MIRIAN MICHEL
Santa Ana,CA
Summary
Experienced professional with strong leadership skills and the ability to coordinate people and resources effectively. Proven track record of successfully managing multiple tasks within tight deadlines and adaptable environments. Proficient in using MS Office, Excel, EPIC, Office Ally, Experian, OnBase, E-Clinical Works, ATHENA, and NextGen.
Overview
6
6
years of professional experience
Work History
Revenue Cycle Supervisor
Hoag Memorial Hospital Presbyterian
06.2023 - Current
- Monitored department KPIs and employee performance and adjusted plans to meet daily and monthly goals.
- SME (Subject Matter Expert) for Hoag Specialty Clinic, specifically for Gastroenterology, Vascular Surgery, Hepatobiliary, Neuropsychiatry, Neurosurgery, Neurology and Surgical Oncology
- Oversee Collections for Hoag Medical Group and Hoag Specialty Clinic
- Prepare monthly report out based on denials, charges, and payments for Hoag Medical Group and Hoag Specialty Clinic to the VP and CFO of Hoag Clinic
- Identify payer trends to address front-end resolvent or open incident tickets due to system issues.
- Performed root cause analysis to identify revenue cycle performance issues, implementing corrective actions to drive improvement.
- Project Manager for Municipal programs (NLF and LA City Fire) to ensure outstanding balances are collected from the insurance.
- Established strong relationships with clinic site leadership and other departments.
- Analyzed financial data for trends and opportunities, providing valuable insights for management decision-making.
- Customer Service inquiries and handled subpoena requests to fulfill billing records. SBO requests regarding patient billing requests, concerns, and patient escalations.
- Handled HIM WPR Cases (wrong patient registration) to ensure the correct patient insurance, demographics, and claims were billed.
- Managed accounts receivable aging, ensuring timely follow-up on outstanding balances and promptly resolving discrepancies.
- Conducted regular staff meetings to review performance metrics, address challenges, and foster an environment of continuous improvement within the team.
- Streamlined billing procedures to increase accuracy, reduce errors, and improve overall collections.
- Collaborated with cross-functional teams to develop and implement revenue cycle policies and procedures.
- Hired, managed, developed, and trained staff; established and monitored goals; conducted performance reviews; and administered salaries for staff.
Patient Billing & Collections Supervisor
University Of California, Irvine
12.2022 - 06.2023
- Supervise daily functions of surgery, radiation oncology, pediatrics collections unit
- Maintain staff calendar and payroll transactions for staff
- Maintain oversight and supervise all aspects of revenue cycle billing process beginning with charge capture
- Troubleshoot problems and issues of daily correspondence
- Reviewed patient diagnosis codes to verify accuracy and completeness
- Create, track, and maintain productivity logs for coding and collections team
- Keep abreast of third-party, government, commercial contracts, and billing/collections requirements
- Prevent financial delinquencies by working closely with managers to resolve billing issues
- Oversee overall workflow of billing department(s) and ensure timely task performance
- Meet monthly department goals for charges and accounts receivables
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
Billing Specialist Lead
Hoag Memorial Hospital Presbyterian
11.2021 - 11.2022
- Report payor trends that directly impact cash flow
- Assist the team with questions and training as needed
- Resolve claim edits and denials
- Communicate with leadership in overseeing workflows and processes
- Minimize re-work and address front-end process issues
- Oversee and reorganize various platforms of information during system transition
- Generate A/R reports, prioritize high dollar and close to timely filing accounts
- Address front end issues with registration and authorizations.
Medical Billing Specialist
Hoag Memorial Hospital Presbyterian
06.2020 - 11.2021
- Retrieve encounter data uploaded by provider sites
- Train new hires in current workflows
- Obtain additional patient demographic through EHR system
- Verify authorizations for consultations
- Run monthly/bi-weekly reports to consolidate charges
- Communicate with site staff for additional encounter questions
- Identify encounters that require coding
- Manually enter charges in the appropriate practice management system
- Identify appeals and submit within a timely filing.
Billing Representative
Pacific Medical Clinic
06.2019 - 06.2020
- Communicate effectively in written and verbal form to insurance companies and third parties for outstanding balances
- Identify billing errors on claims and resubmit them
- Post insurance payments, review and process denials
- Submit Request for authorizations
- Submit claims both electronically and by mail
- Verify patient eligibility and Health plan coverage
- Translate from English to Spanish between physician and patients.
Education
High School Diploma -
Lorin Griset Academy
Santa Ana, CACertificate of Completion - Medical Coding
Santa Ana College
Santa Ana, CA01.2022
Certificate of Completion - Medical Terminology I & II
Santa Ana College
Santa Ana, CA01.2022
Trade - Medical Billing & Coding
Taller San Jose Hope Builders
Santa Ana, CA06.2017
Skills
- Commercial and Government provider reimbursement
- Microsoft Office
- New Hire Training
- Handling complaints
- Billing Practices
- Denial resolution
- Data Analytics
- Medical Billing and Collections
- Goals and Performance
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Revenue Cycle Supervisor
Hoag Memorial Hospital Presbyterian
06.2023 - Current
Patient Billing & Collections Supervisor
University Of California, Irvine
12.2022 - 06.2023
Billing Specialist Lead
Hoag Memorial Hospital Presbyterian
11.2021 - 11.2022
Medical Billing Specialist
Hoag Memorial Hospital Presbyterian
06.2020 - 11.2021
Billing Representative
Pacific Medical Clinic
06.2019 - 06.2020
High School Diploma -
Lorin Griset Academy
Certificate of Completion - Medical Coding
Santa Ana College
Certificate of Completion - Medical Terminology I & II
Santa Ana College
Trade - Medical Billing & Coding
Taller San Jose Hope Builders
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