LATOYA FERGUSON
Summary
Strategic in financial management, thrive on maximizing productivity and efficiency in task completion. Skilled in budgeting, risk assessment, and strategic planning. Excel at communication, problem-solving, and leadership, ensuring seamless operations and team synergy.
Overview
12
12
years of professional experience
Work History
Director of Revenue Cycle Management
CareDx
Brisbane, CA
09.2023 - Current
- Develop and manage complex revenue cycle projects
- Determine coverage, coding and reimbursement strategies and global health technology agencies
- Assist Commercial, Finance and other internal teams as needed to operationalize
- Oversite of operational performance to anticipate the needs of Sr
- Leadership, forecasting, projections, and modeling
- Travel 15% of the time based on organization objectives
- Oversite of 41 RCM specialists (onsite, hybrid, remote)
- Oversite of department costs and budget; handle third party vendor relational (domestic and global)
Director of Strategic Reimbursement and Implementation
PerkinElmer Genomics
Pittsburgh, PA
09.2019 - 06.2023
- Create Global P&R strategy for Genomic products
- Determine coverage, coding and reimbursement strategies and global health technology agencies
- Assist Commercial, Finance and other internal teams as needed to operationalize P&R
- Oversee the creation of health economics and outcomes research; maintain insights related to gene therapies
- Brand strategy participation
- Help develop and support ideal public policy positions for PKIG portfolio
- Effectively manage and supervise external consultants and billing vendors
- Manage staff of 5 Field Billing Specialists; lead, develop and coach employee team members
- Travel 20% of the time based on company objectives and needs (site visits); pull-through execution/economic barriers for product expansion
- Development of training and onboarding for department new hires; branding functions with Marketing for patient and account awareness
- Prepare and manage reimbursement cost center budget, monitor expenses and invoice payment for all reimbursement programs
Manager of Field Reimbursement Services
Irhythm Technologies
San Francisco, CA
11.2018 - 09.2019
- Manage staff of 5 Field Billing Specialists; lead, develop and coach employee team members
- Travel 50% of the time based on company objectives and needs (site visits); pull-through execution/economic barriers for product expansion
- Development of training and onboarding for department new hires; branding functions with Marketing for patient and account awareness
- Adhere to regulatory and compliance mandates for call recording and audits; internal and external
- Responsible for new product implementation with key HPT’s (high performing targets)
- Vendor relationship manager for all external third party agencies
- Internalize third party billing responsibilities; increase of clean claim submissions
- Develop and execute comprehensive, U.S
- Global strategies to obtain coding, positive coverage decisions and appropriate payment from public and private payers; visibility and direct partnership with stakeholders and Sr
- Leadership
- Manage the credentialing process for state and federal plans; point person for LOA (letter of agreement negation)
- Prepare and manage reimbursement cost center budget, monitor expenses and invoice payment for all reimbursement programs
Manager of Billing and Credentialing
Roche Sequencing Solution
San Jose, CA
11.2016 - 11.2018
- Manage staff of 7 Harmony Care Specialists; lead, develop and coach employee team members
- Development of training and onboarding for department new hires
- Adhere to regulatory and compliance mandates for call recording and audits; internal and external
- Responsible for QA/QC for billing audits
- Internalize third party billing responsibilities; resulting in an increase of clean claim submissions
- Develop and execute comprehensive, U.S
- Global strategies to obtain coding, positive coverage decisions and appropriate payment from public and private payers; visibility and direct partnership with stakeholders and Sr
- Leadership
- Develop execution plan and revenue codes for under and over payments for payers
- Manage the credentialing process for state and federal plans
- Oversee and administer financial assistance programs for under-insured and uninsured patients
- Conduct analysis of reimbursement programs data to identify business impact and payer trends
- Prepare and manage reimbursement cost center budget, monitor expenses and invoice payment for all reimbursement programs
- Monitor important Medicare and private payer reimbursement policies that may have a significant impact on reimbursement for Company technology
Director of Revenue Cycle Management
Natera, Inc.
San Carlos, CA
10.2012 - 11.2016
- Develop and execute comprehensive, multi-year U.S
- Reimbursement strategies to obtain coding, positive coverage decisions and appropriate payment from public and private payers
- Manage staff of 36 employees
- Develop strategies to support the development of new products providing perspective on potential issues regarding reimbursement or procedure coding that will impact the successful launch of products in key markets
- Develop and provide presentation templates and economic cases for the use of our products for particular procedures that are adaptable to all major stakeholders in the patient care continuum
- Work with various functions involved with product positioning and pricing
- Ensure that there is the appropriate data (clinical and economic) to support price points
- Help create studies and or tools to support and protect our price points in the market
- Serve as technical expert, in government reimbursement policies and areas of third party reimbursement, and a source for reimbursement information for internal (marketing, sales, R&D, clinical affairs) and external (customers, payers, trade associations) customers
- Develop and maintain strong working relationships with key opinion leaders including medical society representatives, healthcare providers, government officials, and private payer decision makers as necessary to drive reimbursement strategies
- Manage reimbursement programs to ensure compliance with legal and regulatory requirements
- Conduct analysis of reimbursement programs data to identify business impact and payer trends
- Report of reimbursement program data and results to senior executives, sales and marketing teams and other key internal stakeholders
- Prepare and manage reimbursement cost center budget, monitor expenses and invoice payment for all reimbursement programs
- Work closely with Regulatory, Clinical and RD to establish strategies and processes to create the economic case for our products and how they provide enhanced economic impact in addition to superior outcomes
- These proofs should be targeted at all major stakeholders in the treatment path for procedure/disease state
- Conduct reimbursement assessments for emerging technologies as part of the product development process
Education
Medical Billing and Coding - Certification
Bryman College
M.H.A - Healthcare Administration
California State University of East Bay
B.S - Business Management– Organizational Management and Leadership
Morris Brown College
Skills
- Profitability analysis
- Budget development
- Operational efficiency
- Revenue optimization
- Pricing strategy
- Data-driven decision making
- Account reconciliation
- Regulatory compliance
- Audit coordination
- Month-end closing support
- Process improvement
- Revenue reporting
Timeline
Director of Revenue Cycle Management
CareDx
09.2023 - Current
Director of Strategic Reimbursement and Implementation
PerkinElmer Genomics
09.2019 - 06.2023
Manager of Field Reimbursement Services
Irhythm Technologies
11.2018 - 09.2019
Manager of Billing and Credentialing
Roche Sequencing Solution
11.2016 - 11.2018
Director of Revenue Cycle Management
Natera, Inc.
10.2012 - 11.2016
Medical Billing and Coding - Certification
Bryman College
M.H.A - Healthcare Administration
California State University of East Bay
B.S - Business Management– Organizational Management and Leadership
Morris Brown College
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