Fred Mitchell
Lancaster,CA
Summary
Dedicated Healthcare Revenue Cycle professional with a history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Operations Manager
University of California San Diego Health – Patient Financial Service
09.2023 - Current
- Involves revenue cycle functions for the healthcare enterprise managing inventory for Aetna, Anthem, and Cigna, including system billing, reporting and support
- Ensures account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services
- Impacts processes to include charge capture, coding, insurance identification, data entry, billing, payment posting, refund processing and collections and responsible for / integrated with business office operations
- Provides immediate supervision to a unit of operational and technical employees
- Supervises unit operations to ensure compliance with departmental or organizational policies, procedures, and defined internal controls
- Ensures accountability and stewardship of department resources (operational, financial, and human) in compliance with departmental standards and procedures
- Supervises employees responsible for revenue cycle activities
- Receives predetermined work assignments that are subject to a moderate level of control and review
- Directs subordinates to complete assignments using established guidelines, procedures, and policies
- Works on issues of limited scope
- Manages and leads the daily operations and acts as a resource to staff
- Supervises assigned staff accountability and stewardship of departments resources, ensuring compliance with revenue cycle guidelines
- Ensure staff meets project goals, objectives and timelines within budget
- Participates in the selection, development and evaluation of staff to ensure the efficient operations of the healthcare revenue cycle department
- Recommends salary actions, terminations, performance ratings and other human resources matters
- Delegates work assignments for equal distribution
- Monitors revenue cycle operations, and is responsible for the department's authorization / billing process to maximize reimbursement and minimize billing cycle denials
- Assists with the development of efficient workflows for capturing data from admitting / registration, charge master, decision support, reimbursement, medical records, business office and clinical departments
- Assists in the launch of training programs
- Trains subordinate staff so they are able to offer the departments' ongoing education and training on revenue cycle management policies and procedures
Revenue Cycle Client Service Manager
University of California San Francisco Health – Physician Billing Services
03.2020 - 10.2021
- Coordinate all on-boarding activities related to the revenue cycle for new providers including but not limited to: understanding of services to be provided, charge documents, EMR and Practice Management system set up, workflows for charge capture identified and documented, time of service collection process, and client expectations
- Function as primary point of contact for the client to front end revenue cycle issues and help streamline business operations as they relate to the revenue cycle
- Working collaboratively with coding/compliance departments to ensure providers are receiving appropriate training and feedback
- Work in close partnership with the operational management team and all PBS departments in order to be proactive in assuring successful charge entry, resolution of accounts receivable and patient satisfaction
- Provide accounting and performance reporting/support to the client
- Receive and provide ad-hoc financial reports with recommendations and or status updates
- Receiving Month End Report from production and monitor Month End Balancing Analysis
- Providing for final review and distribution of month-end and executive reports with performance analysis
- Quarterly/Biannual/Annual Client Reviews with primary stakeholders of each specialty
- Review of monthly account balances and aging
- Coordinate and facilitate the processing of billing documentation that requires client interaction regarding discrepancies, credit balances, pending charges, and referrals to collection agencies
- Guide and participate with appropriate PBS management team members in conducting “special projects” as requested by client
- Participate in monthly management meetings to organize, coordinate and enhance service functions
- Provide monthly Client Activity Summaries and Progress Reports to Executive Management
- Maintain regular communications with Coding Department to monitor APCs and to resolve subsequent coding issues
- Support Operations as appropriate in calls or face-to-face meetings on behalf of clients to resolve reimbursement issues with difficult payers
- Promotes and maintains superior customer service to physicians, patients, and all other clients
Patient Financial Services Supervisor
Cedars Sinai Medical Center – Patient Financial Services
02.2017 - 03.2020
- Department conducts patient and physician billing for entire facility (886 beds)
- Review Cisco Reports for call center for accuracy and consistency
- Approve/deny staff time off requests, review Kronos for attendance, oversee daily staffing assignments
- Review settlement requests and escalated requests
- Review and resolve patient inquires while working closely with Risk Management and Quality Services department
- Conduct staff annual performance reviews and corrective actions
- Screen, interview and onboard new hires through interdepartmental cross-training
- Conduct urgent topic department huddles and monthly meetings
- Attend monthly roundtable with Director to provide department KPI for high level performance metrics report
- Collaborate with Enterprise Information Services (EIS) for department work queues
- Supervise30+ direct reports including2 Team Leads,4 contractors, and3 interns
Patient Financial Services Team Lead
Cedars Sinai Medical Center – Patient Financial Services
02.2013 - 10.2017
- Lead15+ employees; perform staff reviews; mitigate issues, and provide staff work assignments
- Generate daily/monthly reporting for the department and senior management
- Perform monthly and quarterly Quality Reviews (QR’s) for department
- Complete Bad Debt approval review with a threshold of $2,500 - $15,000
- Create and approve Work Papers/Job Aid documents
- Trained ancillary departments, outsourced vendors, and new hires on department functions
- Facilitate department meetings and in-service; serve on interview panel for candidates
- Serve as point of contact for the Heart Institute, Breast Center, and THO
- Single Billing Office (SBO) credentialed trainer
Financial Care Specialist I
Cedars Sinai Medical Center – Patient Financial Services
02.2010 - 01.2013
- Handled inbound/outbound call and patient account-related issues
- Processed payments and refunds, created payment plans, and resolved self-pay account issues
- Processed discount to CSMC employee and physicians
Commercial Follow-Up
Cedars Sinai Medical Center – Samuel Oschin Cancer Center
10.2009 - 02.2010
- Submitted appeals for underpaid claims/denials and resolved outstanding patient balances
- Submitted/resubmitted claims to primary and/or secondary carriers; Resolved weekly ATB Report
- Handled inbound/outbound calls to insurance and patients; Requested/submitted medical records
Commercial Collector
Providence Health Systems – Patient Financial Services
03.2008 - 09.2009
- Reviewed commercial payer contract for expected reimbursement and adjusted claims accordingly
- Resubmitted claims, medical records, and itemized statements with proper documentation
- Collaborated with Insurance Representatives to verify patient responsibilities
- Generated A/R and month-end reports; reviewed payer correspondence
Collector (Eisenhower Medical Center)
Cymertrix
06.2006 - 03.2008
- Professionally answered inbound/outbound insurance claim status calls
- Reviewed and analyzed EOB, contractual adjustments, and insurance underpayments
- Queued claims for submission to secondary insurance both electronically and hard copy
Education
Medical Coding and Billing Instructional Program -
Maric College
Carson, CA01.2006
Skills
- EPIC Super-User, ICD-10, Tableau
- MEDITECH, CPT, Kronos
- PASSPORT, HCPCS, Uptivity
- EMDEON, NDC, Cisco CUIC
- INVISION, DRG, Cisco CCE
- HMO/PPO, PRMPT I & II, Cisco Finesse
- A/R Management,1800IVR, OnBase
- IBM Cognos, InBasket, MyChart
Certification
- Cedars-Sinai Patient Financial Services Credentialed Trainer (2013)
- Cedars-Sinai Patient Financial Services Specialist (CSPFSS) (2014)
- Microsoft Certified Course / MCITP – ABCO Technology, Los Angeles, CA (2010)
- Certified Revenue Cycle Professional (CRCP) – American Association of Healthcare Administrative Management (AHAM) (Expected:2019-11)
- Healthcare Finance Management Association (HFMA)
Timeline
Operations Manager
University of California San Diego Health – Patient Financial Service
09.2023 - Current
Revenue Cycle Client Service Manager
University of California San Francisco Health – Physician Billing Services
03.2020 - 10.2021
Patient Financial Services Supervisor
Cedars Sinai Medical Center – Patient Financial Services
02.2017 - 03.2020
Patient Financial Services Team Lead
Cedars Sinai Medical Center – Patient Financial Services
02.2013 - 10.2017
Financial Care Specialist I
Cedars Sinai Medical Center – Patient Financial Services
02.2010 - 01.2013
Commercial Follow-Up
Cedars Sinai Medical Center – Samuel Oschin Cancer Center
10.2009 - 02.2010
Commercial Collector
Providence Health Systems – Patient Financial Services
03.2008 - 09.2009
Collector (Eisenhower Medical Center)
Cymertrix
06.2006 - 03.2008
- Cedars-Sinai Patient Financial Services Credentialed Trainer (2013)
- Cedars-Sinai Patient Financial Services Specialist (CSPFSS) (2014)
- Microsoft Certified Course / MCITP – ABCO Technology, Los Angeles, CA (2010)
- Certified Revenue Cycle Professional (CRCP) – American Association of Healthcare Administrative Management (AHAM) (Expected:2019-11)
- Healthcare Finance Management Association (HFMA)
Medical Coding and Billing Instructional Program -
Maric College
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