JENIFER MUDAHY
HACKENSACK,NJ
Summary
Accomplished Revenue Cycle Manager with a proven track record at Genesis Orthopedics & Sports Medicine, enhancing revenue performance and denial resolution. Leveraged healthcare industry knowledge and billing cycle expertise to streamline operations, achieving significant improvements in cash flow management. Skilled in team building leadership and critical thinking, consistently exceeding financial goals through strategic planning and relationship management. Results-driven Revenue Cycle Manager experienced in financial statement review, auditing and reporting. Well-versed in producing reports, evaluating department operations and handling month- and year-end closings. Meticulous, conscientious and methodical in approach. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
20
20
years of professional experience
Work History
Revenue Cycle Manager
Genesis Orthopedics & Sports Medicine
12.2022 - 01.2024
- Monitored and guided revenue cycle operations.
- Implemented process improvements, ensuring accurate charge capture and coding compliance.
- Provided staff training on revenue cycle management best practices, increasing productivity across departments
- Completed financial reporting and analysis for billing revenue cycle.
- Managed cross-functional teams to improve overall revenue cycle operations.
- Streamlined workflows to minimize claim rejections and maximize reimbursement rates from insurance providers.
- Maintained a thorough understanding of regulatory requirements, ensuring compliance throughout all aspects of the revenue cycle.
- Coordinated with finance team to produce accurate monthly reports on collection metrics and trends.
- Established strong relationships with payers, improving communication and resolving disputes more effectively.
- Reduced accounts receivable days outstanding, optimizing billing and collections efforts.
- Served as liaison between organizations leadership team members and payers during contract negotiations, securing favorable terms for reimbursement rates.
- Negotiated contracts with third-party vendors for billing-related services, achieving cost savings without compromising quality.
- Supported clinical team members with revenue cycle procedures and addressed issues.
REVENUE CYCLE MANAGER
MILLENIUM MEDICAL BILLING
02.2021 - 12.2022
- Managed cross-functional teams to improve overall revenue cycle operations.
- Conducted regular audits to identify areas for improvement in the revenue cycle process.
- Negotiated contracts with third-party vendors for billing-related services, achieving cost savings without compromising quality.
- Created financial dashboards to provide insights into key performance indicators.
- Developed strategic plans for day-to-day financial operations.
- Increased revenue by a quarter million within 3 months of my employment
- Implemented workers compensation clearing house which would produce 2 million more in revenue than previous years
- Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
- Supported financial director with special projects and additional job duties.
- Established and checked coding procedures, monitored reports and updated internal files.
- Trained new team members on scripts, company services, and collection strategies.
- Negotiated to collect balance in full.
- Monitored customer accounts for payment delinquency and initiated collection efforts.
CENTRAL MEDICAL SERVICES OF WESTROCK
REVENUE CYCLE MANAGER
04.2018 - 02.2021
- Conducted regular staff meetings encouraging open dialogue about challenges faced in daily work activities, fostering a supportive work environment.
- Examined claims forms and other records to determine insurance coverage.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Maintained contact with claimants and attorneys to determine treatment status.
- Documented information gathered in field and uploaded data to company database for efficient processing using Advanced data systems and Medics Cloud
- Created collections log as well as IME log to capture all things needed for claims to move to be paid during the hearing proceedings
- Reviewed Hearing notices to direct on treatment plan
- Communicated with patients to update on claim status as needed
- Maintained strong relationships with top payers such as NYCTA and other Federal employers
- Conducted seminars for union workers to provide information of being injured on the job and reporting processes and procedures
Workers Compensation Collections Supervisor
Centers For Cognition
04.2017 - 04.2018
- Enhanced collections efficiency by implementing and monitoring strategic collections plans.
- Streamlined department operations by optimizing workflows, policies, and procedures.
- Maintained a high level of customer satisfaction through professional communication and dispute resolution tactics.
- Established performance metrics to evaluate team success and identify areas for improvement.
- Maintained workers compensation flow chart to assure accurate collections
- Improved team productivity through ongoing coaching, training, and performance evaluations.
- Mentored junior staff members on best practices in debt collection techniques and procedures.
- Spearheaded process improvements that led to faster resolution of delinquent accounts without sacrificing quality service delivery.
- Negotiated to collect balance in full.
- Achieved performance goals on consistent basis.
Medical Billing and Collections Specialist
New York Spine And Sport Rehabilitation Medicine
04.2015 - 04.2017
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
- Provided essential support to the medical billing team, allowing for a more efficient and effective overall operation within the department.
- Implemented efficient workflows within the department that led to increased productivity levels among staff members while reducing errors in claim submissions.
- Facilitated effective communication between healthcare providers, patients, and insurance companies to resolve billing disputes promptly.
- Contributed significantly towards reducing the number of denied claims by identifying potential issues upfront during the initial review phase of the process.
- Corrected, completed and processed claims for multiple payer codes.
- Processed billing calls and answered questions from patients and third-party carriers.
- Assisted in reconciling deposit and patient collections.
- Managed all workers compensation and No-Fault claims for all states
Medical Biller and Coder/Intern
City Podiatry
12.2014 - 01.2015
- Correctly coded and billed medical claims
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Applied previous experience and knowledge acquired from schooling
Medical Biller and Coder
Affiliated Physicians
04.2011 - 12.2014
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- conducted eligibility and benefits for each scheduled patient
- Submitted all claims to the clearing house inclusive of scrubbing and audit
Accident & Health Insurance Agent
Humana Medicare
08.2008 - 04.2012
- Maintained compliance with all industry regulations while completing paperwork accurately and efficiently.
- Educated clients on the intricacies of their health insurance policies, empowering them to make informed decisions.
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Efficiently managed high-pressure situations such as claim denials or unexpected policy cancellations.
Workers Compensation Claims Specialist
Tokio Marine Nichido & Fire Ins
09.2005 - 09.2006
- Examined claims forms and other records to determine insurance coverage.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Handled claim volume of 200 cases
- Issued indemnity payments as needed
- Scheduled surveillances as needed for investigative needs
Claims Adjuster
Hereford Insurance Company
11.2003 - 09.2005
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Examined claims forms and other records to determine insurance coverage.
- Documented all investigation activity and presented reports to management.
- Verified insurance claims and determined fair amount for settlement.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Prepared summaries of damage, payments, and policy coverage.
- Answered customer questions regarding deductibles.
- Attended industry conferences and workshops to stay current on trends and developments within the field of claims adjusting.
Education
CPC - MEDICAL BILLING AND CODING
SANFORD BROWN INSTITUTE
New York, NY10.2014
AGENT/BROKER LICENSE - PROPERTY & CASUALTY
ST JOHN'S UNIVERSITY
New York, NY01.2008
Bachelor of Science - Business Administration And Management
Monroe College
The Bronx, NY06.2000
Skills
- Revenue performance
- Denial Resolution
- Healthcare Industry Knowledge
- Billing cycle expertise
- Account Monitoring
- Cash Flow Management
- Data Analytics
- Claims Management
- Account resolutions
- Medical Billing
- Revenue Enhancements
- Clinical team guidance
- Procedure optimization
- Customer Service
- Attention to Detail
- Critical Thinking
- Decision-Making
- Team Building Leadership
- Relationship building and management
- Prioritizing and Planning
- Proactive and Focused
- Goal Setting
- Recruitment and hiring
Timeline
Revenue Cycle Manager
Genesis Orthopedics & Sports Medicine
12.2022 - 01.2024
REVENUE CYCLE MANAGER
MILLENIUM MEDICAL BILLING
02.2021 - 12.2022
CENTRAL MEDICAL SERVICES OF WESTROCK
REVENUE CYCLE MANAGER
04.2018 - 02.2021
Workers Compensation Collections Supervisor
Centers For Cognition
04.2017 - 04.2018
Medical Billing and Collections Specialist
New York Spine And Sport Rehabilitation Medicine
04.2015 - 04.2017
Medical Biller and Coder/Intern
City Podiatry
12.2014 - 01.2015
Medical Biller and Coder
Affiliated Physicians
04.2011 - 12.2014
Accident & Health Insurance Agent
Humana Medicare
08.2008 - 04.2012
Workers Compensation Claims Specialist
Tokio Marine Nichido & Fire Ins
09.2005 - 09.2006
Claims Adjuster
Hereford Insurance Company
11.2003 - 09.2005
CPC - MEDICAL BILLING AND CODING
SANFORD BROWN INSTITUTE
AGENT/BROKER LICENSE - PROPERTY & CASUALTY
ST JOHN'S UNIVERSITY
Bachelor of Science - Business Administration And Management
Monroe College