Summary
Overview
Work History
Education
Skills
Certification
Timeline
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Milagros Woodard

Anna,TX

Summary

Top-notch Vice President of Revenue Cycle Management with a proven track record of success leading and growing organizations. Strong background in strategic planning, financial management, RCM, credentialing, Payor enrollment, and team development. Skilled in identifying opportunities and implementing practical business strategies with a commitment to staying informed about the latest trends, technologies, and best practices.

Overview

26
26
years of professional experience
1
1
Certification

Work History

Vice President of Revenue Cycle Management

Telemedicine Company
06.2019 - Current
  • Responsible for the timeliness and accuracy of all healthcare billing, coding, auditing and Payer enrollment
  • Develop documented policies and procedures for the revenue cycle functions
  • Oversee all billing department functions, including accounts receivable, claim monitoring, compliant claim submissions, and write-off review
  • Ensure cash is posted correctly, insurance companies are accurately paying claims, and payors are correctly set up in the system
  • Responsible for collection of all outstanding claims
  • Ensure that outstanding accounts and accounts receivable are controlled, and that bad debt is within the target
  • Develop a system of aging and monitoring receivables, as well as follow-up processes and procedures
  • Evaluate accounts for write-off and identify improvement opportunities to reduce future write-offs
  • Established performance goals for the department and outlined processes for achievement.
  • Increased company growth through collaboration with sales and marketing departments.
  • Represented the organization at industry conferences and events.
  • Streamlined operations to maximize business efficiency and profits.
  • Developed and implemented new strategies and policies to establish long-term business objectives and provide strong and sustainable organizational leadership.
  • Identified opportunities to improve business process flows and productivity.
  • Compile monthly revenue cycle billing statistics
  • Develop and monitor adherence to appropriate departmental productivity metrics and report KPIs to management monthly
  • Implements and monitors appropriate internal controls as they relate to the revenue cycle function
  • Oversaw business-wide changes to modernize procedures and organization.
  • Oversee provider enrollment/contracting and negotiations
  • Oversee the gathering of any applicable billing data for claims selected for medical review
  • Responsible for oversight and overall development of the revenue cycle teams
  • Oversee the cash posting team, and develop measurable goals for the individual contributors and team as a whole
  • Manage members of the team, assign job duties, review timecards, conduct performance reviews, and implement disciplinary actions
  • Manage Provider Auditing and Education
  • Manage HIM Department and ensure compliance
  • Remain educated on regulatory changes in the health industry
  • Established and maintained strong relationships with customers, vendors, and strategic partners.
  • Manage EMR, AthenaHealth and others
  • Implemented advanced data analytics tools to drive data-driven decision-making across all levels of the organization, leading to better business outcomes.
  • Communicated business performance, forecasts, and strategies to investors and shareholders.

Practice Manager and Operations

C3 Spine
11.2016 - 06.2019
  • Assure clinic is open and appropriately staffed during regularly scheduled hours and that all facilities and equipment are available, operational, safe, and clean
  • Select, train, supervise, and monitor quality and production levels of site staff
  • Develop monthly staff schedule, review timecards, and provide input for payroll calculation
  • Assure staff is adequately trained and equipped to perform their jobs
  • Communicate and ensure compliance with company policies and procedures, address performance and disciplinary issues
  • Resolve and approve billing holds, financial refunds and accounting corrections originating at the site
  • Monitor supply inventories and order all supplies
  • Interact with customers, review customer feedback, and address customer service issues
  • Identify community marketing opportunities and engage staff in grassroots marketing
  • Inspect and maintain records on facilities and equipment
  • Coordinate facility and equipment maintenance and other vendor services
  • Perform front-end registration and/or clinical tasks as a back-up in case of absence or high demand
  • In Charge of all Marketing, including social media and websites, Sales, IT and day-to-day operations
  • Managed the office budget, reducing unnecessary expenses and allocating funds for necessary improvements.
  • Designed and introduced a leadership development, coaching, and team management model, resulting in the promotion of employees to increased levels of responsibility.
  • Managed the office budget, reducing unnecessary expenses and allocating funds for necessary improvements.
  • Developed and implemented strategies to improve patient access, satisfaction, and care quality.
  • I oversaw accounting, budgeting, and financial reporting.
  • Collaborated with marketing teams to develop promotional materials that effectively highlighted the practice''s unique offerings.
  • Reconcile Monthly financials with CPA, Software company and Office
  • Conduct regular staff meetings and annual performance evaluations for the administrative team
  • Work with physician to develop business strategies and patient services
  • Handle all marketing, sales and social media
  • Key Success: Reduce A/R within 6 months by 33% and increase revenue by 20%.

Continuous Improvement/Project Manager

Spectocor
01.2014 - 11.2016
  • In this Position, I was responsible for leading and facilitating the Company's Continuous Improvement effort and applying the appropriate Continuous Improvement tools to drive improvement in all departments, quality, problem solving and Value Analysis to drive out waste and improve productivity
  • I work closely with all department managers to identify ways to make things better, including the Company's bottom line
  • Defining framework for business improvement initiatives by Six Sigma DMAIC methodology (Define, Measure, Analyze, Improve and Control)
  • Facilitate cross functional assessments of projects to identify quick wins and eliminate process gaps
  • Monitor the overall functioning of processes, identifying improvement areas and implement adequate measures to maximize customer satisfaction level
  • Assist department managers with department goal-setting work-flows and tracking processes, work flows for CI measures
  • Lead and/or coordinate a wide variety of identified and approved six sigma initiatives and projects designed to improve throughput time, flexibility, quality and value
  • Facilitate the selection, scope, and planning of specific improvements projects
  • Assist with the development of training materials and effectively deliver those materials in a team environment to ensure employees are trained in CI concepts and philosophy
  • Serve as a change agent by communicating and institutionalizing Lean Six Sigma initiatives
  • Conduct regular project reviews with management team to assure accomplishment of key results
  • Monitor the effectiveness of services and make recommendations to improve
  • Managed Salesforce system.
  • Championed new lean strategies, frameworks, and project elements to drive multidisciplinary growth and process overhaul.
  • Lead cross-functional teams in the successful execution of complex projects, meeting or exceeding established goals.
  • Implemented lean production methods to reduce waste by 25%.

Billing Manager

Spectocor
10.2011 - 01.2014
  • Monitor facility data processing functions to ensure data integrity related to billing, payroll, corporate and state/federal reporting requirements
  • Orient and train staff
  • Ensure accuracy of ICD-9 & CPT 4 coding
  • Ensure that daily reports are collected and batched for billing and charge entry
  • Perform daily quality analysis of coding and billing, process improvement and implementation
  • Oversee staffing, performance management, recruitment and retention
  • Oversee daily operations of charge entry, billing & coding departments
  • Perform facility unbilled activities, including physician query follow up, physician incomplete record follows up, collaboration with facility department leaders
  • Perform monthly audits to identify billing & coding errors
  • Proactively manage including corresponding communications and escalation paths, significant issues in Coding operations (e.g., backlogs, turnover), status of projects, barriers and successes
  • In charge of all the Insurance Contracting for the company
  • Perform productivity and quality monitoring and provide timely and consistent feedback to coding/facility staff
  • Oversee work flow of billing department
  • Responsible for auditing physician records and providing quarterly analysis of clinical documentation
  • Responsible for abstracting clinical information from a variety of medical records and assigning appropriate ICD9 and CPT codes
  • Complete payroll processes and personnel reviews
  • Review daily encounter batch inputs for daily clearing and billing
  • Perform monthly audits to identify billing errors, short payments, overpayments, unpaid claims, productivity and staffing issues
  • Perform as a physician and facility liaison-communicating processing errors and educating providers on current billing trends
  • Interact with third party collections agencies to resolve patient accounts
  • Negotiate and settle outstanding accounts with insurance and patients
  • Coordinate implementation of ICD10 CM through teaching and presentations
  • Review final adjustment requests
  • Run month end billing reports and coordinate analysis for clients
  • Review denied claims for accuracy and presentation of coded data for reimbursement
  • Develop coding policies and written procedures to ensure smooth work flow
  • Conduct quality assurance activities, report results to management, provide feedback and training to coders
  • Resolve escalating payer issues.

Last Title Held - Project Manager

United Healthcare
02.1998 - 10.2011
  • Project managed cross-functional teams and established program level work plan with visibility and cross project issues resolution for each phase of an implementation
  • FTE, 90 reports
  • Acted in a highly consultative manner working closely with the customer, internal product experts, and operations functional teams to ensure that the expectations were translated into detail requirements
  • Drove teams to arrive at a solution that meets customer specifications and can be delivered in the time frame required
  • Direct and coordinate activities of project personnel to ensure implementation progress on schedule and satisfy customer specifications
  • Prepare detailed and accurate implementation status reports and work aggressively to resolve gaps and issues and keep the Implementation on track
  • Prepare documentation related to project scope and requirements; obtain and maintain all required project setup data
  • Prepare user acceptance test plans, execute and document user acceptance testing conditions and scripts, manage development and execution of training, and document and implement new systems
  • Provided strong leadership and judgement
  • Facilitated senior management decision making within the scope and change management process
  • In charge of writing all SOP's, P&P's and Training manuals
  • Also worked in several departments in UHC including Customer service, Processing Claims, Adjusting Claims, Audit review, High Dollar Inpatient Claims payment, High Dollar Outpatient Claims payment, Provider enrollments, Tracer department, Medical Review, Training, Transplant Unit, United Behavior Health, VA, Subject Matter Expert, managed 30 Claims processors for 4 years, Lean Six sigma team and writing policies and procedures for the company.
  • Facilitated change management processes within organizations by effectively communicating benefits of new systems or processes being introduced during projects.
  • Managed risk assessments and implemented mitigation strategies to minimize potential issues during project execution.

Education

CDEO, CPB, CPC, CPCO, CRC, CPC-I - Healthcare Coding/Auditing/Education

AAPC
Online

CPMA in Medical Auditing -

NAMAS

Six Sigma Black Belt -

Six Sigma Online

Skills

  • Billing/Coding/Auditing
  • Payor Contracting/Enrollment
  • Licensing and privileging
  • Revenue Generation
  • Revenue Cycle Management
  • Acquisitions
  • Working with Private Equity companies
  • Results-Driven
  • Analytical and Critical Thinker
  • Leadership and People Development
  • Contract Negotiation
  • Change Management
  • Client Relations

Certification

  • Several AAPC Certifications
  • PMP
  • Six Sigma Black Belt


Timeline

Vice President of Revenue Cycle Management

Telemedicine Company
06.2019 - Current

Practice Manager and Operations

C3 Spine
11.2016 - 06.2019

Continuous Improvement/Project Manager

Spectocor
01.2014 - 11.2016

Billing Manager

Spectocor
10.2011 - 01.2014

Last Title Held - Project Manager

United Healthcare
02.1998 - 10.2011

CDEO, CPB, CPC, CPCO, CRC, CPC-I - Healthcare Coding/Auditing/Education

AAPC

CPMA in Medical Auditing -

NAMAS

Six Sigma Black Belt -

Six Sigma Online

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Milagros Woodard