Kristen Furagganan

Work History

Revenue Cycle Manager

Mindful Health Solutions

11.2023 - Current

Lead, mentor, and develop the denial management team, providing training, performance feedback, and guidance on complex denial resolution.
Oversee daily operations of denial management, ensuring timely and accurate follow-up and appeal processes
Monitor denial trends and develop strategies to reduce future occurrences through root cause analysis and cross-functional collaboration
Provide analysis and recommendations for systems/process improvements and for specific issue resolution within NextGen and Waystar.
Collaborate with billing, coding, compliance, and clinical teams to correct systemic issues contributing to denials
Developed performance metrics to monitor revenue cycle efficiency and drive improvement initiatives.
Analyze aging reports and key performance indicators (KPIs) to prioritize work and achieve departmental goals
Provide regular reporting to senior leadership on denial volumes, recovery performance, and process improvement initiatives
Maintain up-to-date knowledge of payer guidelines, policy changes, and regulatory requirements
Conducted regular audits to identify areas for improvement in the revenue cycle process.
Established strong relationships with payers, improving communication and resolving disputes more effectively.
Monitored industry trends to anticipate changes that may impact the organization''s revenue cycle performance.
Supported clinical team members with revenue cycle procedures and addressed issues.
Manage projects related to denial prevention, technology enhancements, and payer contract escalations
Foster a culture of accountability, collaboration, and continuous improvement within the team

Revenue Cycle Manager

Carbon Health

01.2021 - 01.2023

Successfully managed and processed billing for over 70,000 medical claims per month.
Responsible for monthly client invoices for employer paid services and collections of unpaid invoices.
Conduct quarterly QA audits to review progress and discuss opportunities for improvement.
Manage the entire revenue cycle process including billing, collections, patient collection, accounts receivable, claims submission, and payments.
Ensure accurate and timely submission of credentialing and enrollment applications with health plans.
Identify reimbursement issues, ensuring that claims, denials, and appeals are efficiently processed.
Resolve billing-related issues.
Work collaboratively with revenue cycle leadership and key departments to enhance cash flow and to eliminate manual work with automation.
Established and maintained departmental policies and procedures to ensure compliance with standard operating procedures.
Implemented and managed electronic billing systems including electronic claims processing applications to maximize efficacy and accuracy.
Developed and maintained strong professional relationships with internal and external stakeholders. Analyzed and monitored revenue cycle performance metrics to identify and resolve areas of process improvement.
Coordinated with other departments to ensure timely reimbursement and accurate coding of services.
Developed and implemented training programs for revenue cycle to ensure consistent knowledge and skills.
Analyzed revenue cycle data to identify and resolve gaps in revenue collection.
Developed and maintained a database of patient billing information to ensure accuracy.

Revenue Cycle Manager

One Medical

01.2020 - 01.2021

Managed a billing team consisting of insurance collectors, contract analysis, and cash posters.
Participated in the day-to-day operations relating to revenue cycle processes, working to maximize profitability and increase revenue.
Trained others in implementing a cross-functional revenue cycle team.
Analyzed and reported on billing cycle data to inform management.
Oversaw daily internal activities to ensure the highest efficiency and accuracy in collection among commercial payers.
Developed Revenue Cycle specific policies in regard to payer follow-up, appeals, write-offs, and time to cash.

Medical Billing Manager

iRhythm Technologies, Inc

01.2017 - 01.2020

Trained and mentored new medical billing staff members who completed claims integrity, made outbound patient and insurance calls, and obtained prior authorizations.
Developed and maintained effective communication between the medical billing staff and other departments.
Developed and maintained an effective medical billing workflow system.
Implemented new processes to streamline medical billing operations, resulting in increased efficiency and accuracy.
Identified and corrected errors in medical claims before submission.
Demonstrated expertise in state and federal medical billing regulations.
Developed strong working relationships with insurance providers to facilitate quick payment of claims.
Responsible for all aspects of employee performance management.
Demonstrated ability to accurately code and process medical claims efficiency and expediently.
Collaborated with other departments to ensure accuracy and compliance with billing regulations, enhance cash flow and to eliminate manual work with automation.

Client Services Manager

GetixHealth/Stanford Valley Care

01.2013 - 01.2017

Managed all functions of the organizations billing and revenue cycle to maximize cash flow, while maintaining and improving internal and external customer relations.
Assigned and monitored work of the A/R staff by providing support and interpretation of instructions and objectives.
Supported the client relationship to ensure an exception client experience and 100% client rendition.
Developed and maintained strong customer relationships to gain customer loyalty and referrals.
Led client onboarding processes, ensuring seamless integration and satisfaction with services.
Developed training materials for staff to enhance service delivery and compliance standards.
Streamlined communication channels between clients and internal teams, improving response times.
Coordinated cross-functional meetings to align client needs with operational capabilities.
Built client relationships by responding to inquiries, identifying and assessing clients' needs, resolving problems, and following up with potential and existing clients.
Developed new employees and on-going performance assessment of current employees.
Built a strong rapport with key decision-makers within client organizations, fostering trust and long-lasting partnerships.

Patient Financial Services Supervisor

Sutter West Bay Hospitals

01.2009 - 01.2013

Reviewed and adjudicated the approval or denial of financial assistance applications.
Collaborated with the manager to developed and executed work plans, process flow, and job aids.
Assisted the manager in developing, monitoring, and reporting department productivity measures and statistics to maintain cash/accounts receivable team goals.
Evaluated overall trends in customer service/correspondence and prepared documentation to delineate problems and reporting trends to the manager.
Assisted the manager in reviewing system functionality.
Determined areas of improvement and reported these changes to the appropriate parties to update.
Led financial operations to optimize patient billing and collections processes.
Developed training programs for staff on compliance and regulatory requirements.
Reduced outstanding account receivables by diligently monitoring patient accounts and addressing discrepancies.
Developed staff competencies by providing ongoing training in billing practices, coding updates, and customer service techniques.

Accounts Receivable Supervisor

Pacific Medical Center

01.2003 - 01.2009

Managed accounts receivable processes, including invoicing, collections, and cash management for a team of10 staff.
Successfully managed billing operations for a fast-paced hospital, ensuring accuracy in all billing processes.
Developed and maintained relationships with clients and vendors to ensure prompt payment.
Analyzed accounts receivable data to recognize trends and identify areas of improvement.
Generated periodic reports to analyze accounts receivable performance and provide insights to management.
Recognized and documented any discrepancies between invoices and payments.
Led monthly team meetings to review progress and discuss opportunities for improvement.
Reported monthly vendor goals and measurements to the Manager, Director, and the VP/CEO of the medical center.
Resolved patient inquiries in a timely manner to ensure patient satisfaction.
Developed and implemented strategies to increase collection rates and reduce bad debt losses.
Ensured compliance with all relevant regulations and policies related to accounts receivable. Monitored patient accounts and identified potential risks for payment delinquency.

On-site Billing Supervisor

Patient Accounting Services

01.2001 - 01.2003

Provided oversight, training and mentoring to billing staff to ensure the highest standards of excellence.
Utilized various software systems and databases to manage, process and analyze billing information.
Monitored billing processes, identified deficiencies, and implemented corrective actions to streamline operations.
Communicated with insurance companies to ensure timely payment of claims and proper resolution of any denials.
Compiled and reported comprehensive billing data for executive review.
Reconciled account discrepancies, resolved disputes and ensured accuracy on accounts receivable.
Developed and implemented new processes for billing and collections that increased efficiency and accuracy.
Overlooked all aspects of billing and insurance collections.
Conducted reviews for annual performance evaluations.

Summary

Overview

Work History

Revenue Cycle Manager

Revenue Cycle Manager

Revenue Cycle Manager

Medical Billing Manager

Client Services Manager

Patient Financial Services Supervisor

Accounts Receivable Supervisor

On-site Billing Supervisor

Education

Associate of Applied Science - Healthcare Administration

Skills

Languages

Timeline

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