Kristen Furagganan
Vacaville,CA
Summary
Results-driven healthcare finance expert with robust experience optimizing financial operations and enhancing revenue streams. Known for strong team collaboration and a flexible, adaptable approach to evolving challenges. Proven skills in healthcare finance, process improvement, leadership, and vendor management. Valued by employers for reliability, strategic thinking, and delivering consistent results that support organizational goals.
Overview
25
25
years of professional experience
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.
- Supervise denial management processes to ensure accurate documentation, timely follow-up, and effective appeals in compliance with policies.
- Track denial patterns and lead cross-departmental efforts to address root causes and minimize recurring denials.
- Analyze system performance and troubleshoot specific issues, recommending improvements for NextGen and Waystar platforms to enhance efficiency
- 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.
- Report regularly to leadership on denial rates, recovery performance, and improvement initiatives.
- Keep informed of payer guidelines and regulatory updates to support compliant billing practices.
- 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.
- Provided guidance to clinical teams on revenue cycle procedures and addressed billing-related 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 high-volume billing in a fast-paced, high-claims environment.
- Responsible for monthly client invoices for employer paid services and collections of unpaid invoices.
- Conduct quarterly quality assurance (QA) audits to evaluate team performance, track progress, and identify opportunities for improvement.
- Oversee end-to-end revenue cycle operations, from billing and claims submission to collections and payment reconciliation
- 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.
- Troubleshoot and resolve billing-related issues to maintain smooth revenue cycle operations.
- 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.
- Led the implementation and oversight of electronic billing and claims processing systems, significantly improving efficiency and reducing errors.
- Fostered effective relationships with key stakeholders while analyzing revenue cycle metrics to drive continuous process improvements.
- Facilitated interdepartmental collaboration to support precise coding of services and ensure timely revenue collection
- Created and implemented revenue cycle training programs to standardize team knowledge and improve performance.
- Utilized data analytics to pinpoint weaknesses in the revenue cycle process, driving targeted improvements in cash flow and collection efficiency
- Collaborated on building the practice management system to establish workflow queues, improving team productivity.
- Supervised vendor performance and supported implementation, startup, and training processes.
Revenue Cycle Manager
One Medical
01.2020 - 01.2021
- Supervised a multidisciplinary billing team responsible for insurance collections, contract analysis, and payment posting.
- Assisted with daily revenue cycle operations to optimize revenue and profitability.
- Provided training to staff on establishing and managing a cross-functional revenue cycle team.
- Provided management with data-driven reports on billing cycle performance to inform process improvements
- Managed daily activities to optimize collection efficiency and accuracy with commercial payers.
- Established targeted policies to improve payer follow-up processes, streamline appeals, manage write-offs, and reduce time to cash..
Medical Billing Manager
iRhythm Technologies, Inc
01.2017 - 01.2020
- Guided new medical billing team members through claims integrity checks, conducting outbound calls, and securing prior authorizations.
- Established and sustained clear communication pathways to support collaboration between billing staff and cross-functional departments.
- Created and sustained a medical billing workflow system to optimize billing processes and reduce errors.
- Implemented process enhancements that optimized medical billing efficiency and accuracy.
- Detected and corrected claim discrepancies pre-submission to reduce denials and delays.
- Demonstrated expertise in medical billing regulatory compliance.
- Established collaborative relationships with insurers, resulting in faster claim reimbursements
- Oversee comprehensive employee performance management to drive productivity and professional growth.
- Monitored vendor team performance to ensure consistent productivity and accuracy standards.
- Created Salesforce dashboards to improve monitoring and reporting of team performance.
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.
- Maintained strong client relationships to deliver exceptional service and achieve full client retention.
- Led onboarding to ensure smooth integration and client satisfaction.
- Developed training materials to support service excellence and compliance.
- Optimized communication pathways between clients and internal teams to accelerate response times.
- Organized cross-functional meetings to align client needs and operational capabilities.
- Cultivated client relationships through effective communication, needs assessment, problem resolution, and consistent follow-up.
- Trained new employees and managed ongoing performance evaluations.
- Established and nurtured trusted relationships with key client decision-makers to support long-term partnerships.
Patient Financial Services Supervisor
Sutter West Bay Hospitals
01.2009 - 01.2013
- Evaluated financial assistance applications to ensure decisions aligned with established policies and criteria.
- Worked closely with management to design and roll out work plans, process flows, and instructional materials.
- Assisted in developing and reporting productivity metrics to meet cash/accounts receivable objectives
- Analyzed customer service correspondence trends, documented key issues, and communicated insights to management..
- Worked alongside the manager to review and optimize system functionality.
- Evaluated operations, recommended enhancements, and collaborated with teams to update procedures accordingly.
- Led patient billing and collections to optimize financial operations.
- Developed training programs for staff on compliance and regulatory requirements.
- Effectively minimized outstanding accounts receivable through proactive account monitoring and issue resolution.
- Provided continuous training to enhance staff skills in billing, coding, and customer service.
Vendor Manager
California Pacific Medical Center
01.2003 - 01.2009
- Managed vendor billing company performance in a dynamic hospital billing setting.
- Built and sustained vendor relationships to improve payment timeliness and accuracy.
- Track vendor adherence to service level agreements (SLAs), quality standards, and regulatory requirements through regular audits and performance reviews.
- Work closely with clinical staff, procurement, finance, compliance, and IT departments to ensure vendor services align with patient care goals and organizational policies.
- Identify opportunities to streamline vendor management processes to enhance operational efficiency and patient care quality.
- Led monthly team meetings to review progress and discuss opportunities for improvement.
- Reported monthly vendor goals and measurements to the RCM Leadership.
- Performed quarterly quality assurance scorecard assessments to track vendor performance metrics.
- Performed quarterly vendor site visits, facilitated discussions, and provided constructive performance feedback.
- Conducted thorough monthly reviews of vendor invoices to ensure correctness and authorize payments.
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.
Education
Associate of Applied Science - Healthcare Administration
06-1994
Skills
- Revenue optimization
- Expertise in billing processes
- Account performance tracking
- Effective cash flow oversight
- Skilled in data interpretation
- Claims resolution management
- Dispute resolution expertise
- Billing cycle analysis
- Analytical problem-solving
- Strong attention to detail
- Skilled at managing multiple tasks
- Trustworthy work ethic
- Effective team collaboration
- Building professional relationships
- Team development
- Proactive self-starter
- Vendor Relationship Building
Timeline
Revenue Cycle Manager - Mindful Health Solutions
11.2023 - Current
Revenue Cycle Manager - Carbon Health
01.2021 - 01.2023
Revenue Cycle Manager - One Medical
01.2020 - 01.2021
Medical Billing Manager - iRhythm Technologies, Inc
01.2017 - 01.2020
Client Services Manager - GetixHealth/Stanford Valley Care
01.2013 - 01.2017
Patient Financial Services Supervisor - Sutter West Bay Hospitals
01.2009 - 01.2013
Vendor Manager - California Pacific Medical Center
01.2003 - 01.2009
On-site Billing Supervisor - Patient Accounting Services
01.2001 - 01.2003
Silicon Valley College - Associate of Applied Science, Healthcare Administration