JEANMARIE COLEMAN
Sterling,USA
Summary
Revenue Cycle Manager with a track record of success at COMMUNITY HEALTHLINK, specializing in claims processing and denial management. Achieved substantial increases in cash collections through expertise in payer automation while managing a team of 12. Demonstrated strong analytical skills and effective communication, resulting in operational improvements and enhanced financial reporting.
Overview
30
30
years of professional experience
Work History
Revenue Cycle Manager
COMMUNITY HEALTHLINK
Leominster, USA
01.2014 - Current
- Communicates avoidable denials to Senior Leadership
- Works with various programs to reduce failed claims/activities
- Implement payer automation including ERA electronic payment posting and billing through a clearinghouse in 2018
- Manage a team of 12 employees including hiring, mentoring, training, and performance evaluations
- Changed to a new Third Party Clearinghouse after the Change Healthcare Cyber Attack
- Monitors write off/up for department and report them to CFO monthly
- Monitors and reports 835 Denial Reasons to CFO monthly
- Ensures all 835 payments and denials are posted within 3 business days
- Maintains Fee Matrices for all payer groups
Director of Accounts Receivable Analysis
REPROSOURCE FERTILITY DIAGNOSTICS
Woburn, USA
01.2013 - 01.2014
- Managed all outsourced Accounts Receivable
- Determined outsourced provider negatively impacted the business due to 2/3 reduction in cash collections
- Recommendation to maintain Accounts Receivable in house
- Interviewed with 2 in house revenue management systems and recommended XIFIN Aggressive go live implementation date 90 days from date of decision
- Interview and hire key talent to prepare for implementation
- Maintains payer data base
- Responsible for all ERA/EFT enrollment with XIFIN and Health Information Networks
- Maintained / Increased cash collections during the transition
- Assign projects for Reimbursement Department team members based on current payer trends
- Tested and implemented automated patient payment portal (Interactive Voice Response) and Web Portal
- Developing Standard Operating Procedures
Subsidiary Managed Care Project Analyst
LABCORP / ESOTERIX GENETIC LABORATORIES, LLC & ACCUPATH DIAGNOSTIC LABORATORIES, INC
Westborough, USA
01.2011 - 01.2013
- Managed reimbursement activities for LabCorp Specialty Testing Groups, Esoterix Genetic Laboratories, LLC, and Accupath Diagnostic Laboratories, Inc.
- Liaison between LabCorp and subsidiary businesses for all integration issues
- Communicated negative and positive payer trends for cash forecasting
- Identified, analyzed, defined root cause and address denial trends to ensure timely collection of receivables so cash and DSO objectives are met
- Strong working relationships with payer Provider Representatives to mitigate payer challenges that result in negative cash
- Facilitated meetings and conference calls as needed to resolve payer issues
- Created executive summaries for accounts receivable issues to present to management
- Quantified and processed timely sales and bad debt adjustment requests
Reimbursement Supervisor
GENZYME GENETICS
Westborough, USA
01.2004 - 01.2011
- Managed collection activity for Blue Cross Blue Shield in an organization with $360M in annual sales
- Developed goals for DSO, credit balance, A/R 90, & denial management
- Coordinated efforts with Regional Account Directors in order to resolve large payer issues
- Reported training opportunities to the billing department weekly to increase efficiencies and improve quality
- Implemented up front billing rules to prevent future negative trends
- Managed daily activities for 9 direct reports
- Compiled accounts receivable summary reports monthly to identify trends both positive and negative.
- Identified and communicated A/R at risk monthly for senior management
- Interviewed and hired employees- (23 new hires while company was growing)
- Actively participated in the annual review of Standard Operating Procedures
Supervisor, Outpatient Billing & Collections
LAHEY CLINIC HOSPITAL
Burlington, USA
01.1995 - 01.2004
- Ensured accurate billing by utilizing transmission reports from various payers
- Regularly reviewed of UB92 & 1500 coding requirements to ensure accuracy of CPT & HCPC level II codes
- Recommended system changes and enhancements in order to maximize reimbursement
- Interviewed, hired and evaluated performance in accordance with department standards
- Collaborated with application support department in testing system enhancements
- Designed and implemented a denial management procedure mapping HIPAA rejection code with all third-party payers
- Outlined detailed policies and procedures related to claims reconciliation for Meditech conversion
- Designed and implemented a series of 25 automated collection letters for 1st and 3rd party collections
- Key participant in Process Improvement Team to obtain Advance Beneficiary Notification signatures from patients
Education
High School -
HOLY NAME CENTRAL CATHOLIC HIGH SCHOOL
Worcester, MACertifications - Medical Terminology
MIDDLESEX COMMUNITY COLLEGE
Bedford, MASkills
- Revenue cycle management
- Claims processing and denial management
- Payer automation and accounts receivable
- Financial reporting
Timeline
Revenue Cycle Manager
COMMUNITY HEALTHLINK
01.2014 - Current
Director of Accounts Receivable Analysis
REPROSOURCE FERTILITY DIAGNOSTICS
01.2013 - 01.2014
Subsidiary Managed Care Project Analyst
LABCORP / ESOTERIX GENETIC LABORATORIES, LLC & ACCUPATH DIAGNOSTIC LABORATORIES, INC
01.2011 - 01.2013
Reimbursement Supervisor
GENZYME GENETICS
01.2004 - 01.2011
Supervisor, Outpatient Billing & Collections
LAHEY CLINIC HOSPITAL
01.1995 - 01.2004
High School -
HOLY NAME CENTRAL CATHOLIC HIGH SCHOOL
Certifications - Medical Terminology
MIDDLESEX COMMUNITY COLLEGE
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