Ramona Rodriguez
Burlington,CO
Summary
Talented Revenue Cycle Supervisor oversees and optimizes billing and coding management. Knowledgeable about full revenue cycle process, including accounts receivables, payment posting and customer relations. Astute accounting professional with eye for detail.
Overview
11
11
years of professional experience
Work History
Revenue Cycle Supervisor
Kit Carson County Health Service District
01.2023 - Current
- Conducted regular staff meetings to review performance metrics, address challenges, and foster an environment of continuous improvement within the team.
- Reduced accounts receivable days outstanding by streamlining collection efforts and collaborating closely with customers for prompt payments.
- Monitored department KPIs and employee performance and adjusted plans to meet daily and monthly goals.
- Managed accounts receivable aging, ensuring timely follow-up on outstanding balances and prompt resolution of discrepancies.
- Conducted audits of registrations, insurance verifications, and insurance denials.
- Collaborated with cross-functional teams to develop and implement revenue cycle policies and procedures.
- Performed root cause analysis to identify issues affecting revenue cycle performance, implementing corrective actions to drive improvement.
- Oversaw patient registration processes, ensuring accurate demographic information was collected to facilitate smooth billing operations.
- Analyzed financial data for trends and opportunities, providing valuable insights for management decisionmaking.
- Improved overall cash flow by identifying underperforming areas within the billing process, addressing issues proactively.
- Provided exceptional customer service by addressing billing questions and concerns in a timely, professional manner.
- Streamlined billing procedures for increased accuracy, reducing errors and improving overall collections.
- Enhanced revenue cycle efficiency by implementing strategic process improvements and workflow optimizations.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch.
- Charge master item entry.
HIM Manager
Kit Carson County Health Service District
12.2016 - Current
- Redesigned internal coding process and procedures to improve coding timeliness to 3 business days following documentation completion and maintain total outstanding charts below 3 revenue days.
- Manage the charge master including update of existing charges, identification of missing charges, and addition of new/updated charges.
- Co-lead facility archives purge project and development of organizational document retention and destruction program compliant with current CMS and state archives regulations.
- Designed and implemented clinical department query forms and process to ensure accurate, timely, and complete documentation and records practices.
- Assisted Director of Revenue Cycle with full review and revision of department policies to ensure compliance with current CMS and state regulations and industry best practices.
- Developed department productivity dashboard for continual monitoring of department productivity and statistics and for monthly reporting to Executive Leadership.
- Independently completed chart audits to identify missing/insufficient documentation, missing charges, and coding deficiencies and developed recommendations for Executive Leadership based on findings.
- Responsible for oversight of organization records release program including ensuring and tracking compliant release of patient records.
- Served as medical records subject matter expert on Meaningful Use, Medical Staff, and Utilization Review.
- Manage successful EHR transition in 06/2019.
Business Office Manager (Dual Role)
Kit Carson County Health Service District
12.2018 - 09.2020
- Redesign billing/follow up process to ensure timely billing work.
- Maximized cash flow through optimal billing and collection processes.
- Work with department leaders on monthly denial management.
- Complete the quarterly Medicare credit balance reporting.
- Redesign admissions workflow and procedures to allow for a more timely and efficient process.
- Restructure receipting processes to ensure accuracy.
- Complete all payment posting for insurance and self pay payments.
- Work credit balances for all payers and self-pay credits.
- Improved customer service satisfaction in patient billing through insourcing patient self pay process from external vendor.
- Manage successful EHR Transition in 06/2019.
Home Health/Hospice Administrative Assistant
Caring Hands Hospice/Kit Carson County Health Service District
06.2016 - 12.2016
- Responsible for all billing and coding functions and chart maintenance for both home health and hospice agencies.
- Created and evaluated monthly financial reports for presentation to the Accounting/Finance department.
- Assisted agency Administrator with data mining, reporting, and data aggregation.
- Independently created and presented monthly quality and productivity reports for the Board of Directors.
- Evaluated patient charts for completion and documentation appropriateness and made recommendations to clinicians on improvement of content for record compliance.
Medicaid Biller
Kit Carson County Health Service District
02.2015 - 06.2016
- Responsible for timely and compliant billing of all facility Medicaid claims including inpatient, outpatient, and swing bed services.
- Assisted in the development and completion of department electronic billing practices
- Completed daily payment posting and balanced payments received to deposits for pre-reconciliation on behalf of Accounting/Finance department.
- Completed claims review of all outgoing Medicaid claims to identify and correct internal errors likely to lead to payment delay or denial and made recommendations for process improvement to Department Head based on findings.
- Tracked and researched unpaid claims and completed insurance follow-up on outstanding claims aged over 21 days to ensure timely cash collections on government pay-source claims.
- Developed internal training manual outlining processes for completing billing functions, reviewing claims, and identifying common claim errors including how to correct them.
Medical Coder
Kit Carson County Health Service District
02.2013 - 02.2015
- Completed facility CPT and diagnosis coding for emergency, specialty services, outpatient services, inpatient services, surgery, and swing bed charts.
- Completed requests for release of information from patients, legal offices, and external health providers in compliance with HIPAA regulations and facility policy.
- Responsible for chart maintenance including review of orders, evaluation of signature requirements, assessment of documentation, and scanning/indexing of chart documents.
Education
Associate of Applied Science - Health Information Management
Arapahoe Community College
Littleton, CO05.2020
Skills
- Denial Resolution
- Staff Training
- Administrative Management
- Workflow Planning
- HIPAA knowledge
- Collections experience
- Patient Registration
- Patient account management
- Insurance Verification
- Healthcare compliance
- Billing management
- Data Analytics
- Claims Management
- Payment posting
- Revenue performance
- Billing cycle expertise
- Account resolutions
- Procedure optimization
- Team Leadership
- Decision-Making
- Customer Service Management
- Documentation and Recordkeeping
Otherhospitalinvolvement
- Chair of Employee Engagement Committee/Employee Recognition Committee, 08/2021, 12/2022, Kit Carson County Health Service District, This committee is responsible for all projects related to holiday events, community events and employee engagement and recognition.
- Serve on the Compliance Committee (CC), 10/2022, Current, Kit Carson County Health Service District, The CC is responsible for all matters related to compliance as we aid the designated compliance officer in all activities related to policy review, compliance investigations and all things compliance.
- Serve as the HIPAA Privacy Officer, 12/2016, Current, Kit Carson County Health Service District, I am Chair of the HIPAA Compliance Committee. This committee completes all HIPAA violation complaint investigations and provides HIPAA education to all staff.
Certificationsandassociations
- RHIT- Registered Health Information Technician
- GCU-Bachelors of Science in Health Information Management with estimated graduation year of 2026. (Will test for my Registered Health Information Administrator (RHIA) upon completion of my bachelors).
Timeline
Revenue Cycle Supervisor
Kit Carson County Health Service District
01.2023 - Current
Business Office Manager (Dual Role)
Kit Carson County Health Service District
12.2018 - 09.2020
HIM Manager
Kit Carson County Health Service District
12.2016 - Current
Home Health/Hospice Administrative Assistant
Caring Hands Hospice/Kit Carson County Health Service District
06.2016 - 12.2016
Medicaid Biller
Kit Carson County Health Service District
02.2015 - 06.2016
Medical Coder
Kit Carson County Health Service District
02.2013 - 02.2015
Associate of Applied Science - Health Information Management
Arapahoe Community College
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