Regina Little
Leavenworth,KS
Summary
Highly accomplished and results-driven Medical Billing and Coding Professional with 14 years of experience in managing and optimizing billing operations, ensuring regulatory compliance, and driving organizational process improvements. Highly skilled in analyzing billing data, identifying trends, and implementing effective solutions to enhance revenue generation and reduce denials.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Financial Administrative Specialist
Veterans Health Administration
10.2024 - Current
- 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
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- 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.
- Trained new employees on medical billing software, policies, and procedures, ensuring accuracy in claims submission from day one.
- Conducted comprehensive weekly audits to assess employee performance
- Analyzed review data to ensure accuracy within the Billing Life Cycle process
- Communicates modifications in database and payer contracts to billing staff.
- 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.
- 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
- 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.
- Designed and presented educational audiovisual presentations using MS PowerPoint
- Produced grammatically correct and error-free reports
- Excelled at building relationships through strong interpersonal abilities.
- Fostered positive interactions through respectful and professional communication practices
- Cultivated and sustained strong relationships across organization, industry representatives, Veterans, and public members
Supervisory Financial Administrative Specialist
Veterans Health Administration
08.2017 - 10.2024
- Analyzed and evaluated issues to identify effective solutions for recruitment dilemmas.
- Engaged in strategic discussions with management to project workforce planning needs.
- Facilitated resolution of issues concerning payroll.
- Entered position information into automated HR system.
- 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.
- 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.
- Adjusts short-term objectives and timelines.
- Defined schedules for corrective actions within established frameworks.
- 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.
- Delivered support utilizing phone calls, emails, and Teams platforms.
- 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 for 20+ employees.
- 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 VHA medical centers.
- 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.
- 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.
Financial Administrative Specialist
Veterans Health Administration
01.2016 - 08.2017
- 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
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- 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.
- Trained new employees on medical billing software, policies, and procedures, ensuring accuracy in claims submission from day one.
- Conducted comprehensive weekly audits to assess employee performance
- Analyzed review data to ensure accuracy within the Billing Life Cycle process
- Communicates modifications in database and payer contracts to billing staff.
- 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.
- 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
- 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.
- Designed and presented educational audiovisual presentations using MS PowerPoint
- Produced grammatically correct and error-free reports
- Excelled at building relationships through strong interpersonal abilities.
- Fostered positive interactions through respectful and professional communication practices
- Cultivated and sustained strong relationships across organization, industry representatives, Veterans, and public members
Lead Medical Reimbursement Technician
Veterans Health Administration
08.2014 - 01.2016
- Enthusiastically assisted in training new staff members on reimbursement policies and procedures..
- Maintained knowledge through continuing education and advanced training.
- Collaborated with medical coders to ensure accurate diagnostic codes were applied to claims, minimizing rejections due to coding errors.
- Trained 100% of new team members on medical reimbursement processes, fostering a knowledgeable and competent workforce.
- 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.
Medical Reimbursement Technician
Veterans Health Administration
08.2011 - 08.2014
- 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.
Education
Certificate of Technical Studies - Health Information Management
Pinnacle Career Institute
Kansas City, MO05-2009
Skills
Billing Management
Report Development
Skilled in Various Software
Facilitate Training Applications
Performance Metrics Tracking
Presentation Design
Billing and coding
Employee communications
Staff training and development
Complex Problem-solving
Cross-functional teamwork
DMEPOS specialized knowledge
Certification
- Certified Coding Specialist, NAHP
- Medical Billing and Coding Program - May 2009
Timeline
Financial Administrative Specialist
Veterans Health Administration
10.2024 - Current
Supervisory Financial Administrative Specialist
Veterans Health Administration
08.2017 - 10.2024
Financial Administrative Specialist
Veterans Health Administration
01.2016 - 08.2017
Lead Medical Reimbursement Technician
Veterans Health Administration
08.2014 - 01.2016
Medical Reimbursement Technician
Veterans Health Administration
08.2011 - 08.2014
Certificate of Technical Studies - Health Information Management
Pinnacle Career Institute
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