ELYSE AIKIN
Prince Frederick,MD
Summary
Reimbursement professional with proven track record in managing complex reimbursement processes and ensuring compliance with regulatory standards. Known for strong collaboration and results-driven approach, adaptable to changing needs, and reliable in team settings. Skilled in financial analysis, process optimization, and strategic planning.
Overview
18
18
years of professional experience
Work History
Senior Reimbursement Analyst
CalvertHealth
02.2018 - Current
- Prepare, analyze, and project revenue and volume trends and provide recommendation of rate and mark-up changes as appropriate to meet targets and unit rate compliance
- Assist in the preparation and development of the annual budget, including the build of new fiscal year datasets, FTE, salary, and additional pay within Strata Jazz
- Collaborate with clinical departments and Information Systems to ensure proper charging compliance and reduction of denials
- Ensure complete and accurate data is produced on the HSCRC case mix data submission
- Maintain up-to-date knowledge of payment adjustments such as QBR, CDS-A, Market-share and regulatory changes affecting reimbursement.
- Proactively adapting processes accordingly to meet regulatory and industry changes
- Complete financial analyses of revenue generating services to assist in the evaluation and performance of current and future service lines
- Compile and distribute weekly, monthly, and quarterly volume and revenue reports as assigned by senior and executive leadership
- Review of charge audits from government and commercial payers resulting in process improvement, compliance and reduction of audit findings
- Assist with the preparation of the Annual Filing and Medicare Cost Report
- Coordinate and manage the continual update and maintenance of the Charge Description Master
- Report mandated financial and statistical data to the Maryland Health Services Cost Review Commission (HSCRC)
- Assist the Director of Financial Planning and Reimbursement with projects as needed
Supervisor Financial Counseling and Vendor Relations
CalvertHealth
12.2016 - 02.2018
- Supervised and coordinated daily operations of the revenue cycle activities related to customer service, financial counseling, and vendor relations
- Developed tracking reports and presented findings to all levels of management as needed
- worked collaboratively with management to identify training opportunities throughout the revenue cycle
- Completed monthly reconciliation between vendors and patient accounting system
Practice Administrator
Grace Care, LLC
05.2008 - 12.2016
- Managed a team of 15, consisting of the Billing, Accounts Receivable and Customer Service workflows and daily performance activities
- Ensured compliance with billing requirements for Durable Medical Equipment
- Provided executive leadership with sales projections
Education
Bachelor's Degree - Health Services Management
University of Maryland Global Campus
Adelphi, MD 05.2022
Master of Science - Accounting And Financial Management
University of Maryland Global Campus
Adelphi, MD12-2028
Skills
- Strata Jazz
- UKG Productivity
- Microsoft Office (Excel Proficient)
- Financial Reporting
- Strategic Planning
- Independent Problem Solver
- Report Preparation and Presentation
- Time Management
- Multi-Team Collaboration
- Healthcare Reimbursement
- Leadership
Timeline
Senior Reimbursement Analyst
CalvertHealth
02.2018 - Current
Supervisor Financial Counseling and Vendor Relations
CalvertHealth
12.2016 - 02.2018
Practice Administrator
Grace Care, LLC
05.2008 - 12.2016
Bachelor's Degree - Health Services Management
University of Maryland Global Campus
Master of Science - Accounting And Financial Management
University of Maryland Global Campus