of revenue cycle leadership experience. Expert knowledge and understanding of UB-04, CMS-1500 claim forms, EOB's, ICD-10 CM, CPT, HCPCS, DRG, Evaluation and Management codes, and NCCI coding edits. Working in a fast-paced environment, solving problems for continuous process improvements and key performance improvements in areas such as daily operations, department workflows, billing, follow-up, customer service, denials management, collections, cash posting (ERA’s) and reconciliation, outsourced bad debt, self-pay accounts, and maintaining vendor relationships. As an independent and creative thinker, I am searching for an opportunity to contribute to an organization whose mission is to support ongoing innovation to produce high quality performance. Ideally, I want to work with teams that are passionate about establishing processes that exceed industry standards. Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Passionate about continuous learning and professional development.
Overview
13
13
years of professional experience
1
1
Certification
Work History
PFS Manager
Valleywise Health
Phoenix, AZ
09.2016 - 11.2023
- Achieved reductions in AR days, which resulted in more cash collected through mentorship and coaching
- Provided day-to-day operational oversight and improved workflows in Billing, Collections, Cash Posting, and Customer Service
- Tracked billing, coding, self-pay/insurance payments and collections trends using EPIC reports, targeted high dollar accounts for collections and identified root causes of credit balances to improve key performance metrics
- Collaboration with the Revenue Cycle Director and department leaders to monitor and improve EPIC WQ's and dashboard performance
- The purpose was to report at a high level to the senior management
- The leadership and finance teams
- Working closely with EPIC IT team on day-to-day workflow challenges
- Assured that point of service and revenue cycle teams understood federal compliance, OIG initiatives, and state billing and reimbursement regulations by developing and maintaining standard operating procedures and workflows
Owner/ Operator
Trinity Billing Professionals
San Tan Valley, AZ
03.2013 - 08.2016
- Ensured all aspects of the revenue cycle are managed, such as revenues, EFT enrollment, billing, rejected claims, FQHC collections, denials, appeals, and refunds; maintained AR, month-end reconciliation, credentialing, and policies and procedures; maintained a 90% clean claim rate
Billing Supervisor
Phoenix Children's Hospital
Phoenix, AZ
05.2012 - 06.2015
- Supervised twelve employees, monitored daily billing, charge entry, medical records, refunds, variances, and cash posting and reconciliation
- Achieved timely submissions of unbilled, rejected, secondary, fatal and CCI edits
- Served as Interim Customer Service Manager for 4 months
- Achieved effective root cause analysis and resolution by evolving the team from crisis management to a solution-focused organization
- Implemented data tracking and workflow for bankruptcy applications and charity applications
Account Manager
Medical Billing Specialists
Gilbert, AZ
12.2011 - 05.2012
- Managed AR for an intraoperative monitoring company, a pulmonologist, and a sleep center
- Achieved a 30% increase in receivables and maintained monthly billing
- Identified and resolved billing issues by facilitating monthly meetings with practice managers to discuss procedures and contract negotiations
Patient Financial Service Representative
Banner Health
Mesa, AZ
04.2011 - 12.2011
- Responsible for managing large volumes of BCBS Western Region claims, reviewing EOBs for accuracy, appealing claims denied for invalid ICD9 and CPT codes, timely filing of claims, and short payments of claims
- Worked with insurance companies to adjudicate unpaid claims outlined in contracts to prevent claims from becoming uncollectible
- Maintain monthly aging reports to prevent claims from becoming uncollectible
Education
Candidate For B.S. - Healthcare Administration
Columbia Southern University
01-2026
Fundamentals of Medicine Training Course -
AAPC
09.2024
CPC -
American Academy of Professional Coders
01.2024
Skills
- EPIC Enterprise HB/PB
- AMPFM/MedAssets
- MS4
- MYSIS
- NueMD
- Microsoft Office
- EHR
- ChartMaxx
- Isuite
- Kidscan
- Cerner
- Practice Fusion
- Coaching and mentoring
- Innovation management
- Performance evaluations
- Risk management
- Conflict resolution
- Decision-making
- Vendor management
- Data analysis
- Complex Problem-solving
- Contract management
- Policy and procedure development
- Performance management
- Regulatory compliance
- Trend analysis
- Time management
- Revenue management
- Policy implementation
- Change management
- Operations management
- Budget control
- Project planning
- Strategic planning
- Key performance indicators
Certification
- Certified Professional Coder (CPC), AAPC, 2024
- Lean Six Sigma Certified, Yellow Belt, 2018
- Certified Revenue Cycle Representative (CRCR), HFMA, 2014
Accomplishments
- Provided revenue cycle (PFS) training to members of a multi-specialty, FQHC, hospital-based facility on billing and collections.
- A reduction of the AR to 45 days was achieved by discovering trends in denials to improve insurance and patient collections.
- Improved process for reconciling cash applications.
- A 54% reduction was achieved in outstanding credit balances.
- Reduced customer service call abandonment rate by 12%.
- Teamed up with the Chief Compliance Officer, in establishing a Patient Identity Theft Prevention Committee.
Professional References
Available upon request
Professional Development
- Certified Professional Coder (CPC), American Academy of Professional Coders, 01/01/24, present
- CPC (ICD10, CPT Coding and Billing)/ Fundamentals of Medicine Training Course, AAPC, 03/01/24, 09/30/24
- Candidate for B.S. in Healthcare Administration, Columbia Southern University, 01/01/20, present
Technical Skills
· EPIC Enterprise HB/ PB– Valleywise Health
· AMPFM/MedAssets - Phoenix Children's Hospital
· MS4 - Banner Health
· NueMD- Trinity Billing Professionals
· Microsoft Office -Advanced Proficiency in Word, Power Point and Excel with regards to spreadsheets, formulas, and pivot tables
References
References available upon request.
Timeline
PFS Manager
Valleywise Health
09.2016 - 11.2023
Owner/ Operator
Trinity Billing Professionals
03.2013 - 08.2016
Billing Supervisor
Phoenix Children's Hospital
05.2012 - 06.2015
Account Manager
Medical Billing Specialists
12.2011 - 05.2012
Patient Financial Service Representative
Banner Health
04.2011 - 12.2011
Candidate For B.S. - Healthcare Administration
Columbia Southern University
Fundamentals of Medicine Training Course -
AAPC
CPC -
American Academy of Professional Coders
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