Jill Ford
Little Falls,USA
Summary
Focused leader with extensive experience in Health Plan Operations and Revenue Cycle Management. Results-driven professional prepared for a new role with a strong background in assessing and processing claims, resolving disputes, and ensuring compliance with regulations. Skilled in system implementations and policy interpretation, with a proven track record of fostering team collaboration and adapting to changing needs. Known for reliability, effective communication, and focus on achieving optimal outcomes.
Overview
21
21
years of professional experience
Work History
Claims Manager
VOANS Senior CommUnity Care PACE
Eden Prairie, MN
11.2022 - Current
- Directed daily claims operations, ensuring departmental goals and KPIs were consistently achieved through effective leadership and workflow optimization.
- Led the transition from a Third-Party Administrator (TPA) to in-house claims processing on the QuickCap system, serving as Project Manager to ensure a seamless and compliant implementation.
- Implemented and standardized SOPs to streamline claims workflows, enhance accuracy, and improve auto-adjudication performance.
- Developed and managed performance metrics to drive accountability, efficiency, and productivity across the claims team.
- Conducted internal claims audits to identify underpayments, overpayments, and potential fraud, waste, and abuse, ensuring full regulatory compliance.
- Collaborated cross-functionally with Health Operations, providers, and IT to resolve claim discrepancies and optimize end-to-end revenue cycle performance.
- Analyzed claims data and trends to inform strategic decisions, improve operational efficiency, and support senior leadership reporting.
- Developed job description, recruited, trained, and mentored claims staff, fostering professional growth and building a high-performing, compliant, and customer-focused team.
- Achievement: developed and implemented an inventory analysis tool and daily processing reports following the transition to in-house claims processing. Established a goal to reduce claims backlog inventory over 30 days from 35% to 5%, achieving the target within two months and maintaining less than 1% of claims over 30 days.
Client Success Manager
XIFIN Inc Solutions
San Diego, CA
02.2022 - 11.2022
- Support client with RPM system
- Analysis of site; determine where changes need to be made to maximize system logic and automation and make suggestions to the client.
- Work with third party vendors for support documentation, discovery and outbound collection calls to patients.
- Upsell for new automation features and reporting needs.
- Host weekly meetings with clients
- Weekly reporting through BI and Advanced Analytics.
Revenue Cycle Manager
Terros Health
Phoenix, AZ
11.2019 - 02.2022
- Streamlined revenue cycle operations, reducing accounts receivable backlog by $10M+ in six months and increasing monthly third-party payer payments to $4.1M through improved clean-claim submission rates (98%).
- Resolved major historical backlogs, including 1,730 unposted remits ($6.2M) and 8,000+ payer rejections ($1.9M), restoring financial accuracy and operational flow.
- Led implementation of a new clearinghouse system, ensuring seamless EDI file processing and enhanced claims submission efficiency.
- Developed and monitored key performance indicators (KPIs) to align short- and long-term goals with organizational revenue targets utilizing the Xifin RPM billing system.
- Created financial dashboards and conducted in-depth data analysis to identify revenue trends and inform strategic decisions for sustainable growth.
- Improved compliance and staff performance by developing training programs, ensuring adherence to regulatory requirements, and fostering a culture of continuous improvement.
Associate Billing Director
Neogenomics
CA
08.2018 - 08.2019
- Managed all functions performed by the Front-End Claims Team, Cash Posting, Client Bill, and Collections teams located in CA and FL including strategy planning, data entry, eligibility, EDI (277, 999, 837 and 835), Client Invoicing and all other revenue cycle components utilizing the Telcor billing system.
- Mentor a team of 10 direct reports (60 indirect) associates. Perform employee reviews and responsible for hiring new staff and counseling existing staff when warranted.
- Liaison for cross functional departments and Senior Management.
- Set goals and metrics to meet standard productivity for all team members.
- Recommend and implement process changes to maximize reimbursement for services rendered.
- Weekly and EOM reporting and analysis.
- Managed remote staff in CA and FL
Independent RCM Consultant
AIM Laboratories
01.2018 - 06.2018
- Recommended new approaches, policies, and procedures to influence continuous improvements in the Company’s efficiency and services performed. Developed month-end reporting and closing efficiencies.
- Assisted in planning, development and implementation of company objectives, business, and strategic plans; develop specific team goals and standards that directly support the strategic plan
- Remote, Contract
Director of Billing
Little River HealthCare/DBA Timberlands Testing
Collinsville, IL
11.2015 - 03.2018
- Review the billing department's financial objectives, policies, and procedure and present recommendations for improvements to the VP of Revenue Cycle.
- Recommendations for proficiency in billing; third party and client collections, clean up backlog, client and patient level billing services, CPT and HCPC codes, worked collaboratively with clients to implement prior authorization procedures and meet documentation guidelines that apply to them. Xifin RPM system
- Managed a remote Team.
Billing Manager
Reliable Medical Supply
Brooklyn Park, MN
11.2015 - 02.2016
- Career advancement outreach
Contracting Revenue and Billing Analyst
Laboratory Corporation of America/DBA Medtox Scientific Laboratories
St. Paul, MN
08.2011 - 11.2015
- Claim trends, utilization, and financial reporting. Responsible for identifying changes in reimbursement, fee schedule changes/updates. Streamline projects and facilitate meetings regarding changes and/or updates needed.
- Xifin RPMSystem Administration and maintenance.
- Created a new Payer naming and numeric identifier for over 1500 Third Party Payers in the RPM system; spearheaded project to transition exisiting ID’s to new ID’s.
- Held a significant role in the research and implementation of the 2015 CPT HCPCS updates; assisted in building cross reference codes from 2014 to new codes, ran test environment, reported revenue impact prior to final implementation of system updates.
- Worked directly with MCE’s (Managed Care Executives), Director, Project Analyst IS Team, Contract Administrator, and other staff to maximize outcome of payer projects.
Contract Payer Reimbursement Analyst
Center for Diagnostic Imaging
St. Louis Park, MN
06.2004 - 08.2011
Education
Diploma -
Nevis Public School
Nevis, MNAAS - Medical Office Systems (Health Information System)
PHILLIPS JUNIOR COLLEGE
Spokane, WASkills
- System Adminisration & Reporting
- Strategic Planning and System Implementation
- Best Practices & Regulatory Compliance
- Team Leadership & Staffing
- Cross-functional Collaboration & Communication
- Claims RPM SME / EDI and Coding
- Contracts / Collections / Aging AR
- MS office suite
- Attention to detail
- Critical thinking
- Team building
Timeline
Claims Manager
VOANS Senior CommUnity Care PACE
11.2022 - Current
Client Success Manager
XIFIN Inc Solutions
02.2022 - 11.2022
Revenue Cycle Manager
Terros Health
11.2019 - 02.2022
Associate Billing Director
Neogenomics
08.2018 - 08.2019
Independent RCM Consultant
AIM Laboratories
01.2018 - 06.2018
Director of Billing
Little River HealthCare/DBA Timberlands Testing
11.2015 - 03.2018
Billing Manager
Reliable Medical Supply
11.2015 - 02.2016
Contracting Revenue and Billing Analyst
Laboratory Corporation of America/DBA Medtox Scientific Laboratories
08.2011 - 11.2015
Contract Payer Reimbursement Analyst
Center for Diagnostic Imaging
06.2004 - 08.2011
Diploma -
Nevis Public School
AAS - Medical Office Systems (Health Information System)
PHILLIPS JUNIOR COLLEGE
CHARACTERISTICS
- Strong interpersonal & communication
- Meticulous attention to detail
- Poised under pressure
- Goal oriented