DEBRA B BENAVIDEZ
Edgewood,NM
Summary
Experienced and versed in administrative office management, related regulatory guidelines, and problem-solving and critical thinking. Highly knowledgeable in areas of research grant administration, overseeing internal and external business activities, budget preparation, and fiscal management for AP/AR activities. Knowledgeable of human resources concepts, practices, policies, and procedures. Ability to supervise and train employees, with strong interpersonal and communication skills and the ability to work effectively
Overview
24
24
years of professional experience
1
1
year of post-secondary education
Work History
Revenue Cycle Manager
UNM Student Health & Counseling
Albuquerque, NM
10.2020 - Current
- Exempt employee working 40 plus hours week
- Performs complex and comprehensive financial and operating analyses to be used directly in senior management decision making; gathers clinical practice data from wide variety of internal and external sources
- Participates in strategic business planning for department; research new clinical practice opportunities and make recommendations to management regarding financial feasibility
- Manages daily administrative operations of organization; provides direct supervision to subordinate employees, including planning, assigning, and organizing work; interviews hires, and trains support personnel
- Develops, implements, administers, and evaluates department’s annual clinical revenue action plan
- Monitors and evaluates provision of patient services within practice, including all operations affecting billing and provider productivity; interacts with and guides clinical managers in enhancing operating efficiency and improvement of responsiveness to patients
- Managing staff performance by providing regular feedback, performance reviews, and one-on-one meetings
- Managing revenue cycle department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing
- Oversees and evaluates department's billing operations to ensure compliance with appropriate procedures and applicable laws, regulations, and policies; trains and updates physicians and staff on proper billing and coding practices and recommends remedial action as appropriate
- Provides consultation, leadership, and expertise to internal management in planning, implementation, and delivery of coding education
- Assesses educational needs of coding staff, management, and physicians and develops programs or educational research resources to meet those needs
- Develops and implements comprehensive educational plan for all clinical specialty coding
- Managing and working with physicians regarding medical coding practices
- Strong oral communication skills and ability to deliver presentations to large groups
- Oversees medical coding of multiple clinical department specialties.
Clinical Research Manager
UNM Cancer Center
Albuquerque, NM
09.2019 - 10.2020
- Exempt employee working 40 plus hours week
- Manages clinical monitoring process and administration of clinical trials
- Managing team of Data Coordinators in monitoring, filing, and clinical trial administration
- Plans and organizes daily operations of research unit, to include protocol and systems, budgeting, staffing, and grant/contract administration
- Training data coordinator team members and evaluating their performance
- Assists in all aspects of study design, implementation, and administration, ensuring compliance with HRRC (IRB) requirements, Federal/State regulations, and grant and/or contract parameters
- Provides technical leadership and administrative supervision to technical staff engaged in execution of research protocol; participates in staff hiring, provides training, allocates and coordinates work assignments, and evaluates performance of staff
- Develops quality standards and programs; monitors and maintains quality of unit performance in accordance with internal HSC policies and standards and grant and/or contract parameters
- Develops and/or adapts, implements, and evaluates specific research and data collection methodologies, protocols, systems, and techniques, as appropriate to research specialty area
- Participates in experiment design; may develop and/or coordinate research and computer protocols
- Oversees and coordinates data compilation and computation, ensuring quality control and compliance with protocol; reviews result for validity and reliability and provides initial analyses of results to researchers
- Oversees and coordinates scheduling and efficient usage of research facilities and equipment; ensures that facility and equipment usage follow all relevant federal, state, local, and institutional regulations, policies, and guidelines
- Develops operating goals and objectives for unit; implements and administers methods and procedures to enhance operations as appropriate to team
- Ability to provide technical leadership and direction to lower-level staff members
- Guides and facilitates faculty and staff in developing and preparing research proposals, contracts, sub-contracts, and agreements, including budgets, documentation, and interpretation of funding requirements.
Sr. Revenue Management Specialist Practice Manager
UNM Medical Group
Albuquerque, NM
02.2013 - 09.2019
- Exempt employee working 40 plus hours week
- Experience with HR including Faculty and Staff hiring, OFACD, Faculty Contracts and UNMJobs
- Oversees medical coding of multiple clinical department specialties
- Knowledge of physician documentation requirements for billing purposes
- Experience evaluating and designing business plans in clinical setting
- Plans, monitors, and quality-controls performance of department's clinical revenue-generating operations, including oversight of performance of agents of department; develops and implements appropriate operating benchmarks and standards
- Oversees and administers all facets of acceptance of candidates into medical residency programs to include recruitment, selection, and onboarding of residents
- Experience providing support to faculty in leadership roles and problem-solving in complex environment that spans multiple departments and organizations
- Develops, administers, and coordinates complex clinical rotation schedules for residents
- As appropriate, fellows, both within and external to HSC components, ensures that proper sites and preceptors fully support all rotation schedules
- Experience with all stages of pre-award grant and contract development: identification of funding opportunities, guideline review and evaluation, budget development, completions of electronic and paper applications, document collection and formatting, development of sub-awards, etc.…
- Manages fiscal affairs of unit, including budget planning, expenditure and cost analysis, procedures for expense payments, and financial projections; coordinates account reconciliation and financial reporting activities; develops systems to improve financial control and processing; directs administration of transportation, lodging, and meal coordination for travel, meetings, and conferences; participates in development of new projects and/or programs; may prepare proposals for funding of equipment, remodeling, or other needs of unit
- Performs complex and comprehensive financial and operating analyses to be used directly in senior management decision making; gathers clinical practice data from wide variety of internal and external sources
- Directly and administratively supervises unit employees, including final approval of hiring decisions, performance appraisals, scheduling, training, employee development, disciplinary actions, and conflict mediation; determines staff salary levels; develops procedures and assigns work tasks to improve efficiency
- Responsible for coordination, maintenance, audit, and enhancement of UNMMG chargemaster and provider reimbursement contract management and claims payment verification systems
- Skill in examining and re-engineering operations and procedures, formulating policy, and developing and implementing new strategies and procedures
- Working knowledge and strategic understanding of medical billing and reimbursement principles, procedures, and documentation
- Responsible for reviewing and analyzing reimbursement and related contracts to ensure payors are paying according to contractual terms/conditions and to determine impact of various contract variables on valuation of claims and changes in payor reimbursement
- Provide analytical results and recommendations to management regarding action plans to resolve payment variances, including underpayment appeals
- Using claims payment verification system validates those payments issued to UNMMG are appropriate according to contractual terms/conditions
- Appeals all underpayments identified for assigned payors.
- Managed agendas and calendars, boosting productivity and improving organizational initiatives.
- Adapted to workflow changes and implemented continuous process improvements to overcome obstacles.
- Managed payroll, transactions, invoicing and budgeting to decrease financial inconsistencies.
- Assisted executive leaders in decision-making procedures by creating daily reports to advise leaders on corrective actions and process improvements.
- Reduced recordkeeping errors by precisely handling financial transactions, journal entries and accounts payable and receivable activities.
- Developed revisions for systems and procedures by evaluating operational practices and identifying improvement opportunities.
- Drove workflow improvements by streamlining processes.
- Managed bi-weekly payroll employees, as well as insurance matters, workman's compensation and compliance reporting.
- Increased revenue by developing key programs focused on promoting business.
- Tracked expiration dates on documents and communicated with appropriate staff to avoid late filing.
- Assisted with managed care auditing processes and performed internal file audits.
- Maintained accurate files, records and credentialing documents in well-maintained databases using various of EDC systems
- Worked closely with practitioners to help each obtain privileges at assigned healthcare facilities
- Received and evaluated applications to look for missing and inaccurate information.
- Conducted primary source verifications such as background checks and board certifications.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Pre-screened resumes prior to sending to corporate hiring managers for consideration.
- Completed human resource operational requirements by scheduling and assigning employees.
- Administered benefits programs, analyzed compensation and other competitive data and prepared budgets.
- Oversaw HR needs for fifty -employee and over saw ten divisions.
- Reduced expenses by analyzing compensation policies and implementing competitive programs while ensuring adherence to legal requirements.
- Handled ten calls per day to address customer inquiries and concerns
- Identified issues, analyzed information and provided solutions to problems
- Participated in continuous improvement by generating suggestions, engaging in problem-solving activities to support teamwork
- Created plans and communicated deadlines to complete projects on time.
- Devoted special emphasis to punctuality and worked to maintain outstanding attendance record.
- Learned new skills and applied to daily tasks to improve efficiency and productivity.
- Participated in team-building activities to enhance working relationships.
- Created spreadsheets using Microsoft Excel for daily, weekly and monthly reporting.
- Resolved conflicts and negotiated mutually beneficial agreements between parties.
Director
Lovelace, Central Business Office, Lovelace Rehabilitation Hospital
Albuquerque, NM
03.1998 - 02.2013
- Patient Access, Pre-Registration, and Insurance Verification, exempt employee working 40 plus hours week and on every other weekend
- Provided managerial oversight of scheduling function for all providers, including but not limited to physicians, mid-levels, and fellows in medical and radiation oncology, in addition to supporting surgical and diagnostic sub-specialties
- Regularly interacted with chief executive officer and chief financial officer for improving patient service and responsiveness to referring providers
- Identified appropriate metrics and performed comprehensive financial analyses in direct support of senior leadership decision-making related to operational effectiveness in collating, collecting, and submitting in- and outpatient charges
- Responsible for charge reconciliation, performing appropriate research, as necessary, to identify missed charges with Department/division
- Responsible for working with providers and Lovelace clinic staff as electronic outpatient charge capture systems are implemented in coming year
- Worked in collaboration with Department CEO and Administration to develop and implement operating procedures for front-end charge capture process
- Responsible for all activities pertaining to collection of accounts receivable for Medicare, Medicaid, HMOs, PPOs, insurance plans, and any other third-party accounts receivable.
Education
Certified Physician Practice Manager (CPPM) - Health Administration, Public Administration
American Academy of Professional Coders (AAPC)
Salt Lake City, UT 01.2024 - 05.2025
High School Diploma -
Sandia High School
Albuquerque, NM05.1991
Skills
- Data Analysis
- Compliance Assessment
- Creative and Innovative
- Adaptable to Changing Conditions
- Performance improvement
- Project Management
- Budgeting
- Strategic planning
- Business administration
- Decision Making
- Team Collaboration
- Financial administration
- Strategic leadership
- Database development
- Financial Management
- Business Development
Timeline
Certified Physician Practice Manager (CPPM) - Health Administration, Public Administration
American Academy of Professional Coders (AAPC)
01.2024 - 05.2025
Revenue Cycle Manager
UNM Student Health & Counseling
10.2020 - Current
Clinical Research Manager
UNM Cancer Center
09.2019 - 10.2020
Sr. Revenue Management Specialist Practice Manager
UNM Medical Group
02.2013 - 09.2019
Director
Lovelace, Central Business Office, Lovelace Rehabilitation Hospital
03.1998 - 02.2013
High School Diploma -
Sandia High School
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