Ilene Davila
Precise Medical Billing
Victoria
28
years of professional experience
Dynamic healthcare and revenue cycle professional with over 27 years of experience in clinical nursing, medical coding, physician practice administration, provider credentialing, revenue cycle consulting, and healthcare operations. Currently employed as an Auditor at Baylor Scott & White Health while leading Precise Medical Billing, a consulting firm established in 2006. Achievements include maintaining a 99% coding accuracy rate, enhancing physician practice revenue by over 35%, and reducing accounts receivable over 90 days to below 10%. Detail-oriented with exceptional communication and project management skills, consistently recognized for a proactive approach to problem-solving and optimizing processes to support team objectives in fast-paced environments.
Work History
Auditor I, Coder II
3 Years 11 Months- Audit coding completed by internal coders and third-party vendors, providing detailed feedback and education to improve coding accuracy.
- Audited coding from internal coders and third-party vendors, delivering detailed feedback and education that enhanced coding accuracy.
- Review and validate coded data to ensure accurate reimbursement, regulatory compliance, and quality reporting.
- Collaborate with Clinical Documentation Integrity (CDI) specialists and coding leadership to identify documentation improvement opportunities.
- Communicated audit findings and recommended corrective actions to ensure consistent coding practices across the team.
- Completed coding assignments for various specialties to support operational efficiency. across multiple specialties as needed to support departmental operations.
- Maintain productivity and quality standards while working remotely in a high-volume healthcare environment.
Founder & Medical Billing Consultant
20 Years- Founded and successfully operated a medical billing consulting firm providing revenue cycle management, coding, credentialing, compliance consulting, and operational support to physician practices across multiple specialties.
- Improved revenue by more than 35% within 90 days for multiple physician clients through workflow improvements, payer follow-up, and revenue cycle optimization.
- Established and optimized billing processes to enhance operational efficiency.
- Reduced accounts receivable over 90 days to less than 10% through proactive collections management and process improvements.
- Conducted coding reviews and chart audits, enhancing documentation quality and ensuring accurate reimbursements.
- Oversaw provider enrollment and credentialing processes for Medicare, Medicaid, BCBS, Aetna, UnitedHealthcare, Cigna, and other commercial payers, ensuring compliance and timely access to services.
- Managed appeals and denials, and monitored reimbursement performance.
- Implemented EMR systems, clearinghouses, and billing workflows for new physician practices.
Central Billing Office Trainer-Remote position
8 Months- Trained, answered questions, and assisted with the Go Live of the EHR with practice sizes as large as 36 users independently.
- Trained assigned clients throughout the U.S. on how to effectively use the practice management/medical record software, eCW, which included coding, billing, A/R management, reporting, documenting, etc.
- Developed knowledge of client operations of their business operations to help them reach their goals.
- Assessed client practices for opportunities — including growth opportunities and risks — so that I could recognize and act upon opportunities to maximize the benefits of EHR implementation.
- Gained an understanding of their business operations to help them reach their goals.
- Coordinated client requests and expectations with internal eClinicalWorks teams, ensuring effective communication and support.
Practice Administrator
1 Year 10 Months- Performed nurse duties to support staff during absences.
- Accounts Payable/Accounts Receivables/Cost analysis/Management.
- Accounts Payable/Accounts Receivable/Cost analysis/Management.
- Responsible for hiring, training, reprimanding, and termination of employees.
- Performed nurse duties to assist when staff was out.
- Compiled monthly reports detailing key performance metrics. and staff meetings.
- Responsible for hiring, training, reprimanding, and terminating of employees.
- Resolved integration issues with Greenway Prime Suite software to enhance operational efficiency.
- Oversaw daily operations, ensuring efficient patient flow and optimal staff allocation.
- Developed and implemented patient scheduling systems, enhancing appointment management efficiency.
LVN/Administrative Assistant
3 Years 2 Months- Executed nursing duties including patient triage and injections, ensuring accurate patient assessments.
- Conducted pre-procedure patient education and short stay assessments to facilitate smooth outpatient procedures.
- Performed all insurance verification, and pre-certification for office visits and procedures.
- Obtained prior-auth on medication, and referral verification from primary physicians.
- Collection of copays and patient balances.
- Collected copays and patient balances at the front desk during office hours.
- End of day processes to include balancing of monies.
- Quarterly review of patient accounts with outsourced billing company.
- Initiated marketing strategies to promote practice growth.
LVN
1 Year 6 Months- Primary nurse to two family practice physicians, and gastroenterologist.
- Conducted EKG, NCS, PFT, ear lavage, injections, and patient education to support patient care and treatment plans.
- Managed pre-certification, referrals, and prior authorizations to ensure timely access to necessary services.
Accounts Receivable/Insurance Verification
1 Year 6 Months- Verified insurance benefits for 14 physicians, ensuring accurate billing and timely reimbursement.
- Performed data entry and posted payments, maintaining accurate financial records.
- Performed data entry and payment posting accurately and efficiently.
- Collaborated with coding department to resolve denied claims, facilitating prompt adjustments and resubmissions.
Education
Certified Gastrointestinal Coder - Nursing
Certified Professional Coder
Licensed Vocational Nurse - Nursing
Skills
Microsoft Office Suite
EMR software expertise
Interpersonal communication
Team development
Coding compliance
Presentation skills
Analytical thinking
Detail orientation
Collaborative teamwork
Timeline
Auditor I, Coder II
Baylor Scott & White
09.2022 - CurrentRead More
Central Billing Office Trainer-Remote position
eClinicalWorks
03.2016 - 11.2016Read More
Practice Administrator
Victoria Obstetrics & Gynecology Associates
05.2014 - 03.2016Read More
Founder & Medical Billing Consultant
Precise Medical Billing
08.2006 - CurrentRead More
LVN/Administrative Assistant
Carlos E. Chinea, MD, PA
06.2003 - 08.2006Read More
LVN
American Regional Health Center
12.2001 - 06.2003Read More
Accounts Receivable/Insurance Verification
American Regional Health Center
01.1999 - 07.2000Read More
Victoria College
Licensed Vocational Nurse from Nursing
Read More
AAPC
Certified Professional Coder
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AAPC
Certified Gastrointestinal Coder from Nursing
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