Strong leader and SME with 24 years of RCM expertise who leverages sound judgement to collaborate and solve problems while streamlining operations to decrease costs and accelerate cash collections. Detail-oriented team player with strong organizational skills with the ability to handle multiple projects simultaneously with a high degree of accuracy. Served on AAPC National Advisory Board [2013-2015].
Hi, I’m
Erica T. Cousin
Kernersville,NC
Summary
Overview
26
years of professional experience
3
Certifications
Work History
West Virginia University Medicine
Manager, Enterprise PB Coding
2023.06 - Current (2 education.years_Label & 2 education.months_Label)
Job overview
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Cross-trained existing employees to maximize team agility and performance.
- Maximized performance by monitoring daily activities and mentoring team members.
- Monitored and analyzed business performance to identify areas of improvement and make necessary adjustments.
- Communicated clearly with employees, suppliers and stakeholders to keep everyone on same page and working toward established business goals.
- Developed and maintained relationships with customers and suppliers through account development.
- Controlled costs to keep business operating within budget and increase profits.
- Developed and implemented business strategies to achieve business goals and stay competitive.
- Planned and budgeted accurately to provide business with resources needed to operate smoothly.
- Defined clear targets and objectives and communicated to other team members.
Steward Healthcare
Sr. National Director, RCM
07.2022 - 10.2022
Job overview
- Multitasked and managed multiple deliverables and projects concurrently and facilitated enterprise resource planning.
- Collaborated on deployment automation solutions to expedite implementation of advance technologies.
- Solved functional and technical obstacles and worked closely with project team from multidisciplinary workstreams.
- Identified and diminished performance gaps by coaching and supervising RCM team members.
- Evaluated existing operations and current market trends to identify necessary improvements and capitalize on changes.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Set aggressive targets for employees to drive company success and strengthen motivation.
- Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Developed flowcharts and diagrams to describe and lay out logical operational steps.
- Responsible for improvements in the revenue cycle
- Leveraged data mining and analytics to identify RCM improvement opportunities.
- Engage in all aspects of revenue cycle management to work strategically, proactively, and collaboratively align system resources for effective outcomes.
- Provided strategic operational leadership and oversight for all processes associated with revenue cycle operations
- Ensured compliance with administrative, legal, and regulatory requirements associated with federal and commercial regulations.
- Served as the subject matter expert (SME) in revenue cycle management, including reporting results to executive-leadership, identifying performance issues, and recommending actions to drive success.
Conifer Health Solutions
Market Director, Clinical Revenue Integrity
01.2017 - 06.2022
Job overview
- Accountable for driving sustainable, measurable, and optimal mid-revenue cycle operations/outcomes.
- Facilitated multidisciplinary collaborations and implementations on revenue cycle optimizations and standardizations.
- Responsible for research and communication of healthcare regulations relative to federal, commerical, acute care, FFS, and specialty practices.
- Developed and executed tactical plans/budgets to achieve strategic goals.
- Oversight of coding operations including productivity and quality initiatives aligned with organization and client goals.
- Maintained corporate coding standards, core competencies, and performance expectations.
- Collaborated with coding audit team on action plan development in response to coding quality audit results.
- Tracked/trended application of CRI policies/procedures to steer mid-cycle operations towards KPI targets
- Involved with business expansion and targeted growth activities.
Conifer Health Solutions
Manager, Clinical Revenue Integrity
01.2015 - 01.2017
Job overview
- Expanded cross-functional organizational capacity by collaborating across departments on priorities, functions and common goals.
- Required to successfully execute complex scope of assigned projects.
- Required to act as primary on-site adviser to client.
- Accountable for implementation and monitoring of operational performance metrics for both client and project team.
- Responsible for identifying opportunities for development of business and IT strategies.
- Required to anticipate solutions to prevent potential financial and compliance liability to the client and Conifer Health Solutions.
- Responsible for facilitating meetings/ presentations with project team and/or executives of client’s organization.
- Required to exhibit superior mid-cycle analysis skills and in-depth knowledge of key benchmarks.
- Compiled data highlighting key metrics to report information, determine trends and identify methods for improving mid-cycle processes.
- Evaluated report data to proactively adjust and enhance operations.
- Cross-trained existing employees to maximize team agility and performance.
- Executed gap analysis on CRI processes for new acquisitions.
- Made recommendations based on gap analysis and industry best practices.
- Facilitated operational alignment with core performance metrics.
- Change agent responsible for managing all aspects of mid-cycle transitions.
- Delivered efficient operational status for new clients
- Stabilized client processes for transition into operations
- Collaborated with client executive leadership to exceed transition expectations that allowed clients to focus on delivering quality care to the patients they served.
- Responsible for managing the productivity, quality and staffing needs of A/R team.
Cornerstone Healthcare
Central Charge Review Supervisor
01.2013 - 10.2014
Job overview
- Coordinated schedules for optimal coverage of daily workload and adjusted quickly to changing demands.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Facilitated communications between internal customers and field personnel to answer questions or resolve concerns.
- Maintained energy and enthusiasm in fast-paced environment.
- Performed duties in accordance with applicable standards, policies and regulatory guidelines to ensure workplace compliance.
- Developed and maintained courteous and effective working relationships.
- Coordinated daily work for Central Charge Review Representatives to ensure accuracy, appropriateness and timeliness of submitting charges to insurance carriers
- Innovatively restructured the charge review team into provider based-payer specific subject matter experts.
- Improved coding accuracy while providing staff with specialty coding, cross-training opportunities
- Designed a newsletter to promote coding accuracy by providing relative coding and payer trend updates.
- Accountable for identifying and resolving practice charge entry errors
- Oversaw the efficient, timely, and accurate charge capture for 48 practices.
Cornerstone Healthcare
Medicare/ Medicaid Patient Account Representative Supervisor
01.2012 - 01.2013
Job overview
- Collaborated with CBO service lines to resolve issues with billing, claim follow-up, and payments.
- Oversaw reconciliation of EOBs with patient financial records.
- Prepared reports detailing follow-up actions, flags and other key information.
- Monitored flags and resolved urgent items with accuracy and efficiency.
- Compiled and analyzed data for review by senior management of bad debt or write-off prospects.
- Prevented impending loss and increased profitability by enforcing scheduled collection campaigns, consistently achieving targeted recovery rate.
- Provided educational and operational support to patient account representatives.
- Identified and addressed A/R trends, inefficiencies or system opportunities.
- Responsible for identifying qualified applicants, interviewing, training and evaluation of employees.
Novant Health
Cash Applications Supervisor
01.2009 - 01.2012
Job overview
- Complied with established internal controls and policies.
- Performed routine closings, maintained clean, accurate and accessible records and kept close eye on transaction updates throughout each quarter.
- Established and enforced internal controls, workflows and policies for tracking, reconciling and reporting on accounting activities.
- Recruited, interviewed, hired and trained employees; and implemented mentoring program to promote positive feedback and engagement.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Developed strategic plans for day-to-day cash application operations.
- Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
- Identified improvement changes regarding key processes for internal controls and cash application procedures.
- Validated existing accounting management and reporting systems to assess quality and conformance, identify problems and implement corrective actions.
- Oversight for all components of cash application functions, including payment posting, general ledger allocations, bank reconciliation, bad debt logs, cash management functions, finance audits and EFT processing.
- Identified and resolved AR trends relative to cash applications.
- Monitored staff productivity and completed quality assurance audits.
Accu-Med Services
Billing Manager
01.2007 - 01.2009
Job overview
- Reviewed billing problems, researched issues and resolved concerns.
- Managed monthly billing process to complete billings and returns to meet company revenue policies.
- Trained and mentored staff on procedures, compliance requirements and collections techniques.
- Created new standard operating procedures improving billing accuracy and cash flow.
- Performed billing, collection and reporting functions for office generating over $15M annually.
- Conducted performance reviews and implemented improvement plans.
- Performed testing for billing modules, enhancing new functionality and process improvements.
- Complied with established internal controls and policies.
- Performed routine closings, maintained clean, accurate and accessible records and kept close eye on transaction updates throughout each quarter.
- Established and enforced internal controls, workflows and policies for tracking, reconciling and reporting on accounting activities.
- Checked payroll, vendor payments, expense reimbursement and other accounting disbursements for accuracy and compliance.
- Oversaw all aspects of billing including coding, EDI, AR and payment posting for radiological and DME providers.
- Facilitated payer credentialing and provider enrollment for radiological and DME providers.
- Indirectly managed X-Ray and Ultrasound Technicians
- Created monthly practice analysis and budget reports for clients.
- Oversaw all bookkeeping and payroll processes.
MedQuest Associates
Certified Coding Associate
01.2003 - 01.2007
Job overview
- Interacted with radiologists and other healthcare staff to ensure coding accuracy.
- Reviewed outpatient radiological records and interpreted documentation to identify diagnoses and procedures.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Resourcefully used various coding books, procedure manuals and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Correctly coded and billed medical claims for IDTF facilities.
- Accurately selected proper descriptive code when more than one anatomical location was indicated.
- Verified signatures and checked medical charts for accuracy and completion.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
MedQuest Associates
Accounts Receivable Associate
01.2002 - 01.2003
Job overview
- Responded to inbound and initiated outbound inquiries regarding accounts and payments.
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Collaborated on coding and billing education for IDTFs and business service center personnel.
- Responsible for all claims and self-pay collections including claim denial corrections.
First Choice Diabetic Supplies
Office Manager
01.1999 - 01.2002
Job overview
- Aggregated and analyzed data related to administrative costs to prepare budgets for CEO.
- Communicated company objectives through regular correspondence and status updates.
- Maintained computer and physical filing systems.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Optimized organizational systems for payment collections, AP/AR, deposits and recordkeeping.
- Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.
- Coached new hires on company processes while managing employees to achieve maximum production.
- Managed budgets, appointment scheduling, employee and event itineraries and accounts to improve productivity initiatives.
- Utilized client and staff feedback to maintain customer partnerships and increase revenue.
- Monitored and evaluated personnel performance to complete annual reviews, recommend advancement or address productivity concerns.
- Managed customer shipments, customer file maintenance and supply inventory.
- Created and distributed marketing materials.
- Validated and reconciled coding, billing, AR, and cash applications for all revenue.
First Southern Cash Advance
Branch Manager
01.1998 - 01.1999
Job overview
- Maintained friendly and professional customer interactions.
- Required to hire, train and evaluate new employees
- Enhanced branch production rates through efficient cash advance repayment processes.
- Created strategies that developed and expanded existing customer sales, resulting in increase in annual sales.
- Maintained confidentiality of bank records and client information to prevent mishandling of data and potential breaches.
- Evaluated applications against outline specifications to approve or reject cash advances.
- Executed daily validation and reconciliation of bank deposits and withdrawals
- Maintained and balanced branch cash drawers.
Education
NC A&T University
Bachelor of Science from Industrial Engineering
University Overview
Kaplan University
Bachelor of Science from Business Administration And Management
University Overview
Skills
- End-To-End Revenue Cycle Management SME
- Revenue Growth
- Business Operations
- Operational Efficiency
- Collaborate Cross-Functionally
- Administration and Reporting
- Certified Coder/Instructor and Revenue Cycle Representative [CPC, CPCI, CRCR]
Certification
- CRCR- Certified Revenue Cycle Representative
- CPC - Certified Professional Coder
- CPCI- Certified Professional Coder Instructor
Timeline
Manager, Enterprise PB Coding
West Virginia University Medicine
2023.06 - Current (2 education.years_Label & 2 education.months_Label)
Sr. National Director, RCM
Steward Healthcare
07.2022 - 10.2022
Market Director, Clinical Revenue Integrity
Conifer Health Solutions
01.2017 - 06.2022
Manager, Clinical Revenue Integrity
Conifer Health Solutions
01.2015 - 01.2017
Central Charge Review Supervisor
Cornerstone Healthcare
01.2013 - 10.2014
Medicare/ Medicaid Patient Account Representative Supervisor
Cornerstone Healthcare
01.2012 - 01.2013
Cash Applications Supervisor
Novant Health
01.2009 - 01.2012
Billing Manager
Accu-Med Services
01.2007 - 01.2009
Certified Coding Associate
MedQuest Associates
01.2003 - 01.2007
Accounts Receivable Associate
MedQuest Associates
01.2002 - 01.2003
Office Manager
First Choice Diabetic Supplies
01.1999 - 01.2002
Branch Manager
First Southern Cash Advance
01.1998 - 01.1999
NC A&T University
Bachelor of Science from Industrial Engineering
Kaplan University
Bachelor of Science from Business Administration And Management
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