MARIA CASTILLO
Union,NJ
Summary
Director of Revenue Cycle Management with 32+ years of experience leading end-to-end revenue cycle operations across hospitals, physician groups, mobile health, imaging, and ambulatory services. Expertise includes revenue capture, multi-specialty fee schedules, payer enrollment and credentialing, EDI, coding, claims management, AR, denials, compliance, reporting, EMR/SaaS systems, and team leadership. Proven track record of improving collections, reducing DSO, optimizing workflows, and scaling revenue cycle operations.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Senior Director of Revenue Cycle Management Consultant
Life Mobile Care
Livingston, NJ
01.2025 - Current
- Built and optimized full RCM infrastructure for outpatient and ambulatory services, including charge capture, coding workflows, claims processing, payment posting, denials management, AR follow-up, reconciliation, and reporting.
- Developed and implemented multi-specialty fee schedules, ensuring accurate pricing and reimbursement across imaging, diagnostics, lab, and ambulatory services.
- Oversaw payer enrollment and credentialing for new providers and service lines; achieved 100% timely payer enrollment and reduced credentialing turnaround by 30%.
- Managed EDI functions, including electronic claim submission (837), payment posting (835), eligibility verification (270/271), and remittance advice processes; improved first-pass claim acceptance by 15%.
- Implemented charge capture workflows to ensure accurate and timely documentation from clinical, imaging, and mobile medical teams.
- Developed standardized coding guidelines, ensuring proper use of ICD-10, CPT, HCPCS codes, and payer-specific modifiers; reduced coding errors by 12%.
- Established clean-claim workflows and scrubbing rules, reducing claim denials by 10% and improving cash collections.
- Managed revenue integrity processes, including audit checks, coding validation, encounter reconciliation, and missing charge reports.
- Implemented weekly AR strategies, identifying aging trends and high-risk accounts; reduced DSO by 18 days.
- Strengthened denial management through root-cause analysis, appeals, staff training, and payer escalation pathways.
- Led payment posting and reconciliation operations ensuring accuracy between bank deposits, EMR, QuickBooks, and clearinghouses.
- Created credit balance and refund resolution processes, reducing overpayments by 25%.
- Established compliance workflows aligned with CMS, Medicare, Medicaid, commercial payer guidelines, and HIPAA regulations.
- Implemented eligibility verification standards and real-time eligibility tools, reducing front-end rejections by 20%.
- Built structured communication channels between clinical, scheduling, imaging, intake, and billing teams to improve revenue capture and reduce documentation gaps.
- Oversaw implementation and optimization of AthenaOne EMR, FlexScan, clearinghouse configurations, payer mappings, and RCM system rules.
- Implemented KPI dashboards covering collections, DSO, first-pass resolution, denial rates, charge lag, and cash posting timeliness.
- Developed SOPs for each stage of the revenue cycle (charge capture, coding, billing, AR, denials, EDI, reporting, compliance).
- Led performance evaluation, employee mentoring, new-hire onboarding, and quarterly training, improving staff productivity by 20%.
- Supported rapid business growth, including opening two new outpatient-focused business units (Life Medical Group, PC & Life Mobile Imaging, Inc.).
- Ensured audit readiness through internal controls, documentation checks, and revenue integrity audits.
- Managed HR functions including talent acquisition, performance plans, payroll setup, and policy development using Paycom.
- Key Outcomes: Increased collections by 15% year-over-year; Reduced claim denials by 10%; Improved DSO by 18 days; Reduced credentialing turnaround by 30%; Improved staff productivity by 20%; Enhanced first-pass claim acceptance by 15%.
Assistant Director of Patient Accounts
University Hospital
Newark, NJ
09.2023 - 01.2025
- Directed Patient Accounts Department including charge posting, Inpatient & Outpatient billing, correspondence, follow-up, customer service, cash posting, and bad debt for hospital and Newark Ambulance receivables.
- Promoted development of work standards; monitored quality and quantity of work processed.
- Developed and implemented policies for charge posting, billing, credentialing, reconciliation, EDI, EFT, ERA, refunds, PLB offsets, and bad debt write-offs.
- Developed, monitored, and distributed late charge reports.
- Identified payer issues and worked with financial management to resolve revenue cycle issues.
- Performed monthly AR and cash collection analyses; implemented changes to maintain strong cash flow.
- Ensured billing systems accurately forwarded data to Epic Resolute for hospital and physician billing.
- Reviewed audit reports and implemented policy/procedure changes as required.
- Managed procurement for departmental vendor and payer contracts; initiated RFPs and responded to inquiries.
- Monitored key performance metrics for vendors and payers; participated in Revenue Cycle Committee.
- Conducted staff performance reviews, recruitment, and disciplinary actions.
- Ensured departmental policies, job descriptions, and appraisals were current.
- Developed and conducted staff training sessions; enforced policies equitably.
- Participated in annual budget preparation and monitoring; identified operational efficiency opportunities.
- Ensured compliance with all regulatory guidelines, including patient privacy and confidentiality.
- Revenue Cycle Systems: EPIC, Waystar, HealthQuest, Gaffey.
- Managed 64 employees.
Director of Central Billing Office (Consultant/Project)
Hunterdon Healthcare Group
Flemington, NJ
10.2022 - 09.2023
- Directed all revenue cycle functions and overall operations of the Central Billing Office.
- Monitored billing functions for Central Billing Office Staff and Physician Practices in compliance with guidelines.
- Led a team of billing managers, supervisors, credentialing staff, trainers, and support staff.
- Managed day-to-day operations, ensuring timely and effective execution of policies.
- Collaborated with COO, CFO, Regional Directors, Practice Managers, and Physicians to review monthly goals and outcomes.
- Promoted outstanding customer service and ensured productivity and quality targets were met.
- Directed accounts receivable management staff for AR follow-up, claims/billing, and cash collections.
- Managed inpatient, outpatient, ambulatory, anesthesia, physician, credentialing, and client billing revenue by utilizing systems (Affinity, NextGen, Waystar, EPIC).
- Directed processes for billing submission, denials handling, and AR follow-up.
- Evaluated registration and insurance verification data integrity.
- Negotiated managed care contracts and monitored agreement compliance.
- Led project restructuring of CBO and improved revenue cycle management; current cash $96M & goal $120M by 2024.
- Managed 67 employees, including managers, supervisors, and staff.
Director of Revenue Cycle
DOCGO-Ambulnz, Inc.
New York, NY
06.2020 - 10.2022
- Directed Mobile Health Billing Department; ensured compliance with coding and billing rules.
- Monitored legislation and regulatory changes affecting billing and collections across multiple states.
- Identified, analyzed, and implemented solutions to improve collections, reduce bad debt, and lower DSO.
- Reported to CFO on revenue, bank deposits, AR/AP, and insurance fee negotiations.
- Designed, monitored, and assessed key RCM metrics, including DSO, DDO, KPI, bad debt, and risk levels.
- Led large revenue cycle projects, including audits, P&L, budgets, and technology enhancements.
- Managed RCM functions including verification, documentation, billing, QA, AR, and denial management.
- Billed for 15 states and jurisdictions, including outpatient, mobile services, and ambulance services, managing complex multi-state regulatory and payer requirements.
- Implemented multi-state compliance and payer rules, reducing cross-jurisdiction denials by 12%.
- Streamlined billing and claims submission processes, resulting in first-pass claim acceptance of 92% across all states.
- Developed weekly AR tracking and follow-up, reducing DSO by 22 days and improving cash collections by 14%.
- Achievements: Built and structured a new billing department within 3 months; billed $447M and collected $400M (2021–2022).
Senior Operations – Billing Manager
ON TIME BILLING SERVICES
Roselle, NJ
06.2019 - 06.2020
- Managed a team of 15 employees; implemented process and technology training.
- Maintained proficiency, efficiency, and compliance with Medicare/Medicaid, Commercial, PIP, and Workers Compensation insurance.
- Oversaw ambulance/transport billing, collections, and client accounts.
- Ensured accurate, timely billing and paperwork completion.
- Evaluated and resolved billing system issues.
- Reviewed compliance, credentialing, payment options, and revenue cycle methodologies.
- Collaborated with business development and marketing for new leads and existing account challenges.
- Conducted regular staff counseling, performance reviews, and disciplinary actions.
Manager/Director of Revenue Cycle Management
BIO-REFERENCE LABORATORY
Elmwood Park, NJ
01.2017 - 05.2019
- Managed a team of 35 employees; implemented process and technology training.
- Ensured data accuracy and divisional financial performance, including revenue enhancements.
- Provided instruction, leadership, and supervision for cash application, AR claims, denial appeals, refunds, and provider-level balance adjustments.
- Experience with EMR project management, payer/provider credentialing, and operations in medical centers or hospitals.
- Achievements: Managed $30M un-posted cash, $50M AR, $10M EDI rejections, 6-month backlog of partial/full medical denials; implemented Chase-JP Morgan EFT/ERA credentialing.
Medical Office Manager
NJ RETINA ASSOCIATES
Union, NJ
10.2015 - 12.2016
- Managed a team of 20+ employees; evaluated and organized office operations.
- Oversaw staffing, time off, training, and new employee onboarding.
- Monitored patient demographics, government/commercial plans, charity care, OON billing, AP, EMR, and Athena systems.
- Maintained provider licenses and revalidated credentials; managed credentialing applications for payers and hospitals.
- Collaborated with Revenue Cycle Director and billing staff to resolve denials.
- Maintained provider profiles on CAQH, PECOS, NPPES, Availity, and CMS databases.
- Ensured compliance with HIPAA, OSHA, and federal/state regulations.
Supervisor, Revenue Cycle/Collections/Bill Review
OCM MANAGEMENT, INC.
Parsippany, NJ
02.2008 - 09.2015
- Managed a team of 20+ employees in a call center environment.
- Utilized ICD-9/ICD-10, DRG, DNFB for correcting medical billing codes via EDI/EFT/ERA.
- Processed collections, AR, AP, and reconciled accounts.
- Reviewed clinical reports and generated monthly aging reports.
- Managed third-party billing for 43 states across orthopedics, dental, radiology, and multi-specialty services, handling Workers Compensation, auto, and commercial insurance claims.
- Specialized in bill review, denials management, PPO discount appeals, and retroactive billing, achieving a 90%+ success rate on appeals and recovering over $2.4M annually in underpaid claims.
- Implemented process improvements in claims review, retro billing, and appeal workflows, reducing denial turnaround time by 25% and improving AR recovery efficiency.
- Oversaw PIP, workers compensation, group health, dental, DMEs, home care, PT, radiology, provider credentialing, and EMG/NCS coverage.
- Negotiated fees and OON/retro accounts; recouped $203K/month in 90+ day overdue balances.
- Utilized custom-built Ross and Phoenix billing systems for financial management, scheduling, and billing operations, optimizing workflow, reporting, and claim accuracy.
Supervisor of Accounts Receivable
NEW JERSEY SPINE CENTER
Chatham, NJ
10.2002 - 02.2008
- Managed a team of 15 employees; collected Medicare, Medicaid, workers’ compensation, auto, commercial, and self-pay claims.
- Performed EFT/manual claim submissions, posted payments, reconciled accounts, and resolved appeals/denials.
- Analyzed reimbursement histories, delinquent accounts, and payment plans.
- Verified patient demographics and insurance; drafted appeals correspondence.
- Assisted front desk and oversaw inventory control for the claims department.
Education
Some College (No Degree) -
Hostos Community College
Bronx, NYSkills
- Revenue Cycle Management
- Medical Billing
- Invoice Billing
- Claims Resolution
- Payer Enrollment
- Credentialing
- EDI
- Multi-specialty Pricing
- CRM
- DRG Management
- UCR Management
- Fee Schedule Management
- AR Management
- Collections
- Reconciliation
- Denials Management
- Refunds
- Bad Debt Management
- Appeals Management
- ICD-10
- CPT
- HCPCS
- Modifiers
- Compliance
- HIPAA
- Medicare
- Medicaid
- Commercial Compliance
- EMR Systems
- RCM Systems
- KPI Dashboards
- Reporting
- Project Management
- Process Improvement
- Employee Leadership
- Training
- Performance Management
Certification
- NAAC–CAC Certified Coder, National Association Ambulance Coder
- Computer Programming – Little Shepherds Community Services
- Medical Record Analyst Internship – Segundo Ruiz Belez
- Software: Microsoft Office, Excel, PowerPoint, Athena, ECW, NextGen, Affinity, Oracle/NetSuite, EPIC, Waystar, QuickBooks, Workday
Timeline
Senior Director of Revenue Cycle Management Consultant
Life Mobile Care
01.2025 - Current
Assistant Director of Patient Accounts
University Hospital
09.2023 - 01.2025
Director of Central Billing Office (Consultant/Project)
Hunterdon Healthcare Group
10.2022 - 09.2023
Director of Revenue Cycle
DOCGO-Ambulnz, Inc.
06.2020 - 10.2022
Senior Operations – Billing Manager
ON TIME BILLING SERVICES
06.2019 - 06.2020
Manager/Director of Revenue Cycle Management
BIO-REFERENCE LABORATORY
01.2017 - 05.2019
Medical Office Manager
NJ RETINA ASSOCIATES
10.2015 - 12.2016
Supervisor, Revenue Cycle/Collections/Bill Review
OCM MANAGEMENT, INC.
02.2008 - 09.2015
Supervisor of Accounts Receivable
NEW JERSEY SPINE CENTER
10.2002 - 02.2008
Some College (No Degree) -
Hostos Community College