Lekallar Hilley
Riverdale,IL
Summary
PROFESSIONAL SUMMARY OBJECTIVE: Clinical Medical Associate with over 15 years of experience performing multiple tasks and assisting physicians in providing patient care and to work for a company that can utilize my professional customer service skills, leadership abilities and educational background while providing me with the opportunity to create new skills.
Overview
15
15
years of professional experience
Work History
Director of Revenue Cycle Operations/Front desk operations
University of Illinois
05.2023 - Current
- Oversee the daily operations of the Revenue Cycle department for all related functions of billing, collections, revenue, and AR Management
- Responsible for the analysis, design, strategic development, and execution of revenue cycle initiatives related to improving revenue, improving cash collections, reducing cycle times, reducing costs, and increasing practice efficiencies while assuring these activities are performed consistent with federal and state laws, payer rules and policies, client practice, and internal policies and procedures
- Establish, monitor, and report performance benchmarks. Communicate to Department and College Leadership on the performance standard and quality expectation to help achieve or exceed performance goals. Identifies areas for process improvements, facilitating and directing changes
- Oversight of staff responsible for scheduling, registration, prior authorization
- Responsible for HR functions for staff within the faculty practice including hiring, performance evaluations, disciplinary action
- Directly supervises staff level positions, assuring individuals are trained in all aspects of their job functions and performing at the expected level
- Perform other related duties and participate in special projects as assigned.
- Established a robust forecasting process to accurately predict revenue trends and inform decisionmaking.
- Developed and distributed quarterly management revenue and analysis reports using proven software tools.
- Checked payroll, vendor payments, commissions and other accounting disbursements for accuracy and compliance.
- Developed strategic plans for day-to-day financial operations.
Healthcare Reimbursement Analyst I/Transplant Coordinator
University of Illinois
06.2021 - 05.2023
- Provide all case management services to patients and families of the Medical Center at Chicago
- Acts as the primary contact for all financial clearance prior to services being rendered
- Enter accurate registration information including patient demographics, updating patient insurance information, obtain benefits and authorization, if needed, prior to patient arrival
- Work within the University of Illinois Hospital charity care policy for uninsured patients; assist clinical staff as necessary within the Emergency room, inpatient, and all kids' department
- As it relates to patient Insurance plans to ensure accurate billing and increase revenue collection
- Provide assistance and assessing the patient in obtaining babies name and verifying demographics and completion of birth certificates, death certificate and the processing of all forms and submission to the State of Illinois
- Assist with patient accounts as part of a comprehensive patient care team and research additional funding options and collaborates with industry peers to provide current and knowledgeable support
- Interview patients to obtain demographic and social data as related to financial status, income, and access to community and medication resources to assist in the preparation, maintenance, and monitoring of reimbursement initiatives
- Assist uninsured patients in completing ABE (Medicaid application) and charity care application to obtain insurance while aiding with IDPA 2636, All kids, MANG/disability, Emergent Need, SA Vouchers, CVC applications, ABE, SNAP, or any financial entitlement program to patient families when necessary
- Follow up with patients to determine status of coverage through state and Federal entitlements and manufacturer programs
- Function as a clerical support person to other Health Social Work Staff as needed
- Upgrades to all appropriate encounters for patients whom applications are were (Self Pay to Approved Insurance)
- Handles the complete financial case management of transplant recipient, donor, and all transplant related services
- Interview patient by telephone and in-person to collect demographic, financial, insurance, referral physician and medical data
- Verify insurance coverage for transplant services to expedite billing and collections
- Investigate charge disputes, and if found to be valid prepare documentation to Initiate correction
- Responsible for pre-registration, insurance verification (in/Outpatient), and the pre/post-transplant accounts
- Reviewing all inpatient and outpatient clinical activities within the EPIC system, Review and confirm all billing is appropriate with the insurance payer
- Coordinates patients' appointment schedules, confirm appointments, set up return appointments
- Initiates retrieves and review medical records
- Assist in the supervision of student workers, other clerical staff in the clinical unit
- Establishes and maintains effective procedures for obtaining and maintaining patient unit supplies and equipment, maintains inventory of equipment and supplies
- Prepares reports as requested by superiors
- Serves as a liaison between clinical team and other administrative staff
- Verifies external referrals from health care facility
- Monitors workflow, trains new staff, is responsible for training permanent, temporary, and backup coverage in all phases of reception work.
Certified Medical Assistant
Rush University Medical Center
12.2016 - 06.2021
- Efficient handling of front desk administrative duties answering phones and returning patient calls, check-in, and check-out patient's, scheduling appointments, registering new patients, updating existing patient's profiles, process and collect copay payments and call-in prescriptions under direct supervision of the doctor
- Maintains and complete all prior authorizations insurances for both our Chicago and Oak Park locations for outpatient sleep studies
- Input DME orders for patient's CPAP machines request
- Enter payroll when manager is unavailable
- Manages and create all physicians' templates and block open slots requested dates for physician in EPIC
- Conducts annual performance reviews in conjunction with manager
- Set up peer to peers or appeals as needed and assists with denials for sleep studies
- Assist with managing the medical assistants in scheduling of daily duties operations under the direction of the manager
- Room and prepare patients to exam rooms and triaged patient by obtaining pertinent information to be documented in EPIC, which included vital signs, height, weight, blood pressure, temperature and heart rate update past medical history, medications, and current chief compliant of office visit, while maintaining optimum patient care
- Recommended improvements that facilitated patient flow and reduced average wait time by 10 minutes
- Provided clinical and operational support in the delivery of patient care in physician practice settings and in clinical offices
- Assigned tasks to team members based on individual strengths and promoted teamwork-driven environment to meet goals
- Developed department leadership among team members by coaching and providing challenging assignments
- Collected statistical data and documentation to report on production status
- Interviewed, hired, and trained all employees and scheduled work hours
- Met and exceeded productivity by 100% after implementing new processes to improve quality output
- Oversaw day-to-day operations and special projects in fast-paced office setting.
Clinic Coordinator III
Rush University Medical Center
05.2009 - 12.2016
- Greets and acknowledges patients at the front desk, accurately schedule, check-in and check-out, registrar new patient, insurance verification, answering phones efficiently and courteously
- Answer a large volume of incoming calls to the Occupational/Physical therapy clinics for inpatient and outpatient scheduling, Schedules patients and refers phone calls as needed
- Coordinates all providers' templates
- Collects copay payments, posts payments in EPIC, and reconciles end-of-day receipts
- Resolves office problems and facilitates solutions, confers with supervisor to resolve more complex issues, assists in training of new employees, generates letters requested by physician for patients, per office protocol
- Takes accurate, clear, and concise messages that provide sufficient information for the clinical staff and effectively handle the issue or request
- Supports access by utilizing the wait list and filling appointment slots created by cancellations and no shows
- Appropriately transfers patients to pre-registration for insurance verification
- Performs daily cash reconciliation and batch close process at the end of each business day per process in an accurate manner
- Completed post-visit follow-ups by calling patients with lab results and appointment reminders
- Recruited, hired, and trained top-quality candidates to elevate the team's performance and long-term success.
Education
MBA - Concentration Management
Roosevelt University
Chicago, ILCertification - Medical Assisting
Northwestern College
Bedford Park, ILBBA - Business Management
Robert Morris College
Bensenville, ILCertificate - Medical Transcription and Medical Billing CPT/ICD
Ashworth University
Norcross, GASkills
- Microsoft Word
- Excel
- PowerPoint
- Typing 45-50 wpm
- Medical terminology
- Patient scheduling
- Clinical and administrative support
- Office support
- Medical front desk management
- Patient care
- Clinical operations
- Vital signs and examinations
- Reimbursement Regulations
- Determine Medical Necessity
- Problem-solving
- Profitability analysis
- Revenue optimization
- Strategic planning
- Analytical thinking
- Attention to detail
- Team leadership
- Account Reconciliation
- Financial Resource Management
- Revenue Generation
- Recruitment and Hiring
- Cash Handling Expertise
Timeline
Director of Revenue Cycle Operations/Front desk operations
University of Illinois
05.2023 - Current
Healthcare Reimbursement Analyst I/Transplant Coordinator
University of Illinois
06.2021 - 05.2023
Certified Medical Assistant
Rush University Medical Center
12.2016 - 06.2021
Clinic Coordinator III
Rush University Medical Center
05.2009 - 12.2016
MBA - Concentration Management
Roosevelt University
Certification - Medical Assisting
Northwestern College
BBA - Business Management
Robert Morris College
Certificate - Medical Transcription and Medical Billing CPT/ICD
Ashworth University
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