Eileen Blackwell
Jackson
Summary
Revenue Cycle Director with over a decade of expertise in healthcare billing and revenue cycle management, leveraging advanced analytics and innovative strategies to drive financial performance and operational efficiency. Skilled in team leadership, appeals processes, and payer policy navigation, consistently achieving high success rates in appeals and optimizing revenue streams. Passionate about fostering continuous improvement and implementing transformative solutions for sustainable growth.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Revenue Cycle Director
Shore Heart Group
06.2021 - 01.2025
- Works collaboratively with other departments/senior leadership to identify, install & manage
revenue performance improvement initiatives
Measure & manage staff performance/productivity and employment standards
Providing strategic analysis/assessments resulting in long-term RCM transformational work - A team player; Led development of
opportunities and management of team resources to grow the business - Developed a solid system for denial prevention and patient billing
Provide analysis and data-driven recommendations on deliverables to the practice administrator and managing partners
Mentor develop and coach new and existing staff, Assisting them to create reference materials specifically for their role.
Contribute to the compliance with, development, and updating of, department standard
operating policies and procedure - Conduct performance evaluations, counsel, and provide corrective actions to assigned
personnel, and work to facilitate individual and team development that drives positive results. Responsible for compliance with and enforcement of company/department policies and procedures - Work closely with Hospital Campuses and Surgery Center Regional Directors (RD) and other
members of Operations, as well as other departments, to convey issues and propose solutions
that will improve efficiencies, and reduce costs
Monitor and manage designated departments' labor costs, inventory levels, and production
planning. Optimize productivity while avoiding unnecessary expenses such as excess overtime
Lead initiatives to develop new approaches to streamline existing processes, reorganize work,
implement new technologies, and improve resource utilization, with a focus on the best cost
methods.
Complete Pre-cert and Collection department set up, with hybrid capabilities - Establish and
maintain open communications with contract facility customers. Monitor key performance
indicators and collections goals, resolve billing issues assist in documentation review for
appeals, and ensure accurate timely payments.
Review current coding guidelines and implement them with the team of coders and collectors
Manage pre-cert department workflow ensuring all procedures are authorized before service; minimizing no authorization denials
Managed over 25 employees time approvals, working closely with HR (Extensis) (Quickbooks) - Optimized software usage through regular system updates, customization of modules, and staff training sessions.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Analyzed business processes to identify cost savings and operational efficiencies.
Sr. Revenue Cycle Appeal Specialist
Orthopedic Sports Medicine & Rehabilitation Center
01.2019 - 01.2021
- Trained staff on appeals, enhanced team efficiency, and denial management skills
- Optimized appeal processes through in-depth analysis of surgeries, edits, and payer medical policies, significantly enhancing revenue outcomes.
- Assist the VP of Revenue Cycle in team meetings to instruct and prepare for the implementation of deliverable projects.
- Strong relationships with payers, nurse case managers, medical directors, and internal stakeholders; facilitated smoother communication and favorable appeal outcomes
- Led comprehensive training programs for new hires, focusing on appeal processes and AR Denial management to boost team efficiency and skills
- Analyzed medical documentation and payer policies, achieving 90% success in appeals and significantly enhancing revenue outcomes. Utilizing this information to assist providers in criteria for medical necessity.
- Monitored ongoing industry trends related to healthcare appeals management; staying current on best practices and adjusting strategies to maintain effectiveness.
- Improved claim resolution times by efficiently managing a high volume of appeals and coordinating with various departments.
- Developed customized appeal letters tailored to each case's unique circumstances, increasing the likelihood of successful outcomes.
- Acted as a reliable resource for colleagues in need of assistance or guidance on complex cases, fostering a collaborative and supportive work environment.
Revenue Cycle Director
MBW Billing Services a DME Company
09.2015 - 11.2018
- Led revenue optimization for 16 branches, enhancing efficiency and compliance
- Specialized in resolving claim denials, and improving claim acceptance rates
- Trained staff on Medicare, Medicaid, and commercial billing protocols
- Analyzed financial trends, producing actionable insights for revenue growth
- Maintained provider portals, ensuring seamless user access and activity
- Developed a trend reporting system for billing errors and denial codes, enhancing clean claim submissions and reducing rejections
- Conducted regular staff training on prescription order accuracy, Same and Similar checks, and insurance portal management to boost team efficiency
- Spearheaded nationwide Medicare billing practices implementation, ensuring jurisdiction rule compliance and streamlining operations across branches
- Optimized revenue cycles for 16 branches, enhancing efficiency and compliance
- Analyzed financial trends to produce actionable insights for growth
- Supported organizational growth initiatives through proactive involvement in budget planning and financial forecasting activities.
- Reduced outstanding accounts receivable balances by diligently monitoring aging reports and following up on overdue invoices.
- Ensured timely claim submission by effectively managing coding workflows within the department.
- Mentored junior staff members to develop their skills and advance within the organization''s revenue cycle management hierarchy.
- Boosted patient satisfaction by providing timely, accurate billing statements and addressing inquiries with professionalism and empathy.
- Participated in industry conferences and educational sessions to stay current on emerging trends, best practices, and regulatory changes affecting healthcare revenue cycle management.
- Achieved a high level of compliance by implementing strict adherence to regulatory guidelines, including HIPAA privacy rules.
- Improved overall financial performance with consistent evaluation and implementation of revenue cycle best practices.
Education
CPC -
AAPC
02.2025
BLS -
01.2024
Certification -
BOC
01.2018
Associate - Business
Cuny Queens College
01.2000
CPT -
Sanford Brown
01.1999
Skills
- Revenue Cycle Management
- Payer Policies
- Appeals Processes
- Documentation Review
- Analytics
- Project Management
- Team Leadership
- Hospital Information Systems
- Professional Claims
- Facility Claims
- Pharmacy Billing
- Durable Medical Equipment
- Out of Network Negotiations
- KPI
- Deliverable Reporting
- Denial resolution
- Revenue cycle optimization
- Revenue performance
- Medical coding
- Claims investigation
- Claims management
- Organizing and prioritizing work
- Revenue enhancements
- Budgetary analysis
- Revenue metrics analysis
- Policy review
- Billing cycle performance
- Policy analysis
- Attention to detail
- Problem-solving abilities
- Critical thinking
- Account management
- Team management
- Negotiation tactics
- Financial analysis and reporting
- Payment and investigation escalations
- Regulatory compliance adherence
- Client relationship management
- Operations management
- Goal setting
Personal Information
Title: Revenue Cycle Director / Billing Manager
Certification
Basic Life Support
Languages
Spanish
Limited Working
Timeline
Revenue Cycle Director
Shore Heart Group
06.2021 - 01.2025
Sr. Revenue Cycle Appeal Specialist
Orthopedic Sports Medicine & Rehabilitation Center
01.2019 - 01.2021
Revenue Cycle Director
MBW Billing Services a DME Company
09.2015 - 11.2018
BLS -
Certification -
BOC
Associate - Business
Cuny Queens College
CPT -
Sanford Brown
CPC -
AAPC
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