Loriann Pizarro
Websites
Summary
Revenue Cycle Manager | Account Manager |
Billing Manager Well-versed mobilizing revenue cycle, streamlining cash flow, and strengthening internal/external relations. An enthusiastic and purposeful professional who manages overall medical billing processes, coordinates follow-ups with accounts receivables, and facilitates insurance payments. Adept at restructuring customer processes by identifying potential issues and applying tried and tested strategies. Demonstrated success in building relationships with customers, key business executives, stakeholders, and cross-functional teams by anticipating clients' needs, providing best customer service experience, and ensuring seamless delivery of solutions in response to customer queries. Proven collaborator with a strong focus on empowering, supervising, training, and guiding cross-functional teams regarding claims processing, billing/reporting systems, and healthcare business procedures. Solid history of enforcing contract/accounting policy compliance, analyzing revenue cycles, handling A/R balances, and drafting reports in support of financial closing processes and contractual obligations.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Revenue Cycle Manager
- Well-versed mobilizing revenue cycle, streamlining cash flow, and strengthening internal/external relations.
Revenue Cycle Manager
Vita Health
01.2022 - Current
- Monitored and guided revenue cycle operations.
- Implemented process improvements, ensuring accurate charge capture and coding compliance.
- Provided staff training on revenue cycle management best practices, increasing productivity across the department.
- Completed financial reporting and analysis for billing revenue cycle.
- Managed cross-functional teams to improve overall revenue cycle operations.
- Streamlined workflows to minimize claim rejections and maximize reimbursement rates from insurance providers.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Negotiated contracts with third-party vendors for billing-related services, achieving cost savings without compromising quality.
Denials Management Manager
Foresight Mental Health
10.2021 - 11.2022
- Exceeded initial goal of recovering $1.2 million of revenue within first 3 months of hire.
- Managed and motivated employees to be productive and engaged in work.
- Accomplished multiple tasks within established timeframes.
- Maximized performance by monitoring daily activities and mentoring team members.
- Communicated clearly with employees, suppliers and stakeholders to keep everyone on same page and working toward established business goals.
- Monitored and guided revenue cycle operations.
- Implemented process improvements, ensuring accurate charge capture and coding compliance.
HIM Manager
MDLIVE
04.2021 - 05.2022
- Focus on achieving all set targets and deadlines by delivering active supervision to Coding Specialists in clerical and coding operations while prioritizing workload as per departmental goals and turnaround confinements.
- Facilitated successful cross-functional collaborations for the completion of key projects, fostering strong working relationships among team members.
- Reviewed billing problems, researched issues, and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Managed a team of dedicated medical billers, focusing on professional development opportunities and maintaining a positive work environment conducive to high levels of productivity.
- Enhanced revenue cycle management by overseeing timely and accurate claims submission.
- Collaborated with providers and staff to ensure accurate coding for billing purposes.
Coding & Compliance Specialist
MDLIVE
08.2020 - 04.2021
- Crosschecked compliance of all activities with organization's coding procedures and standards while documenting audit physician medical records, communicating relative changes, and initiating an auditing program.
- Implemented robust record-keeping systems that ensured accurate documentation was maintained according to regulatory requirements at all times.
- Served as a point of contact for employees seeking guidance on compliance matters, instilling confidence in the organization''s commitment to regulatory adherence.
- Evaluated existing policies regularly, identifying areas for improvement and recommending revisions as needed.
- Developed comprehensive training materials to enhance team members'' understanding of medical coding guidelines and industry best practices.
- Reduced claim denials through meticulous attention to detail and adherence to established regulatory compliance standards.
- Increased overall revenue by identifying under-coded services and working diligently to rectify such discrepancies in a timely manner.
- Collaborated with interdisciplinary teams to ensure accurate documentation and proper code assignment for various medical specialties.
- Championed the implementation of new medical coding software solutions, leading training sessions and providing ongoing support to ensure seamless integration within existing workflows.
Revenue Cycle Collections Analyst
MDLIVE
03.2019 - 08.2020
- Offering non-stop assistance to staff members in processing electronic claims, remittances, and funds transfer set up for major carriers while supporting the company's missions of integrity, quality, growth, stability, and people.
- Maximized recoveries by implementing effective collection strategies tailored to individual account circumstances.
- Reduced delinquency rates by consistently monitoring and analyzing customer accounts.
- Stayed up-to-date on industry trends and developments relating to credit control and collections methodologies, incorporating relevant knowledge into daily operations.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Liaised between patients, insurance companies, and billing office.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Delivered timely and accurate charge submissions.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Responded to customer concerns and questions on daily basis.
- Evaluated current coding practices and provided recommendations for improvements which led to increased efficiency.
- Audited and corrected billing and posting documents for accuracy.
Billing Manager
Sun Hyperbaric
12.2017 - 03.2019
- Verified patient insurance eligibility and benefits through insurance companies and EDI websites
- Utilized Athena software and CSA to update patient payments and generate statements accordingly.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Reviewed billing problems, researched issues, and resolved concerns.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Collaborated with cross-functional teams to resolve billing-related issues swiftly, minimizing negative impacts on overall operations.
- Implemented policies that improved accounts receivable collections, resulting in reduced outstanding balances and increased cash flow.
- Boosted team productivity through effective delegation of tasks, setting performance targets, and providing constructive feedback.
- Performed testing for billing modules, enhancing new functionality and process improvements.
- Worked with customers to develop payment plans and bring accounts current.
- Created a transparent work environment that fostered open communication between team members, promoting collaboration and problem-solving skills development.
- Enhanced client satisfaction levels by ensuring timely delivery of accurate invoices and addressing concerns professionally.
- Increased efficiency in billing processes by implementing new software and automating routine tasks.
- Developed a strong rapport with key stakeholders by maintaining open lines of communication and promptly addressing any concerns raised.
- Assisted sales team in developing pricing strategies based on a thorough understanding of billing guidelines and market conditions.
- Established and checked coding procedures, monitored reports and updated internal files.
- Performed banking, business administration and financial tasks to guarantee five-star service for clients.
- Created financial dashboards to provide insights into key performance indicators.
- Developed strategic plans for day-to-day financial operations.
- Collaborated with C-level executives and stakeholders to develop long-term financial plans.
Medicaid Analyst Case Manager
Medicaid Office UNO
09.2016 - 10.2016
- Mitigated issues and discrepancies in application management while processing applications and renewals
- Professionally inputted data into corresponding Medicaid Application Systems for eligibility decision and notices preparation while following Medicaid policies and procedures.
- Reduced clients'' wait time for services by streamlining referral process and partnering closely with external agencies.
- Conducted thorough assessments to identify client needs, developing appropriate interventions for optimal care.
- Facilitated connections between clients and community resources, promoting social integration and increased selfsufficiency.
- Enhanced quality of care for Medicaid Waiver clients through meticulous case management and documentation.
- Advocated for client rights, ensuring access to necessary services and supports within the community.
- Evaluated effectiveness of current intervention strategies, modifying as needed based on data-driven insights.
- Maintained open lines of communication with all stakeholders involved in client care, fostering a collaborative approach to problem solving.
- Ensured compliance with state and federal regulations by maintaining up-to-date knowledge on policy changes.
- Mentored new case managers, sharing best practices to ensure success in delivering high-quality care to Medicaid Waiver clients.
- Maintained detailed records of patient progress, documentation of services and case notes.
- Provided ongoing support to clients and families by addressing concerns, answering questions, and offering guidance throughout the waiver process.
Patient Account Representative Billing Manager
Hamilton Medical Group - Lofton Staffing
01.2016 - 08.2016
- Aligned payments billing with defined center's policies by determining required deposits and follows ups
- Informed family members of payment methods and center's services via extensive discussions and educational sessions.
Administrative Assistant
Coil Tubing Solutions - Lofton Staffing
11.2014 - 11.2015
- Implemented all top to bottom functions of calendar management for Managing Director, including appointments scheduling, complex travel arrangements, and meetings/conferences coordination.
Revenue Cycle Reimbursement Specialist
Sheridan Healthcare
03.2014 - 10.2014
- Studied potential trends by evaluating A/R reports and additional financial data on a consistent basis
- Proposed expert-level suggestions to fix billing processes and improve follow-ups of unpaid/underpaid accounts.
Process Associate | Billing Specialist
Apollo Healthcare/Sutherland Global
08.2011 - 03.2014
- Regularly answered 90+ calls while retrieving insurance information from patients and authorization from the insurance company
- Undertook duties of opening correspondence and mailing out requests for ambulance reports on no fault/workers comp cases in interaction with the legal department.
Education
Associate Degree in Science -
Broward College
12.2022
Skills
- Cash Flow Maximization
- Billing Systems Implementation
- Claim Entry & Payment Posting
- Policies & Procedures Implementation
- Regulatory Compliance Control
- Client Relationship Management
- Cross-Functional Collaborations
- Healthcare Management
- Training & Development
- Denial Management
- Stakeholder Engagements
- Documentation & Reporting
- MS Office Suite
- Smart Sheet
- Tableau
- Salesforce
- Denial Resolution
- Revenue performance
- Billing cycle expertise
- Team Building Leadership
- Proficiency in Athena, AdvanceMD, Kareo, DrChronos
Certification
- Licensed Medical Billing & Coding NCCT, NCICS-CPB
- Lean Six Sigma
Timeline
Revenue Cycle Manager
Vita Health
01.2022 - Current
Denials Management Manager
Foresight Mental Health
10.2021 - 11.2022
HIM Manager
MDLIVE
04.2021 - 05.2022
Coding & Compliance Specialist
MDLIVE
08.2020 - 04.2021
Revenue Cycle Collections Analyst
MDLIVE
03.2019 - 08.2020
Billing Manager
Sun Hyperbaric
12.2017 - 03.2019
Medicaid Analyst Case Manager
Medicaid Office UNO
09.2016 - 10.2016
Patient Account Representative Billing Manager
Hamilton Medical Group - Lofton Staffing
01.2016 - 08.2016
Administrative Assistant
Coil Tubing Solutions - Lofton Staffing
11.2014 - 11.2015
Revenue Cycle Reimbursement Specialist
Sheridan Healthcare
03.2014 - 10.2014
Process Associate | Billing Specialist
Apollo Healthcare/Sutherland Global
08.2011 - 03.2014
Revenue Cycle Manager
Associate Degree in Science -
Broward College