Kim Casanova
Montgomery
Summary
Experienced healthcare revenue cycle professional with a strong background in patient account resolution, insurance follow up, and denial management. Skilled in analyzing complex accounts, resolving payer issues, and improving cash flow through timely claim resolution. Proven ability to monitor productivity, support team performance, and maintain compliance with payer guidelines and organizational standards. HFMA Certified Patient Account Representative (CPAR) with expertise in revenue cycle systems and a commitment to operational efficiency and financial performance.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Patient Account Revenue Cycle Assistant Manager
Baptist Health Medical Center
Montgomery, AL
05.2019 - Current
- Managed and optimized workflows for billing and collection teams to ensure timely revenue collection.
- Facilitated internal workflow management focused on improving denial resolution and overall productivity.
- Supervised third-party vendor relationships and offshore operations to maintain high levels of performance, productivity, and quality metrics.
- Identified key trends in denials and assessed root causes. Delivered strategic recommendations to provider practices, resulting in improved operational efficiency.
- Oversaw multi-state provider operations to ensure compliance and efficiency.
- Evaluated claim denials and implemented corrective actions to ensure timely resolutions and compliance with policies.
- Managed accurate and efficient bi-weekly payroll for hourly employees, maintaining compliance with company policies.
- Conducting initial phone screens, interviews, and technical assessments to shortlist candidates.
- Leading teams, managing projects, and driving organizational development.
- Create, implement, and maintain training programs, materials, and onboarding procedures
Clinical Billing Office Manager
River Region Psychiatry
Montgomery, AL
10.2016 - 04.2019
- Analyzed and coded medical malpractice claims, optimizing claim resolution procedures to enhance departmental efficiency.
- Guided a provider enrollment team to ensure accurate and timely handling of data for provider onboarding and recertification with various payers.
- Collaborated with clients to resolve claims, improving financial outcomes by achieving higher collection rates and reducing accounts receivable backlogs.
- Oversaw patient scheduling, registration, and billing processes while maintaining HIPAA compliance and contributing to staff development and interdepartmental policy formulation.
- Oversaw billing operations, ensuring accuracy and compliance with healthcare regulations.
- Managed team performance, providing guidance and training to enhance productivity.
- Established best practices for electronic health record (EHR) integration in billing processes.
- Led cross-functional meetings to align on financial strategies and operational goals.
- Mentored junior staff, promoting knowledge sharing and professional development within the team.
- Reviewed billing problems, researched issues, and resolved concerns.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Collaborated with cross-functional teams to resolve billing-related issues swiftly, minimizing negative impacts on overall operations.
- Reduced errors and discrepancies in invoicing by closely monitoring billing data and conducting regular audits.
- Boosted team productivity through effective delegation of tasks, setting performance targets, and providing constructive feedback.
- Conducted performance reviews and implemented improvement plans.
- Worked with customers to develop payment plans and bring accounts current.
- Optimized resource allocation within the department by analyzing workload trends and adjusting staffing levels accordingly.
- Created a transparent work environment that fostered open communication between team members, promoting collaboration and problem-solving skills development.
- Enhanced client satisfaction levels by ensuring timely delivery of accurate invoices and addressing concerns professionally.
- Developed comprehensive training materials for new hires to quickly acclimate them to company procedures and software systems.
Medical Coding And Billing Specialist
Center for Pain
Montgomery, AL
11.2014 - 10.2016
- Supervised functions within Patient Financial Services, including Registration, Insurance Verification, Financial Counselors, Billing, and Customer Service, improving collection rates and minimizing receivables.
- Resolved claim disputes by investigating and appealing denied claims, and implemented patient payment plans to expedite the recovery of unpaid claims.
- Reviewed and resolved discrepancies in patient accounts, enhancing billing accuracy.
- Collaborated with healthcare providers to verify insurance information and obtain necessary authorizations.
- Trained junior staff on billing procedures and compliance with insurance regulations.
- Analyzed billing trends to identify areas for process improvement and cost reduction strategies.
- Posted and adjusted payments from insurance companies.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Evaluated patients' financial status and established appropriate payment plans.
- Served as a liaison between patients, insurance companies, and healthcare providers to facilitate accurate claims processing and payment resolution.
- Promptly sent out and posted all medical claims.
- Assisted new hires in understanding departmental processes through comprehensive training sessions and ongoing mentorship opportunities.
- Maintained HIPAA compliance while managing confidential patient data, enhancing security measures for sensitive information.
Accounts Receivable Manager
Team Health
Sunrise, FL
01.2010 - 09.2014
- Managed billing and accounts receivables for a network of over 25 physicians and 3 outreach clinics across diverse medical disciplines, including primary, orthopedic, and specialty care.
- Collaborated with ancillary service departments and both revenue and non-revenue generating units, enhancing the efficiency of patient financial services.
- Identified and reported potential areas for strategic improvement to executive staff, supporting the achievement of organizational objectives across multiple facilities.
- Led cross-functional teams to resolve billing discrepancies and improve collection strategies.
- Streamlined accounts receivable processes, enhancing efficiency and accuracy in cash flow management.
- Analyzed financial data to identify trends, informing strategic decisions for revenue improvement.
- Oversaw month-end closing procedures, ensuring compliance with financial reporting standards.
- Implemented automated systems for invoicing and collections, reducing processing time significantly.
- Analyzed aging reports and provided recommendations for improving collections efforts.
- Implemented new collection strategies that led to the recovery of lost revenue.
- Reconciled daily AR ledger and verified proper posting.
- Managed a team of accounts receivable specialists, providing guidance and support for optimal performance.
- Streamlined invoicing and payment systems, resulting in improved cash management.
- Maintained accurate financial records, ensuring compliance with regulatory standards by conducting thorough audits.
- Analyzed financial data to identify trends and areas for improvement in accounts receivable process.
- Enhanced team productivity with regular training sessions on best practices in accounts receivable management.
- Supported financial director with special projects and additional job duties.
- Established and checked coding procedures, monitored reports and updated internal files.
Quality Assurance Manager
Nations Health
Sunrise, FL
01.2007 - 12.2009
- Optimized billing and coding procedures, enhancing collaboration with ancillary service departments to improve Patient Financial Services.
- Designed and implemented quality assurance policies, addressing workflow and production challenges to maintain operational efficiency.
- Documented quality assurance activities, developed detailed audit reports, and produced training materials and operation manuals to support compliance with standards and safety regulations.
- Led quality assurance initiatives to enhance compliance with regulatory standards and improve patient safety.
- Developed and implemented quality management systems to streamline operations and increase efficiency.
- Analyzed data trends to identify areas for improvement in product quality and operational workflows.
- Collaborated with cross-functional teams to ensure alignment with quality objectives and customer expectations.
- Trained team members on quality assurance principles, fostering a culture of accountability and high performance.
- Enhanced product quality by implementing comprehensive QA processes and procedures.
- Facilitated communication between departments regarding quality concerns, fostering collaboration towards shared goals.
Practice Manager
Jess Dental Lab
Sanford, FL
01.2001 - 12.2006
- Managed financial operations, resolved billing discrepancies, and implemented patient payment plans to optimize revenue flow.
- Conducted weekly audits of billing agents and provided feedback to enhance operational efficiency and accuracy.
- Streamlined administrative procedures, managed supply orders, handled correspondence, and submitted service invoices to improve business operations.
- Oversaw daily operations, ensuring efficient workflow and high-quality dental product delivery.
- Implemented process improvements, enhancing production efficiency and reducing turnaround times.
- Developed training programs for staff, fostering skill enhancement and operational excellence.
- Coordinated communication between departments to streamline project timelines and improve collaboration.
- Led team meetings to address challenges, promote best practices, and drive continuous improvement initiatives.
- Maintained compliance with industry regulations and standards, ensuring quality assurance in all laboratory processes.
- Addressed patient concerns promptly and professionally, demonstrating empathy and excellent problem-solving skills.
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Ordered all office supplies and kept check on inventory levels.
- Facilitated communication between staff members, fostering a collaborative work environment that improved overall team performance.
- Developed strong relationships with patients, ensuring a high level of care and satisfaction throughout their experience.
- Developed close working relationships with front office and back office staff.
- Evaluated practice workflows regularly to identify areas for improvement and implement necessary changes efficiently.
- Oversaw the hiring process for new employees, selecting candidates who aligned with the practice''s mission and values.
Patient Registration Representative
Cleveland Clinic
Weston, FL
07.1998 - 12.2000
- Managed patient registration by meticulously updating personal and insurance information, processing financial transactions, and confirming insurance pre-authorizations, ensuring a seamless and supportive patient experience.
- Provided exceptional customer service to patients during check-in and registration processes.
- Processed patient registration information using electronic health record systems.
- Verified insurance coverage to confirm patient coverage for necessary medical services.
- Gathered demographic and insurance information to register patients for medical appointments.
- Imaged and scanned patient and registration documentation into electronic patient records.
- Prepared patient charts before visits to facilitate easy access to relevant information for healthcare providers.
- Collected payments and co-pays from customers using large variety of insurance programs, adjusting amounts based on specific plan directives.
Education
Associate of Science - Medical Billing and Coding
Corinthian College
Hialeah, FL12.2012
High school diploma - undefined
Miami Northwestern Senior High
Miami06.1998
Skills
- Productivity Monitoring
- Revenue Cycle Management
- Process Improvement
- Denial Management & Resolution
- Training& Team Support
- Cash Flow Optimization
- Insurance Followup
- Aging Account Management
- Denial Trend Analysis
- Workflow Optimization
- Data Report & Tracking
- Team Coaching
- Microsoft Excel
- Microsoft Outlook
- Reporting Tools
- EHR Systems
Accomplishments
- Led efforts to resolve complex insurance denials and aged accounts ,improving overall reimbursement turnaround and supporting revenue cycle.
- Monitored team productivity and provided coaching that helped improve account resolution efficiency and quality performance.
- Improved workflow efficiency by ensuring accounts were worked within the assigned worklist and aligned with departmental productivity expectations.
Affiliations
HFMA CPAR Certified
Certified Patient Account Representative through the Healthcare Financial Management Association
Certification
- CPAR
- HFMA
- 2019
Timeline
Patient Account Revenue Cycle Assistant Manager
Baptist Health Medical Center
05.2019 - Current
Clinical Billing Office Manager
River Region Psychiatry
10.2016 - 04.2019
Medical Coding And Billing Specialist
Center for Pain
11.2014 - 10.2016
Accounts Receivable Manager
Team Health
01.2010 - 09.2014
Quality Assurance Manager
Nations Health
01.2007 - 12.2009
Practice Manager
Jess Dental Lab
01.2001 - 12.2006
Patient Registration Representative
Cleveland Clinic
07.1998 - 12.2000
High school diploma - undefined
Miami Northwestern Senior High
Associate of Science - Medical Billing and Coding
Corinthian College
Systems & Software Experience
Athena
Cerner
Greenway
All scrips
eHR
Star Financial
Artiva
IDX
Microsoft Excel