
Detail-oriented Healthcare Revenue Cycle Professional with 17 years of experience. Specialized in Epic software and denial management, driving effective claim appeals and optimizing patient financial outcomes.
Denial Analyst – Medicaid & Managed Care Medicaid | 2024 – Present
• Review, analyze, and resolve complex Medicaid and Managed Care Medicaid claim denials within the Epic system to secure appropriate hospital reimbursement.
• Identify patterns and root causes of denials, collaborating with billing, coding, and clinical teams to prevent recurring issues.
• Draft and submit comprehensive, evidence-based appeal letters backed by payer policies and medical documentation.
• Monitor payer portal updates and regulatory changes to ensure internal compliance with evolving Illinois Medicaid guidelines.
• Track recovery metrics and maintain accurate documentation of dispute statuses within the hospital’s revenue cycle system.
Financial Counselor | 2009 – 2024 • Acted as a trusted financial advocate for patients for 15 years, navigating insurance benefits, pre-authorizations, and out-of-pocket estimates. • Evaluated patient eligibility for state Medicaid programs, financial assistance, and charity care programs using Epic workflows. • Secured hospital revenue by establishing structured payment plans and collecting point-of-service payments in compliance with regulatory standards. • Achieved high accuracy in insurance verification, contributing to reduced front-end registration errors. • Developed extensive knowledge of Rush Copley's patient populations, billing systems, and departmental workflows to enhance service delivery.