MICHELE RUTISHAUSER
Summary
Effective and driven healthcare manager with 12+ years of experience building positive rapport, inspiring trust and ability to guide teams toward achievement of organizational goals. Strong facilitator adept at working cross-departmentally with co-management and top-level leadership. Excellent trainer and mentor.
Overview
13
13
years of professional experience
Work History
Reconciliation Manager | (Team Lead)
Optum
12.2021 - Current
- Escalation and remediation management
- Leveraged and maintained strong relationships with internal and external stakeholders to ensure smooth communication during the reconciliation process.
- Evaluated existing controls within the reconciliation process, recommending enhancements where necessary to strengthen compliance efforts.
- Enhanced reconciliation accuracy by implementing automated processes and streamlining workflows.
- Prepared comprehensive reports on reconciliation activities for senior management review and decision-making process.
Revenue Cycle Manager
Acadia
03.2021 - 12.2021
- Monitoring of operational activity and process adjustments in work flow assignments
- 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.
- Monitored industry trends to anticipate changes that may impact organization's revenue cycle performance.
Medical Billing Specialist
Randstad - Acadia
11.2020 - 03.2021
- Medical Billing
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
Medical Practice Manager / Medical Business Manager
Advanced Primary Health Care, S.C.
11.2011 - 04.2019
- Oversaw daily operations of the medical practice such as staffing schedules, inventory management, office upkeep ensuring an organized work environment conducive to efficiency and patient satisfaction.
- Conducted regular staff meetings to facilitate open communication channels among team members leading to improved collaboration and problem solving.
- Managed budget for the medical practice, reducing overhead costs through careful resource allocation and vendor negotiation.
- Implemented quality improvement initiatives aimed at enhancing patient experience while adhering to industry best practices.
- Increased revenue generation by identifying opportunities for practice growth through expansion of services or acquisition of new patients.
- Developed and maintained electronic record management systems to analyze and process data.
- Supervised team of 8 office personnel.
Education
Associate of Applied Science - Business
Waubonsee Community College
Sugar Grove, ILSkills
- Team Leadership Qualities
- Decision-Making Competence
- Performance Metrics Monitoring
- Ability to multi-task
- Conflict resolution
- Analytical Problem Solving
- Process improvement strategies
- Training and Development Abilities
- Excellent verbal and written communication skills
- Relationship building and management
Accomplishments
- Implemented and shared updated OneNote template used for provider meetings - updating data necessary to meet information sharing with providers creating a cohesiveness between team mates and forward image presented to providers
- Collaborated with Finance team in creating tracking mechanism for provider payments
- Discovered fee schedule changes not implemented with Medicaid plans in multiple states equaling over $250k
Education And Systems
- AAS - Waubonsee Community College － Sugar Grove, IL
- Practice Fusion
- Waystar (Formerly Zirmed)
- Methasoft
Timeline
Reconciliation Manager | (Team Lead)
Optum
12.2021 - Current
Revenue Cycle Manager
Acadia
03.2021 - 12.2021
Medical Billing Specialist
Randstad - Acadia
11.2020 - 03.2021
Medical Practice Manager / Medical Business Manager
Advanced Primary Health Care, S.C.
11.2011 - 04.2019
Associate of Applied Science - Business
Waubonsee Community College