Jamie Bailey
Katy,TX
Summary
Experienced revenue management professional with a deep understanding of healthcare billing practices, insurance requirements, and coding standards. Familiar with applicable laws, managed care practices, and regulations for programs such as Managed Medicaid and Managed Medicare. Skilled in establishing and enhancing billing practices to meet demands, ensure accuracy, and optimize system efficiency. Proven success in recruiting, hiring, training, and motivating high-quality teams. Known for attention to detail, strong work ethic, and goal-oriented approach.
Overview
12
12
years of professional experience
Work History
Revenue Cycle Supervisor
Houston Methodist Hospital
03.2022 - Current
- Oversee the daily work activities of the work unit/department staff, ensuring quality, productivity, functional excellence, and efficiency for Government Advantage
- Train and supervise staff while maintaining adequate staffing levels, budget compliance, claim edits management, claim submission, payer follow-up, denial review, appeal submission and adjudication
- Responsible for monitoring and improving all revenue cycle metrics and measures for their respective departments, including but not limited to the following: AR days, aged AR, cash collections, denials, avoidable write-offs, staff productivity and work quality, credit balances
- Employs a proactive approach in the optimization of positive outcomes by monitoring and improving the department workflow, supporting peer-to-peer accountability, and identifying solutions via collaboration
- Assists in the management of essential and non-essential department expenditures to achieve financial target through optimization of productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications
- Manages staffing needs including scheduling, time off requests and timekeeping
- Responsible for monitoring and determining plan of action for underperforming departments with respect to daily, weekly, and monthly collection performance
Commercial Collector II
Houston Methodist Hospital
08.2021 - 03.2022
- Responsible for high dollar escalation with managing insurance denials by reviewing claims and clinical documentation
- Assist in training and development of new staff and manage quality of work
- Demonstrate strong interpersonal and persuasive abilities to secure accurate and timely payment from third-party payors
- Presents as a positive role model for staff members and patients by working with them to promote teamwork and cooperation
Commercial Collector
Houston Methodist Hospital
06.2018 - 08.2021
- Responsible for managing insurance denials by reviewing claims and clinical documentation, posting payments, handling correspondence letters and writing appeals to correct payment amount and/or non-payment
- Coordinates medical and billing records payments with patients and/or third-party payers
- Manages Accounts Receivable reports for the Billing Department
- Keeps up-to-date reports and notates any trends pertaining to insurance denials
High Dollar Collector
HCA/PARALLON
06.2017 - 05.2018
- Work insurance pools and contact insurance companies to resolve claims that are not paid in a timely manner
- Review EOB’s, remits and payer correspondence in the course of performing account follow-up and escalate and identified issues to the appropriate area for review and response to expedite claim resolution
- Identify problem accounts and escalate as appropriate
- Maintain compliance with pool completion requirements
- Maintain required productivity and QA standards
- Document in the patient account record to identify actions taken
- Work with patients and guarantors resolve payer requests and discrepancies to promptly resolve pending claims
- Practice and adhere to the 'Code of Conduct' philosophy and procedures related to the Collections department
- Other duties as assigned
Patient Access Specialist
The University of Texas MD Anderson Cancer Center
05.2016 - 05.2018
- Facilitates access to MD Anderson Cancer Center services for new and returning patients
- Facilitates access to care and financial clearance process for MD Anderson Cancer Center patients
- Verifies the eligibility/benefits, pre-authorization requirements and available payment options
- Collaborates with payors, third party vendors, patients and any other identified representatives internal or external to the institution to financially clear patients for care
- Escalates financial clearance issues to the supervisor or coordinator for resolution
- Impacts patient medical and financial clearance across a continuum of care served by one or more designated care centers
- Utilizes medical acceptance criteria to screen and schedule appointment for new patients
- Provides financial counseling options to patient including cost estimates, payment plans, discounts and supplemental financial assistance; utilizing medical overrides and account reviews as appropriate
- Collects financial data during intake process to ensure appropriate financial screening of new patients and verifies data during new patient registration to ensure compliance with required forms and consents
- Obtains insurance information, verifies benefits and secures authorizations
Patient Services Coordinator
The University of Texas MD Anderson Cancer Center
03.2015 - 04.2016
- Greet, orient and answer questions
- Advise patients and family members of available services
- Assist in maintaining a safe environment for patients, co-workers, and visitors
- Demonstrate an understanding of the impact their customer interactions will have in developing positive impressions
- Demonstrated excellent customer service to all internal customers through consistent use of customer service standards
- Interpret and coordinate physicians’ orders to schedule diagnostic test, procedures, treatments, labs, and physician appointments
- Manage, monitor, and facilitate complete of the patient scheduling process to ensure optimal efficiency in clinic operations and resources while maintaining the institution’s standards of customer service and quality patient care
- Responsible for monitoring and expediting clinic flow
- Receive multiple telephone calls from internal/external customers, direct calls appropriately in an expedient, courteous and friendly manner
- Take accurate and complete messages
- Responsible for the security and confidentiality of patient information at all times
- Advise patients/family members of available services and use appropriate customer service skills when interacting with co-workers, patients, patient family members, and internal/external customers
- Update and revise all demographic, financial and insurance information as necessary to maintain an accurate patient account
- Collect co-payments as appropriate
- Ensure that the medical record is available for patient care
- Will order, follow-up, and obtain medical records as needed
- Will scan medical document to Mosaiq as described in Rad Onc scanned document policy
- Will prepare therapy charts for simulation and treatment visits
- Retrieve test results as appropriate and prepare the necessary forms
- Visually inspect names on film folders to ensure accurate matching and manually check contents of film jacket to ensure that the contents belong to the patient
- Handle items weighing up to 30 pounds
- Assist in maintaining a safe environment for patients, co-workers and visitors
- Recognize unsafe conditions and report the situation to the appropriate person
- Adhere to universal precautions and principles of asepsis
- Demonstrates awareness of and concern for patient safety
- Assist in maintaining the physical environment in accordance with JCAHO and institutional standards
- Maintain a highly professional and positive attitude
- Utilize time in an efficient manner by completing duties as prescribed by due dates or patient’s needs
- Demonstrate initiative and seek out additional tasks
Receptionist
The University of Texas MD Anderson Cancer Center
01.2014 - 03.2015
- Greet patients, family members and guests
- Provides information and directions to patients, family members, guests and staff as appropriate
- Notifies appropriate personnel of patient arrival and status
- Responsible for routing incoming, outgoing, inter-office, conference and paging calls
- Retrieves information from clinic systems and provides information to patients and staff in a prompt and courteous fashion
- Help patients with scheduling appointments
- Collects, reconciles, and manages patient payments, and picks up and returns the co-payment bag to the cashier daily
- Registers all scheduled patients using multi-screen computer system
- Prints applicable medical record documents using Forms Anywhere
Patient Transporter
The University of Texas MD Anderson Cancer Center
10.2012 - 01.2014
- Transport patients, specimens, expired patients, medical records, and films safely and efficiently throughout the institution
- Assist clinical staff with safely moving patients to and from beds, wheelchairs and stretchers
- Meet and follow productivity standards and compliances set forth by department
- Treat patients with care, discovery, and integrity
Education
MBA - Management
University of Houston
Houston, TX12-2024
Skills
- Denial Resolution
- Claim submission
- Collections experience
- Patient Registration
- Insurance Verification
- Healthcare compliance
- Patient account management
- Claims Management
- Insurance Coordination
- Payment posting
- Collections Management
- Expense Management
- Vendor Relations
- Data Analytics
- Revenue optimization
- Revenue performance
- Teamwork and Collaboration
- Customer Service
- Problem-Solving
- Multitasking and Organization
- Problem-solving abilities
- Excellent Communication
- Organizational Skills
- Active Listening
- Effective Communication
Timeline
Revenue Cycle Supervisor
Houston Methodist Hospital
03.2022 - Current
Commercial Collector II
Houston Methodist Hospital
08.2021 - 03.2022
Commercial Collector
Houston Methodist Hospital
06.2018 - 08.2021
High Dollar Collector
HCA/PARALLON
06.2017 - 05.2018
Patient Access Specialist
The University of Texas MD Anderson Cancer Center
05.2016 - 05.2018
Patient Services Coordinator
The University of Texas MD Anderson Cancer Center
03.2015 - 04.2016
Receptionist
The University of Texas MD Anderson Cancer Center
01.2014 - 03.2015
Patient Transporter
The University of Texas MD Anderson Cancer Center
10.2012 - 01.2014
MBA - Management
University of Houston
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