Jessica Coughlin
Haverhill,MA
Summary
Dynamic revenue cycle management professional driving significant improvements in reimbursement rates through strategic denial and appeals management. Expertise in analyzing claim trends and implementing process optimizations, fostering collaboration among clinical and operational teams to enhance organizational performance and compliance.
Overview
19
19
years of professional experience
1
1
Certification
Work History
PROFESSIONAL BILLING ANALYST II
Boston Medical Center
Boston, MA
01.2022 - Current
- Oversee and analyze claim adjustments, denials, and rejection trends across multiple specialties, ensuring accurate charge capture and timely revenue recognition.
- Manage charge review and denial workqueues, consistently exceeding organizational timeliness standards.
- Investigated and resolved missing charges, complex billing issues, and payer-specific denials as primary escalation point for clinics, enhancing overall billing accuracy.
- Reconcile charges for GI, Cardiology, and Pulmonary diagnostic procedures, partnering with clinical teams to improve documentation and charge accuracy.
- Developed and implemented reporting tools monitoring key revenue cycle metrics, including days in A/R, denial rates, and clean claim rates, facilitating data-driven process improvements.
- Ensured compliance with federal, state, and payer-specific regulations while collaborating with vendors and internal stakeholders to streamline workflows and uphold coding integrity.
BILLING SUPERVISOR
Boston Medical Center
Boston, MA
05.2017 - 01.2022
- Led and developed a team of billing staff, setting performance expectations, conducting regular reviews, and providing ongoing training and mentorship.
- Assisted Director of Revenue in major initiatives, including process optimization and system migrations, enhancing overall operational effectiveness.
- Monitored claim adjustments and payer rejection trends, implementing corrective action plans that contributed to reduced denials and improved net collection percentage.
- Served as Epic Super User during EHR system migration, facilitating system implementation and contributing to optimization efforts.
- Established and refined standard operating procedures and internal controls to ensure consistency and accountability in billing operations.
PATIENT ACCOUNT SPECIALIST
Boston Medical Center
Boston, MA
09.2016 - 05.2017
- Obtained retroactive referrals, appealed rejected claims, updated insurance information to resolve discrepancies and minimize revenue leakage.
- Ensured accurate claim submissions and corrected invalid data, contributing to improved clean claim rates and timely collections.
- Verified and managed collection accounts, enhancing overall A/R management.
REVENUE ANALYST
Cambridge Health Alliance
Malden, MA
01.2014 - 09.2016
- Managed daily billing operations and claim rejections for the Physicians Organization, ensuring compliance with payer requirements and internal policies.
- Processed payer appeals and recommended process improvements to resolve recurring issues.
- Managed daily billing operations and claim rejections for the Physicians Organization, ensuring compliance with payer requirements and internal policies.
BILLING COORDINATOR
Boston Children's Hospital
Boston, MA
12.2011 - 01.2014
- Reconciled lockboxes and ensured timely payment posting, enhancing accuracy of financial reporting.
- Conducted trend analysis to identify process improvements, recommending actions that contributed to reducing underpayments.
- Supported daily billing operations across multiple service areas, updated policies and procedures to streamline functions and ensure compliance.
BILLING REPRESENTATIVE
Boston Children's Hospital
Boston, MA
12.2010 - 12.2011
- Managed the full A/R cycle for the Surgical Foundation, maintaining A/R days below MGMA benchmarks.
- Managed the full A/R cycle for the Surgical Foundation, maintaining A/R days below MGMA benchmarks.
- Reviewed self-pay balances and assisted patients to enhance revenue cycle performance.
BILLING ASSISTANT
Somerville Mental Health Association
Somerville, MA
07.2007 - 12.2010
- Managed clinician billing workflows for accurate and timely submission of claims and payment batches.
- Communicated with insurance agencies to resolve billing and payer-related issues, facilitating smoother claim processing.
- Processed billing statements for client services in a timely manner.
- Assisted clients with billing inquiries and payment options.
- Maintained accurate records of client transactions and account balances.
Education
MBA - Healthcare Administration/Management
Southern New Hampshire University
Manchester, NH11-2023
BS - Healthcare Administration/Management
Southern New Hampshire University
Manchester, NH01-2019
Skills
- Revenue cycle oversight
- Denials and appeals management
- Charge capture and reconciliation
- Accounts receivable management
- Regulatory compliance
- Financial analysis and reporting
- Epic super user and EHR systems
- Workflow optimization
- Team leadership and development
- Cross-functional collaboration
- Patient financial counseling
Certification
HFMA-Certified Revenue Cycle Representative
Timeline
PROFESSIONAL BILLING ANALYST II
Boston Medical Center
01.2022 - Current
BILLING SUPERVISOR
Boston Medical Center
05.2017 - 01.2022
PATIENT ACCOUNT SPECIALIST
Boston Medical Center
09.2016 - 05.2017
REVENUE ANALYST
Cambridge Health Alliance
01.2014 - 09.2016
BILLING COORDINATOR
Boston Children's Hospital
12.2011 - 01.2014
BILLING REPRESENTATIVE
Boston Children's Hospital
12.2010 - 12.2011
BILLING ASSISTANT
Somerville Mental Health Association
07.2007 - 12.2010
MBA - Healthcare Administration/Management
Southern New Hampshire University
BS - Healthcare Administration/Management
Southern New Hampshire University