Kaleisha Council
Cary,NC
Summary
Knowledgeable Compliance Analyst skilled in developing and implementing tracking and training programs to promote revenue compliance. Highly ethical and focused team player with productive, diligent approach. Bringing 11 years of experience in compliance and auditing.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Revenue Integrity Compliance Analyst
UNC Healthcare
Chapel Hill, NC
12.2019 - Current
- Create and submit quarterly reports to monitor the impact of missed revenue and the outcome of revenue posted
- Submits recommendations and assists departments with corrective action plans
- Audits revenue reports to ensure charge accuracy
- Complies reports and submit findings and recommendations to department managers
- Review departmental charge capture procedure
Health Information Coordinator
Carolina Meadows
08.2015 - Current
- Identified trends and opportunities to improve revenue through areas such as workflow and uncovering hidden charges
- Coordinated and provided training and education to staff on policies concerning medical record procedures, documentation, and practices
- Worked closely with the accounting office to investigate claim rejections both as individual claims and exploring systemic issues with claim processing
- Developed and maintained an effective system to track and identify trends in denials to improve Health Clinic Revenue
- Audited documentation to ensure appropriate support for billing level and required elements of documentation are met
- Facilitated and completed appropriate credentialing requirements for medical providers by gathering all required documentation to complete appropriate application forms.
Patient Financial Services Specialist
Wake Health Services
08.2014 - 08.2015
- Followed up on outstanding claims for all NC Medicare, NC Medicaid and Medicare Advantage Plans to timely resolve payment issues
- Analyzed, update, and correct claims data according to established research
- Processed and transmit claims using the CMS1500 or UB04 claim forms
- Promptly handled phone, mail, and personal inquiries from patients regarding their accounts
- Effectively researched and resolved accounts appearing on various reports.
Accounts Research Specialist
McKesson
02.2013 - 08.2014
- Followed up all on outstanding payers including self-pay and/or including denials
- Ensured that A/R greater than 90 days was less than 20% of overall outstanding A/R
- Contacted insurance carriers, patients, or other facilities as needed to get maximum payments on accounts and to identify issues or changes to achieve client profitability
- Handled any patient correspondence in a timely manner
- Entered demographic and insurance data accurately into IDX and Centricity patient management system
- Reviewed claims to make sure billing requirements were met.
Payment Representative
McKesson
01.2013 - 02.2013
- Posted payments and rejections to patient accounts
- Made corrections to misapplied payments
- Reviewed claims and Explanation of Benefits to make sure that payer specific billing requirements were met
- Determined and applied appropriate payment adjustments
- Updated accounts as necessary.
Education
Master’s in Health Care Administration -
Strayer University
Washington04.2024
B.S. in Business Administration/Management -
Limestone University
Florence, SC05.2014
A.S. in Technology -
Florence Darlington Technical College
Florence, SC05.2010
Skills
- Certified Professional Coder
- Ability to research, collect, and analyze data
- Develops and Implements effective systems and processes
- In depth knowledge of preparing appropriate claim documents
- Investigations expertise
- Regulatory knowledge
- Reporting skills
- Compliance understanding
Certification
- CPC-Certified Professional Coder
Timeline
Revenue Integrity Compliance Analyst
UNC Healthcare
12.2019 - Current
Health Information Coordinator
Carolina Meadows
08.2015 - Current
Patient Financial Services Specialist
Wake Health Services
08.2014 - 08.2015
Accounts Research Specialist
McKesson
02.2013 - 08.2014
Payment Representative
McKesson
01.2013 - 02.2013
Master’s in Health Care Administration -
Strayer University
B.S. in Business Administration/Management -
Limestone University
A.S. in Technology -
Florence Darlington Technical College
Similar Profiles
Shondolyn ThorpeShondolyn Thorpe
Behavioral Healthcare Technician /CNA at UNC HealthcareBehavioral Healthcare Technician /CNA at UNC Healthcare
Yolanda BarbourYolanda Barbour
Patient Access Intake Specialist at UNC HealthcarePatient Access Intake Specialist at UNC Healthcare
Estella PhippsEstella Phipps
Administrative Support Supervisor at UNC HealthcareAdministrative Support Supervisor at UNC Healthcare
Catherine TaylorCatherine Taylor
Senior Executive Assistant to Associate Vice Presidents at UNC HealthcareSenior Executive Assistant to Associate Vice Presidents at UNC Healthcare
Parker LaneParker Lane
Outside Services at Lochmere Golf & Country ClubOutside Services at Lochmere Golf & Country Club