Lola O'Rourke
Williamstown
Summary
Results-driven Revenue Cycle Specialist with expertise in revenue cycle management, billing optimization, denial resolution, and strategic planning. Skilled at analyzing financial data, implementing effective billing strategies, and improving operational workflows to maximize cash flow, reduce errors, and increase efficiency. Proven ability to foster collaborative relationships with medical staff, develop employees, and enhance patient satisfaction while driving continuous process improvements and supporting organizational excellence.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Project Manager/Revenue Cyle/Billing/Coding/Credentialing Specialist
English Bulldog Consulting
Williamstown, NJ
01.2025 - Current
- Implemented strategic initiatives to enhance operational performance and drive business growth as owner and operator.
- Cultivated strong relationships with clients and vendors to enhance collaboration and satisfaction throughout all project phases.
- Enhanced project reporting systems to provide clear insights into progress for stakeholders and executive leadership
- Successfully managed multiple projects simultaneously by prioritizing tasks according to urgency, resource availability, and alignment with organizational goals.
- Orchestrated planning, design, and scheduling of project phases for large-scale initiatives.
- Developed comprehensive project plans with clear timelines, milestones, and budget requirements, ensuring timely delivery of high-quality results.
- Managed client interactions to deliver outstanding satisfaction by anticipating needs and exceeding expectations at every stage of the engagement.
- Evaluated project advancement against set goals, implementing schedule and resource modifications to keep initiatives on track.
- Monitored project performance to identify areas of improvement and make adjustments.
- Cultivated skills in prioritizing tasks and maintaining productivity in high-pressure situations.
- Fostered a culture of innovation and creativity within the project team, leading to improved problem-solving capabilities and enhanced outcomes.
- Monitored and evaluated project practices, executing regular audits and updates to maintain adherence to industry standards and regulations.
- Monitored project progress, identified risks and took corrective action as needed.
- Administered credentialing procedures, guaranteeing alignment with established regulatory requirements.
- Coordinated with healthcare providers to confirm qualifications and support seamless onboarding experiences.
- Developed and maintained comprehensive credentialing databases for accuracy and accessibility.
- Reviewed and analyzed credentialing files systematically to verify adherence to regulatory requirements and organizational policies.
- Coordinated and prioritized credentialing tasks, successfully meeting deadlines for multiple providers simultaneously.
- Maintained confidentiality of provider information to uphold data privacy standards and comply with company policies.
- Navigated and rectified complex issues and discrepancies in the credentialing process, ensuring accuracy and compliance.
- Coordinated comprehensive onboarding procedures for new providers, focusing on timely documentation and verification completion.
- Assisted in training new employees on proper credentialing procedures, contributing to their rapid integration into the team environment.
- Coordinated efforts in audit preparation, leading to successful accreditation and acknowledgment of compliance excellence.
- Analyzed provider documentation for inconsistencies and implemented corrective measures to maintain data integrity.
- Facilitated policy revisions to maintain alignment with changing healthcare standards.
- Developed and implemented onboarding and orientation programs for new employees.
- Improved organizational filing systems for confidential employee records, resulting in improved accessibility and efficiency.
- Contributed to the development of detailed job postings and descriptions for various boards.
- Coordinated employee scheduling and assignments to fulfill human resource operational requirements and enhance workforce productivity.
Manager/Revenue Cycle/Medical Billing and Collections Specialist
Advanced Dermatology PC
Sewell, NJ
01.2016 - Current
- Managed office workflows and processes to maintain operational efficiency and adherence to organizational standards.
- Refined scheduling procedures to enhance operational efficiency and elevate patient experience.
- Developed engaging training materials for new hires, ensuring a smooth onboarding process and uniform operational practices.
- Orchestrated integration of electronic health record systems, ensuring streamlined access to accurate patient data for clinical staff.
- Safeguarded company documents and personnel records by maintaining strict confidentiality protocols.
- Executed regular inventory assessments of office supplies, ensuring timely ordering of necessary items.
- Supported recruitment efforts through interview facilitation and onboarding initiatives to enhance team integration.
- Acted as a liaison between upper management and staff, fostering open communication channels to promptly address concerns and issues.
- Designed and implemented comprehensive policy manuals that outline essential procedures and guidelines, promoting an efficient workplace environment.
- Supported operational safety initiatives through regular equipment inspections and adherence to emergency protocols.
- Analyzed and refined office procedures to drive continuous improvement and operational excellence.
- Mediated office disputes promptly and fairly to foster a harmonious workplace environment.
- Managed sensitive employee and client information with strict confidentiality standards.
- Analyzed and optimized workspace layout, resulting in improved operational efficiency and employee productivity.
- Formulated and implemented office policies to ensure alignment with company values and regulatory standards.
- Established and monitored performance goals while conducting evaluations and administering salaries to ensure staff accountability.
- Evaluated employee skill sets to strategically coordinate individual duties, enhancing overall team performance.
- Monitored and improved performance evaluation metrics to ensure alignment with organizational goals and expectations.
- Applied effective project management techniques to navigate obstacles and optimize team performance.
- Enhanced efficiency of payment collection processes and accounts receivable management to ensure accurate recordkeeping.
- Mediated conflicts between employees to foster a collaborative work environment.
- Executed precise billing and coding for dermatology services, upholding industry standards and enhancing operational efficiency.
- Engaged with healthcare providers to ensure timely resolution of discrepancies in patient accounts.
- Analyzed and restructured revenue cycle workflows, driving efficiency improvements and aligning with established best practices.
- Evaluated financial data to uncover trends that inform strategic decision-making and optimize resource allocation.
- Analyzed billing procedures and led initiatives to decrease errors, resulting in improved revenue collection outcomes.
- Executed comprehensive insurance follow-ups and appeals, focusing on improving patient satisfaction and minimizing financial discrepancies.
- Engineered advanced reporting tools to monitor key performance indicators within revenue cycle department.
- Conducted thorough audits to identify billing inaccuracies, ensuring swift resolution to maximize revenue.
- Investigated and resolved billing disputes promptly, ensuring high levels of customer satisfaction and loyalty.
- Performed detailed audits on patient accounts and insurance claims, guaranteeing precision in billing processes.
- Conducted comprehensive checks on insurance eligibility and authorization to achieve optimal reimbursement rates for services rendered.
- Analyzed and refined revenue cycle procedures, resulting in expedited payment collection and increased process efficiency.
- Clarified complex billing statements for patients, promoting transparency and trust in healthcare interactions.
- Optimized reimbursement processes by actively monitoring payer requirements and fostering robust relationships with insurance providers.
- Monitored billing status and generated regular reports to ensure transparency and facilitate upper management oversight.
- Maintained comprehensive documentation of activities associated with unpaid claims and denied services, facilitating effective resolution and follow-up.
- Managed a portfolio of high-risk accounts, effectively reducing bad debt write-offs through proactive communication and negotiation tactics.
- Conducted in-depth analysis of financial reports to identify opportunities for revenue cycle optimization.
- Implemented targeted collection strategies to enhance cash flow and minimize outstanding account balances.
- Designed and established comprehensive policies and procedures aimed at maintaining adherence to industry regulations and standards.
- Facilitated improved cash flow by meticulously tracking and addressing pending claims and appeals for efficient processing.
- Enhanced patient satisfaction by delivering clear and concise explanations of billing procedures and insurance coverage.
- Executed thorough documentation practices to reduce claim submission turnaround time while maintaining compliance with healthcare regulations.
- Developed and executed follow-up strategies to improve revenue collection efficiency and reduce delinquent accounts.
- Implemented streamlined procedures for patient registration and insurance verification, improving the intake process for patients.
- Developed and implemented performance metrics to foster accountability within revenue cycle team, enhancing overall team effectiveness.
- Analyzed and negotiated complex insurance disputes, leading to successful recovery of substantial denied claims.
- Monitored and updated expertise in coding standards, leading to improved accuracy and fewer claim denials.
- Executed comprehensive analyses of revenue cycle metrics, identifying trends and formulating strategic action plans.
- Implemented systematic reviews of billing procedures, resulting in significant error reduction in patient invoices.
- Created and delivered targeted training sessions for new hires, focusing on critical aspects of healthcare billing and coding to optimize team performance.
- Spearheaded continuous process improvement initiatives by identifying inefficiencies in revenue cycle operations.
- Clarified financial policies for patients to reduce confusion and improve upfront collections.
- Developed and executed comprehensive plans for claims management, driving improvements in revenue cycle performance.
- Achieved significant improvements in cash flow by closely monitoring and adjusting patient account statuses.
- Developed detailed reports on billing activities and revenue trends, facilitating data-driven strategic planning.
- Played key role in transition to new billing system, ensuring smooth conversion with minimal disruption to operations.
- Conducted thorough analysis of evolving healthcare regulations, effectively minimizing compliance risks and preventing potential penalties.
- Strategically managed patient payment plans, emphasizing compassionate communication to secure timely payments and sustain patient rapport.
- Identified and resolved payment issues between patients and providers.
- Streamlined organization of materials and catering support for internal and client-focused meetings.
- Executed front desk support duties by promptly addressing tasks in the absence of staff or during lunch periods.
- Utilized active listening and probing questions to resolve issues, ensuring major challenges were promptly escalated to management.
- Enhanced office operational efficiency by streamlining filing systems, resulting in easier access to critical documents.
- Facilitated positive work environment, addressing employee concerns promptly and fostering culture of mutual respect.
- Implemented strategies to streamline office functions, resulting in increased efficiency and enhanced collaboration among team members.
- Oversaw scheduling and communication for executive leadership to enhance operational efficiency.
- Analyzed and optimized coding practices through targeted initiatives, contributing to increased reimbursement rates from payers.
- Led initiatives to enhance customer satisfaction through improved communication regarding billing issues.
- Researched and resolved billing discrepancies to enable accurate billing.
- Conducted thorough research and resolution of billing discrepancies to uphold financial integrity.
- Maintained comprehensive records of payment histories for all accounts, enabling efficient access to information for auditing and analytical needs.
- Reduced errors in financial records by conducting regular audits of billed accounts.
- Conducted regular reviews of billing practices to ensure alignment with current industry regulations and guidelines.
- Managed monthly billing cycles to ensure timely issuance of invoices and statements.
- Streamlined billing process efficiency by implementing updated billing system.
- Cultivated a collaborative atmosphere through active support and mentorship of junior billing staff.
- Streamlined response processes for billing inquiries, ensuring clarity and timeliness in customer interactions.
- Negotiated with insurance companies to resolve disputed claims, securing rightful payments.
- Developed and executed follow-up strategies to optimize payment collection timelines and improve client compliance.
- Conducted regular reviews of billing regulations and compliance requirements to guarantee alignment with legal standards.
- Coordinated efforts with healthcare team to verify billing code accuracy, enhancing reimbursement efficiency from insurance providers.
- Contributed to annual audit by compiling thorough billing records and articulating reasons for variances.
- Proactively addressed potential billing discrepancies by conducting pre-billing audits.
- Analyzed existing workflows to pinpoint areas for improvement, resulting in streamlined billing processes.
- Conducted detailed record-keeping and verification of insurance details to improve accuracy in patient billing operations.
- Resolved customer inquiries and concerns consistently to ensure effective communication and support.
- Administered payment transactions and detailed outstanding balance information to enhance financial transparency.
- Analyzed and adjusted billing and posting records, focusing on precision and compliance.
- Managed the production and mailing of monthly statements while addressing related customer requests for information and clarification.
Project Manager/Billing/Coding and Reimbursement Specialist
Health Information Management (HIM)
Williamstown, NJ
01.2014 - 02.2017
- Achieved operational excellence through effective management of daily activities. Delivered streamlined operations that improved overall team effectiveness.
- Communicated detailed project progress and insights to stakeholders and executive management to facilitate informed decision-making.
- Provided detailed technical and operational direction in project challenges, consistently meeting deliverables according to deadlines.
- Analyzed and restructured health information workflows to bolster data integrity and streamline operational efficiency.
- Developed and implemented continuous improvement initiatives focused on maximizing project efficiency and maintaining cost-effectiveness.
- Orchestrated team collaboration and prioritized tasks to ensure successful completion of projects within established deadlines.
- Analyzed coding accuracy through systematic audits, leading to the refinement of quality assurance practices.
- Utilized advanced software to track claim status, update patient records, and streamline communication within the team.
- Conducted thorough analysis of coding discrepancies to optimize revenue streams and ensure timely reimbursement.
- Conducted thorough research on industry regulations and coding practices by actively participating in relevant workshops, webinars, and conferences.
- Investigated patterns in denied claims to develop focused strategies aimed at improving claim approval rates moving forward.
- Developed and implemented training programs in ICD-10-CM, CPT, and HCPCS code sets to improve team performance and accuracy.
- Contributed to the creation of educational materials used internally for staff development purposes focused on current trends in medical coding and reimbursement methodologies.
- Facilitated collaboration with physicians to assess documentation behaviors and provide guidance on coding methodologies for optimized billing processes.
- Managed high volumes of insurance claims to guarantee prompt reimbursements while adhering to strict deadlines.
- Developed and maintained comprehensive data handling procedures to guarantee adherence to federal regulations, including HIPAA privacy requirements.
- Coordinated with healthcare providers to gather and clarify patient information critical for effective coding and billing operations.
- Executed comprehensive evaluations of medical documentation to ensure adherence to industry guidelines and elevate coding accuracy.
- Streamlined claim submission process by ensuring compliance with payer-specific guidelines and preemptively tackling any discrepancies.
- Implemented process improvements for insurance claims management, resulting in increased efficiency and sustained accuracy rates.
- Advised team members on complex coding issues, leveraging comprehensive understanding of best practices to enhance problem-solving capabilities.
- Applied established coding rules from American Medical Association and Centers for Medicare and Medicaid Services to enhance accuracy in diagnostic code assignments.
- Evaluated outpatient documentation to identify and clarify diagnoses and procedures for improved patient care.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Collaborated with insurance companies to analyze and correct coding discrepancies, enhancing operational efficiency.
- Analyzed coding practices through on-site audits to assess alignment with coding guidelines and improve overall quality assurance.
- Implemented protocols to guarantee accuracy and security of health information and medical records management.
- Optimized patient data management by utilizing electronic medical record systems to enhance accessibility and accuracy.
English/Language Arts Curriculum Supervisor
Trenton Public Schools
Trenton, NJ
08.2012 - 06.2013
- Developed and implemented curriculum frameworks aligning with district educational goals.
- Collaborated with educators to enhance instructional strategies and learning outcomes.
- Analyzed student performance data to inform curriculum adjustments and improvements.
- Coordinated professional development workshops for faculty to support curriculum delivery.
- Oversaw curriculum review processes, ensuring compliance with state standards and regulations.
- Mentored new teachers on effective curriculum implementation and instructional practices.
- Worked with internal stakeholders to perform skill gap assessments and built training content to address gaps.
- Evaluated the effectiveness of instructional materials, making necessary adjustments to ensure optimal learning experiences for students.
- Partnered closely with administrators to develop long-term strategic plans focused on improving overall academic performance across schools in the district.
Educator
School District of Philadelphia
Philadelphia, PA
07.2000 - 08.2012
- Designed and implemented engaging lesson plans to enhance student learning experiences.
- Developed and maintained positive relationships with students, parents, and colleagues to foster a supportive environment.
- Assessed student performance through various evaluation methods, ensuring accurate tracking of progress.
- Led professional development workshops to improve teaching methodologies across the district.
- Engaged in continuous professional development to stay current with educational research and pedagogical strategies.
- Worked with staff members and teachers to design comprehensive and individualized plans to optimize student education.
- Analyzed data to identify trends in student achievement, driving strategic improvements in instructional approaches.
- Served on various school committees focused on improving policies or procedures related to academics, safety, or equity issues – driving positive change at an institutional level.
- Collaborated with colleagues to align curriculum and share best teaching practices, improving overall department effectiveness.
- Led professional development sessions for fellow teachers on topics such as technology integration or assessment design, contributing to a culture of ongoing improvement within the school community.
Education
Medical Billing/Coding - Medical Administration With Billing/Coding
Camden County College
Blackwood, NJ05-2016
Master of Science - Educational Leadership And Management
St. Joseph University
Havertown05-2009
Master of Science - English Language Arts Specialist
Widner University
Chester, PA08-1997
Bachelor of Science - Elementary Education
Temple University
Philadelphia, PA05-1994
Skills
- Revenue Cycle optimization strategies
- Experience in healthcare billing systems
- Proficient in resolving denials
- Healthcare revenue cycle professional
- Healthcare administration
- Annual MACR/MIPS compliance achievements
- MIPS program workflow enhancements
- Partner with medical staff to optimize operational workflows
- Management of provider credentials
- Collaborative strategic planning
- Employee development support
- Patient relations specialist
Accomplishments
- Achieved 99% by completing medical claims with accuracy and efficiency.
- Presented with the Trizetto 99 Club Award for spurring more than 99% growth for 84 consecutive months.
- Achieved 100% of successful MACRA/MIPS attestations for 84 consecutive months by completing MIPS compliance operations with ending scores of 90% and higher with accuracy and efficiency.
- Documented and resolved Medicare Audit which led to a Non-Recoupment of Medicare payments.
- Designed a company-wide safety awareness program, resulting in a 90% reduction in reported injuries.
- Documented and resolved all CLIA Audits which led to successful completion and implementation of CLIA certificate for in-office Mohs Laboratory.
Certification
- Medical Coding License - Active since 2016
- Medical Billing License - Active since 2016
- Healthcare Administration Certification, Active since 2016
- Certified Dermatology Technician, Advanced Dermatology PC - since 2018
Timeline
Project Manager/Revenue Cyle/Billing/Coding/Credentialing Specialist
English Bulldog Consulting
01.2025 - Current
Manager/Revenue Cycle/Medical Billing and Collections Specialist
Advanced Dermatology PC
01.2016 - Current
Project Manager/Billing/Coding and Reimbursement Specialist
Health Information Management (HIM)
01.2014 - 02.2017
English/Language Arts Curriculum Supervisor
Trenton Public Schools
08.2012 - 06.2013
Educator
School District of Philadelphia
07.2000 - 08.2012
Medical Billing/Coding - Medical Administration With Billing/Coding
Camden County College
Master of Science - Educational Leadership And Management
St. Joseph University
Master of Science - English Language Arts Specialist
Widner University
Bachelor of Science - Elementary Education
Temple University