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
Geneva, IL
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
Oak Brook, IL
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)
Aurora, IL
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
Denver, CO
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
Denver, CO
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
Denver, CO
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
Aurora, CO
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