Regina Little

Exercised sound judgment and discretion in interpreting public laws and policies for billing activities.

• Ensured seamless communication in electronic billing exchanges involving CPAC and payers
• Tracked and analyzed information on third party payer community care claim denials.
• Assessed CSA/MRW biller denials to gather procedural insights for coaching billing specialists.
• Conducted comprehensive weekly audits to assess employee performance
• Schedules error correction tasks, making sure they comply with policies and timelines.
• Analyzed review data to ensure accuracy within the Billing Life Cycle process
• Communicates modifications in database and payer contracts to billing staff.
• Assessed workflows to optimize operations and deliver improvements
• Identifies gaps in billing-related knowledge and communicates findings to leadership
• Develop corrective recommendations based on root cause analysis
• Controls evaluations of system error reports from various sources
• Maintained precise database files for system activity tracking and reporting purposes
• Resolved ECS transmission failures by thoroughly reviewing report data
• Maintained accurate electronic Payer ID entries in compliance with CBO directives
• Presented to diverse audiences including direct care teams, management, and top executives
• Facilitated Lean Yellow Belt Project, analyzing refund data for Fiscal Years 2015 and 2016
• Led Lean Black Belt Project to address Medicare denials, serving as Subject Matter Expert
• Identify and address billing training needs
• Conduct analysis of claims transmissions from CPAC to payers and illustrate findings through graphical representation
• Drafts diverse documents including correspondence, ad-hoc reports, and PowerPoint presentations
• Shared results of claim analysis with supervisory and executive levels across multiple sites
• Analyzed data trends and patterns to pinpoint areas for policy and procedure optimization
• Demonstrated expertise in VISTA and CPRS electronic medical record systems
• Evaluated error reports from automated systems and developed graphical feedback for improvement
• Ensured efficient distribution of responsibilities in alignment with employee expertise across 20+ staff
• Reported on expected completion times of tasks
• Ensured alignment with established priorities by tracking work status and implementing day-to-day changes
• Set deadlines for error correction within established policies
• Assess training needs for billing processes and report findings
• Executed corrective actions within established schedules
• Utilized extensive knowledge of laws, policies, and regulations in billing
• Displayed insight into the significance of connecting insurance data to different sections within the VA revenue cycle
• Conducted regular data reviews related to various healthcare service activities at medical centers serviced by CPAC
• Generated billing documentation for healthcare services, medications, and equipment
• Ensured claims were submitted accurately and timely in accordance with industry standards
• Utilizes cutting-edge industry and agency best practices for revenue cycle optimization
• Offer guidance to increase documentation accuracy, efficiency and effectiveness in workplace
• Managed technical and administrative operations pertaining to healthcare insurance claims
• Served as expert in billing matters and liaison within diverse teams such as Denials Taskforce, eBilling efforts, and CBO workforce enhancement
• Excelled at building relationships through strong interpersonal abilities
• Designed and presented educational audiovisual presentations using MS PowerPoint
• Produced grammatically correct and error-free reports
• Collaborated with team members, external clients and CPAC staff courteously
• Fostered positive interactions through respectful and professional communication practices
• Cultivated and sustained strong relationships across organization, industry representatives, Veterans, and public members

• Providing developed advisory services related to the full spectrum of workforce planning, staffing, and recruitment activities.
• Assisted in developing office-level policies concentrating on staffing and recruitment.
• Analyzed and evaluated issues to identify effective solutions for recruitment dilemmas.
• Engaged in strategic discussions with management to project workforce planning needs.
• Analyzed and resolved complex issues by applying adaptable guides.
• Facilitated resolution of issues concerning payroll.
• Entered position information into automated HR system.
• Delivered expert management advisory services in workforce planning, staffing, and recruitment activities.
• Directed personnel training initiatives and provided mentorship support to enhance team performance.
• Utilized database tools to gather information for reporting purposes.
• Handled inquiries regarding technical advisory services in HR.
• Ensure document preparation aligns with regulations and policies.
• Coordinated diverse tasks to adhere to tight schedules.
• Extended job offers after thorough analysis of candidate suitability.
• Crafted and finalized employee performance standards using ePerformance.
• Evaluated employee performance against established benchmarks and metrics.
• Estimate expected completion times and document work achievements.
• Kept staff updated on changes in policies and procedures.
• Performed employee performance evaluations.
• Managed staffing to achieve service objectives.
• Adjusts short-term objectives and timelines.
• Defined schedules for corrective actions within established frameworks.
• Maintained workflow efficiency by providing coverage during supervisor absences.
• Utilized web-based platforms to access crucial information and correspondence.
• Evaluating, rating, and ranking of applications conducted efficiently.
• Conducted job analysis for internal placement duties, ensuring effective promotion and placement product preparation.
• Oversees and drafts replies to correspondence involving All Employee Survey responses.
• Generated diverse written materials including detailed reports, memos, and strategic program proposals.
• Communicates detailed billing data to senior leadership teams and veteran organizations.
• Applied knowledge of healthcare revenue processes, including HIMS coding techniques, patient accounting systems, and billing protocols.
• Assessed staff development and training requirements.
• Delivered support utilizing phone calls, emails, and Teams platforms.
• Trained employees in specific tasks and job techniques.
• Assesses leadership tactics and processes for boosting organizational performance.
• Directed personnel in utilizing the correct strategies for troubleshooting.
• Delivered organized training sessions focused on team collaboration techniques.
• Formulates, enacts, and supports necessary strategies tied to VHA reimbursement compliance.
• Managed workload in VISTA, QuadraMed/Nuance and Microsoft Excel for 20+ billers.
• Demonstrated experience in applying the laws.
• Boosted collection productivity by deploying various strategies tailored to TPP activities.
• Reviewed data related to diverse healthcare service activities at CPAC-serviced medical centers.
• Streamlined operational efficiency within CPAC through active support and guidance.
• Manages administrative and technical health care accounts receivable programs for various insurance companies.
• Functioned as pivotal billing SME and POC across various groups such as Denials Taskforce, eBilling, and CBO workforce development.
• Conducts monthly, in-depth payer variance reviews.
• Assists in effectively preparing and presenting individual and/or group briefings to senior leadership.
• Recognized opportunities for improving policies, procedures, and practices through data-driven analysis.
• Proficient in the electronic medical record system, Veterans Health Information Systems and Technology Architecture (VISTA), and the Computerized Patient Record System (CPRS), HR Smart, Eperformance, VATAS, as well as proficiency in Microsoft Office, Teams, Excel, PowerPoint, and Outlook.
• Monitors work operations on a regular basis to increase the quality of work performed.
• Review and analyze employee work to perform weekly quality review audits.
• Analyzed reports for Billing Life Cycle Quality review.
• Design and present informative audiovisual presentations using MS PowerPoint; lecture, and lead discussion.
• Created reports ensuring clarity, grammatical accuracy and conciseness.
• Establish effective communication with payers, and develop sound revenue operations, innovations, and recommendations for their CPAC, leveraging key VISN and VAMC contacts.

• Assisted with training new staff members on reimbursement policies and procedures.
• Collaborated with other departments such as Accounts Payable, Billing and Collections or Claims Processing to resolve any conflicts quickly.
• Protected medical office operations and integrity by keeping patient information confidential.
• Identified potential billing errors or issues that may result in delayed payments or rejections by payers.
• Checked claims coding for accuracy with ICD-10 standards.
• Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
• Corrected, completed and processed claims for payer codes.
• Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
• Responded promptly to inquiries from internal and external customers regarding reimbursement processes.
• Performed insurance verification, pre-certification and pre-authorization.
• Entered patient charges and payments into electronic health records.
• Identified professional development opportunities and delivered comprehensive, standardized and hands-on training to new staff.
• Maintained updated knowledge through continuing education and advanced training.

• Company Overview: Central Plains Consolidated Patient Account Center, CPCPAC
• Central Plains Consolidated Patient Account Center, CPCPAC
• Processed medical claims according to established guidelines, including verifying authorization and coding requirements.
• Identified discrepancies and carrier issues regarding billing and reimbursements.
• Checked claims coding for accuracy with ICD-10 standards.
• Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
• Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
• Monitored changes in government regulations impacting medical reimbursements.
• Performed insurance verification, pre-certification and pre-authorization.
• Attended provider meetings and workshops when appropriate.
• Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
• Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
• Resolved discrepancies between provider bills and insurance companies' payment policies.
• Reviewed legal claims for accuracy and issues.
• Maintained detailed records of all claims processed, including tracking numbers, dates, amounts due.
• Contributed innovative ideas and solutions to enhance team performance and outcomes.
• Collaborated closely with team members to achieve project objectives and meet deadlines.