Managed the full revenue cycle interdepartmentally, developing processes and procedures minimizing denials and denial trends; CPT/HCPCS/ICD -10 coding of surgical, radiologic and E&M visits; charge capture and clean claims review; decreased denial trends to below 4.9% against state and national averages; IPA contract review and maintenance; created monthly KPI reporting and analysis process; denial trend management; team coaching and education; managed reimbursement exception reports for fee-schedule payment errors; managed reimbursement team developing updated procedures to track non-payments; calculated patient out-of-pocket estimates; self-pay balance reporting to third party collection agency; Workers' Compensation RCM and third-party liability claims' management and lien approvals working closely with case managers and attorneys; tracked performance of third-party vendors; Practice Management system maintenance; annually updated providers on CMS Documentation and Coding Guidelines
Fox Valley Orthopedic Associates
Revenue Cycle Manager
06.2019 - 01.2022
Job overview
Directed the revenue cycle department including certified coders and 20 full cycle revenue management specialists for both facility and professional providers through detailed report analysis; directed provider coding compliance audits and education through appropriate use of ICD-10/HCPCS/CPT; established processes and procedures for 3 departments (Daily Ops, Purchasing and DME program); developed the workers' compensation program to comply with State Law; implemented and monitored individual and departmental KPI indexes; improved department procedures through quarterly assessments; analysis of denial trends and changes in payer policies, payer contracting and reviews; reported unresolved patient accounts to credit agency reducing A/R by $50K monthly; member of the Corporate Compliance Committee; ensured the compliance of government and commercial payer contract adherence; EOM/EOY ledger balancing procedure, reporting to CFO and CEO; delivered individual and team educational advancement through hands-on coaching
Symetria Health
Medical Billing Supervisor
01.2019 - 04.2019
Job overview
Company Overview: temporary contract
Responsible for timely claims submission according to current contracts, charge reconciliation and report analysis to provide quality assurance weekly
Temporary contract
Leyden Dupage Counseling Services
Practice Administrator/Business Office Manager
01.2016 - 01.2019
Job overview
Managed the full cycle billing procedures including denials, appeals and A/R report analysis to assure maximum benefits have been received; developed and integrating new EHR and PM system; managed banking, payables and ledger balancing procedures; advanced reporting of revenue and P&L statements
Renaissance Management Company (Fox Valley Dialysis)
Administrative, Billing and Revenue Cycle Manager
01.2014 - 01.2016
Job overview
Managed and directed the full cycle billing procedures through report analytics to assure maximum benefits have been received
Assessed posting accuracies from payers according to contract; management of banking and ledger balancing procedures; advanced reporting of revenue and P&L statements to CEO
PMIS
Client Billing Manager, Team Supervisor, EMR Instructor/Implementation Manager for GE Centricity
01.2013 - 01.2014
Job overview
Managed the full cycle billing procedures for pediatrics, orthopedic and family medicine, including denials, appeals and A/R report analysis to assure maximum benefits have been received according to contract; oversight of banking and ledger balancing procedures; advanced reporting of revenue and P&L statements to Revenue Cycle Director and CEO
South Denver Cardiology
Account Manager
01.2010 - 01.2013
Job overview
Managed full cycle billing procedures and A/R report analysis assuring maximum benefits have been received according to payer contracts to assess posting accuracies; banking and ledger balancing procedures reporting of revenue to Revenue Cycle Director
Dry Creek Surgery Center
Business Office Management
01.2002 - 01.2006
Job overview
Managed full cycle billing procedures and A/R report analysis to assure maximum benefits have been received
Assessed posting accuracies from payer reimbursement; direct handling of banking procedures; developed and launched reporting tools; accounts payable assistant
Colorado Orthopedic Consultants and Spine Surgery
Private Practice Surgical First Assistant and Office Administrator
01.1990 - 01.1998
Job overview
Certified surgical first assistant and cast technician, held privileges at five area hospitals, CPR/AED certified instructor; staff training and management (clinical and admin), full cycle billing
US Army and Army Reserves
Field/Flight Medic and Surgical First Assistant
01.1987 - 01.1995
Job overview
NBC Specialist, medical assistant, field paramedic, surgical first assistant, trained and experienced in all disciplines of medicine
Timeline
Revenue Cycle Supervisor
Orthopedic Specialists, S.C.
05.2022 - 10.2024
Revenue Cycle Manager
Fox Valley Orthopedic Associates
06.2019 - 01.2022
Medical Billing Supervisor
Symetria Health
01.2019 - 04.2019
Practice Administrator/Business Office Manager
Leyden Dupage Counseling Services
01.2016 - 01.2019
Administrative, Billing and Revenue Cycle Manager
Renaissance Management Company (Fox Valley Dialysis)
01.2014 - 01.2016
Client Billing Manager, Team Supervisor, EMR Instructor/Implementation Manager for GE Centricity
PMIS
01.2013 - 01.2014
Account Manager
South Denver Cardiology
01.2010 - 01.2013
Business Office Management
Dry Creek Surgery Center
01.2002 - 01.2006
Private Practice Surgical First Assistant and Office Administrator