Joie Lane

• Oversaw operations of the RCM department to ensure accurate billing processes.
• Created monthly financial reports on sales, budgeting, forecasting, and expenses.
• Worked closely witstakeholders to developed and implement strategies for improving efficiency of billing processes across departments.
• Evaluated current processes and identified areas for improvement within the organization.
• Conducted regular meetings with team members to review goals, objectives, and progress.
• Ensured compliance with all relevant laws and regulations governing revenue collection.
• Developed and implemented strategies for increasing revenue growth from a metrics driven perspective.
• Created internal training materials related to best practices in revenue management.
• Reviewed denied and claims to identify root causes of denials and necessary corrections.
• Collaborated with insurance representatives to resolve billing discrepancies effectively.
• Documented denial trends for analysis and reporting to management teams.
• Communicated with healthcare providers to gather required documentation for appeals.
• Trained new staff on denial processes and best practices for claims management.
• Implemented Key Performance Indicator processes improvements to enhance efficiency in claim resolution workflow and increase profitability
• Maintained updated knowledge of payer policies and regulatory changes affecting claims.
• Analyzed trends in denials and clean claims for potential process improvement opportunities and denial reduction.
• Tracked progress on appeals throughout the resolution process.
• Processed appeals for rejected or underpaid claims in a timely manner.

• Analyzed compliance policies and procedures to ensure regulatory adherence.

• Conducted risk assessments to identify potential compliance issues and vulnerabilities.
• Reviewed internal controls and recommended improvements for operational efficiency.
• Collaborated with departments to develop compliance training programs and materials.
• Monitored regulatory changes and updated company policies accordingly.
• Assisted in preparing documentation for audits and regulatory examinations.
• Communicated compliance requirements effectively across various teams and stakeholders.
• Maintained accurate records of compliance activities and findings for reporting purposes.
• Reviewed and monitored compliance with applicable laws, regulations, and policies to ensure compliance with regulatory requirements.
• Developed training materials for personnel regarding compliance standards and procedures.
• Analyzed potential areas of risk and developed strategies to mitigate such risks.
• Pursued continuous learning opportunities regarding latest compliance and procedural changes.
• Prepared documents for submission to regulatory agencies as required by law.
• Participated in meetings with external auditors regarding audit results related to compliance matters.
• Completed in-depth reviews of audit reports, client actions and monitoring activities.
• Investigated any suspected violations of the organization's compliance policies.
• Created plans to improve and correct operations in order to stay compliant.
• Managed the preparation and submission of regulatory filings and reports.
• Collaborated with legal and operational teams to address compliance issues and implement corrective actions.
• Led training sessions for staff on compliance practices and regulatory requirements.
• Established and maintained relationships with regulatory bodies and external compliance advisors.
• Conducted detailed audits of internal systems and processes to ensure compliance with regulatory standards.
• Maintained detailed database of compliance data, activities and actions taken.
• Followed up with licensees to verify adherence to requirements.
• Developed and implemented compliance policies and procedures.