Kimberly Cleveland
Newark,DE
Summary
Experienced Practice Manager successful at handling payroll administration and patient relations for 6-physician practice. Promotes business development and community profile by developing positive rapport with patients and handling marketing activities. Successful forging partnerships with hospitals and specialty practices to extend patient care reach. Knowledgeable Practice Manager offering more than 38 years of experience working for several Vascular Surgery providers in management of billing operations. Well-versed in referral management and handling electronic health records.
Experienced with revenue cycle management, ensuring efficient financial processes and revenue optimization. Utilizes strategic planning and process improvements to enhance operational performance. Track record of effective team leadership and collaboration, driving successful outcomes in dynamic environments.
Overview
40
40
years of professional experience
1
1
Certification
Work History
Operation Manager
Azalea Health
03.2023 - 03.2025
- Monitored and guided revenue cycle operations.
- Implemented process improvements, ensuring accurate charge capture and coding compliance.
- Provided staff training on revenue cycle management best practices, increasing productivity across the department.
- Completed financial reporting and analysis for billing revenue cycle.
- Managed cross-functional teams to improve overall revenue cycle operations.
- Streamlined workflows to minimize claim rejections and maximize reimbursement rates from insurance providers.
- Analyzed complex data sets to derive actionable insights for improving internal processes related to revenue cycle management.
- Maintained a thorough understanding of regulatory requirements, ensuring compliance throughout all aspects of the revenue cycle.
- Coordinated with finance team to produce accurate monthly reports on collection metrics and trends.
- Conducted regular audits to identify areas for improvement in the revenue cycle process.
- Improved revenue cycle efficiency by streamlining processes and implementing best practices.
- Reduced accounts receivable days outstanding, optimizing billing and collections efforts.
- Streamlined billing processes, significantly reducing errors and enhancing revenue cycle efficiency.
- Reduced days in accounts receivable by implementing more efficient follow-up procedures with payers.
- Reduced denial rates through meticulous claims review and enhanced coding practices, ensuring maximum revenue capture.
- Collaborated with IT to develop new revenue cycle management software, leading to improved tracking and reporting of key financial metrics.
- Developed and implemented training programs for new hires, leading to more competent and effective billing team.
- Supported financial director with special projects and additional job duties.
- Established and checked coding procedures, monitored reports and updated internal files.
Practice Manager
Delaware Vascular And Vein Center, LLC,
09.1985 - 02.2023
- Developed policies and procedures for effective practice management.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Prepared billing correspondence and maintained database to organize billing information.
- Precisely evaluated and verified benefits and eligibility.
- Filed and updated patient information and medical records.
- Researched CPT and ICD-9/ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Liaised between patients, insurance companies, and billing office.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Posted and adjusted payments from patients and insurance companies.
- Managed collections claims for unpaid bills against estates of debtors.
- Identified and resolved patient billing and payment issues.
- Located errors and promptly refiled rejected claims.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Developed and implemented strategies to improve patient access, satisfaction and care quality.
- Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
- Successfully negotiated client contract renewals to create increased revenue.
- Developed close working relationships with front office and back office staff.
- Oversaw accounting, budgeting, and financial reporting.
- Trained interns and newly hired team members on office procedures and computer system.
- Ordered all office supplies and kept check on inventory levels.
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations.
- Supervised team of 35 office personnel.
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Scheduled surgeries, managed pre-certifications and verified insurance coverage.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Consulted with healthcare professionals on business decisions.
- Provided supervision and management to team of support personnel.
- Created and implemented organizational policies and procedures.
- This work history time frame also includes Christiana Care Vascular Specialists and Delaware Vascular Associates. This vascular practice had corporate name and location changes from September 1999-February 2023.
Skills
- Overseeing practice operations
- Employee onboarding and performance evaluation
- Payroll management
- EHR management
- Utilization oversight
- Accreditation oversight
- Develop organizational policies
- Financial record management
- Healthcare billing expertise with strong knowledge of multiple specialties
- 24 years of expertise in STI Computer Services applications
- Operational efficiency
- Problem-solving
- Employee relations and conflict resolution
- Team leadership
- Decision-making
- Client relations
- Strong knowledge of Change Healthcare/Waystar
Certification
Certified Notary Public
Timeline
Operation Manager
Azalea Health
03.2023 - 03.2025
Practice Manager
Delaware Vascular And Vein Center, LLC,
09.1985 - 02.2023
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