Renee Coleman
GA
Summary
Focused on optimizing accounting, payment collection and administrative functions for high-volume operations at multiple organizations. Well-organized and thorough leader with a disciplined approach to solving problems and enhancing long-term business operations. Efficient Revenue Cycle Manager adept at implementing procedural improvements and executing revenue metrics analysis to dive corporate financial objectives. Eager to apply 20+ years of account management to increase revenue and add value to the Revenue Cycle team. Seasoned Financial Management professional with proven expertise in accounting processes, systems oversight and compliance reporting. Knowledgeable about AP/AR, contract administration, budgeting and all other aspects of successful financial operations. Talented team builder and supervisor with expertise to develop and maintain consistent, accurate and legal accounting structures.
Proven track record in Revenue Cycle billing for: Hospital-PPS and Critical Access, Physician Billing in all Specialties, Ambulance to include Air, LTAC, Nursing Home, SNF Billing.
Extensive Knowledge in Provider Credentialing with CAQH, Availity, PECOS and all state Medicaid programs.
Contract Management
Overview
27
27
years of professional experience
1
1
Certification
Work History
Revenue Cycle Director
Revelations Consulting
, GA
10.2022 - 02.2024
- Developed and implemented departmental policies and procedures to ensure accuracy of revenue cycle operations.
- Conducted financial analyses, such as pricing models and profitability studies, to identify areas for improvement in the revenue cycle process.
- Provided guidance and direction to staff on billing and collections processes, insurance regulations, and coding practices.
- Managed a team of billing specialists responsible for processing claims accurately and efficiently.
- Monitored accounts receivable balances to ensure timely payment from third-party payers.
- Collaborated with hospital departments to improve patient satisfaction scores related to the revenue cycle process.
- Created reports summarizing trends in reimbursement denials, appeals, cash flow, and other metrics related to the revenue cycle.
- Resolved complex issues with insurers regarding payment discrepancies or rejections of claims.
- Analyzed historical data to develop strategies for improving efficiency in the revenue cycle process.
- Implemented new software systems designed to streamline billing operations.
- Developed training programs for employees involved in the revenue cycle process.
- Oversaw all activities related to patient registration, pre-certification, authorization, charge capture, coding compliance auditing, claim submission, follow-up, denial management, accounts receivable collection follow-up, customer service inquiries, issues resolution, cash posting, reconciliation activities.
- Ensured adherence of HIPAA guidelines by staff members handling sensitive information related to the revenue cycle process.
- Regularly monitored performance indicators such as days in accounts receivable, clean claim rate, denial rate., in order to assess effectiveness of current processes.
- Participated in meetings with external vendors providing services related to the revenue cycle process.
- Identified opportunities for cost savings within the revenue cycle process through improved workflow design or automation initiatives.
- Performed quality assurance reviews of medical records documentation prior to submitting claims for reimbursement.
- Evaluated existing workflows and identified areas where improvements could be made that would result in increased efficiency or reduced costs associated with the revenue cycle process.
- Coordinated internal audits of billing documents submitted by providers in order to ensure accuracy of codes used when submitting claims.
- Evaluated revenue cycle processes and established actionable methods to increase productivity and efficiency.
- Analyzed and reported on billing cycle data to inform management.
- Participated in revenue cycle processes, working to maximize profitability and increase revenue.
- Provided revenue cycle process support to all clinical personnel, including resolving procedure challenges.
- Oversaw complete lifecycle of revenue operations.
- Monitored revenue and compared to targets to address variances and resolved actual-to-budget variances.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Checked payroll, vendor payments and other accounting disbursements for accuracy and compliance.
- Created and updated financial reports on frequent basis to present information to leadership teams.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Maintained regular performance appraisals for subordinates through verbal, written and on-going review programs.
- Managed relationships with tax authorities, bankers and auditors.
- Coordinated preparation of external audit materials and external financial reporting.
- Conducted reviews and evaluations for cost-reduction opportunities.
- Analyzed actual financial results to budget, preparing variance reporting to functional groups.
- Analyzed competitors and market trends to facilitate business growth.
- Developed invoicing systems and internal controls to boost billing efficiencies.
- Coordinated approval or rejection of lines of credit or commercial, real estate or personal loans.
- Created financial management mechanisms to minimize financial risk to business.
- Consolidated business data into actionable metrics to simplify and highlight areas of concern and opportunity.
- Developed or analyzed information to assess current or future financial status of firms.
- Built financial models to allocate resources, forecast cash and investment needs and make capital budgeting decisions.
- Recommended new financial and accounting software packages. replacing various non-integrated offerings.
Consultant NearTerm
FASMA
Amarillo, TX
12.2021 - 11.2022
- Podiatry Office Hospital System- Computer Conversion from Athena and Athena 1, Cerner Wisdom, Athena, Care Tracker and STI
- Lead Consultant for new acquisitions
- Super User for Cerner Community Works ad other new Acquisitions systems
- Identified various areas for process improvement for strategic plan 2021-2022
- Improved Bad Debt processes by Changing Bad Debt Vendors
- Improved Financial Assistance Application Process
- Improved POS collections processes
- Reduce Self Pay by implementation of Retro Eligibility
- Responsible for implementation team for conversion to ModMed
- Created and Improve Policies
- Analyzed Billing Data for inaccuracies and missing charges
- Analyzed Charge Master for missing charges
- Analyzed the AR daily for unforeseen payer changes
- Implemented and analyze data to provide strategic information for process changes
- Analyzed Centralized Registration Points to improve POS collections
- Improved Processes for Charge Master
- Reduced 300,000 loss from previous fiscal year
- Managed Provider credentialing to increase cash and reduce denials
- Met with Medicaid Managed Plans monthly to go over monthly denials
- Managed all aspects of Clinic billing and registration
- Created Denial Management Team
- Reduced Denials by 50% by improving billing process and managing denials
- Provided ongoing staff training to front office staff
- Organized meetings between stakeholders to discuss project details and timelines.
- Assisted in developing new methods for data collection and analysis techniques.
- Developed and implemented customized strategies to meet client needs.
- Conducted research and analysis of market trends, customer behaviors, and competitive landscape.
- Created comprehensive reports on project progress and results for clients.
- Provided advice on operational processes, business development initiatives, organizational changes and other areas of improvement.
- Collaborated with clients to develop action plans to address specific challenges and objectives.
- Analyzed complex information from multiple sources to identify patterns or trends that could be used as a basis for decision-making.
- Advised senior management on strategic planning, financial forecasting, budgeting, operations optimization, organizational design, process reengineering .
- Facilitated workshops with cross-functional teams to review current practices related to innovation and growth opportunities.
- Evaluated existing systems and processes against industry best practices for efficiency enhancement purposes.
- Identified potential risks associated with proposed solutions or projects.
- Provided recommendations based on quantitative data analysis regarding strategic direction.
- Reviewed existing policies and procedures and suggested improvements where necessary.
- Coordinated activities among internal departments while ensuring compliance with all applicable laws and regulations.
- Developed solutions tailored specifically to each client's unique needs while staying within their allocated budgets.
- Collaborated with stakeholders to contribute recommendations and deliver client objectives.
- Participated in training and managing new hires to bring new team members up to speed.
- Monitored contract requirements, invoices and receivables to keep books in order.
- Mentored associate consultants to encourage enthusiasm toward tasks and responsibilities.
- Applied techniques to analyze requirements, system capabilities and workflows.
Consultant
HealthTech
Amarillo, TX
02.2020 - 12.2021
- Multi Hospital System, Critical Access, PPS, Multi-Specialty and Rural Clinic
- Team lead for computer conversions
- Super User for Cerner Community Works
- Identified various areas for process improvement for strategic plan 2017-2021
- Improved Bad Debt processes by Changing Bad Debt Vendors
- Improved Financial Assistance Application Process
- Improved POS collections processes
- Reduce Self Pay by implementation of Retro Medicaid Eligibility
- Responsible for implementation team for conversion to Cerner
- Created and Improve Policies
- Analyzed Billing Data for inaccuracies and missing charges
- Analyzed Charge Master for missing charges
- Analyzed AR daily for unforeseen payer changes
- Implemented and analyze data to provide strategic information for process changes
- Analyzed Centralized Registration Points to improve POS collections
- Ensured quality measure were sent for ACO
- Improved Processes for Charge Master
- Reduced 3M loss from previous fiscal year
- Managed Provider credentialing to increase cash and reduce denials
- Met with Medicaid Managed Plans monthly to go over monthly denials
- Managed all aspects of Clinic billing and registration
- Created Denial Management Team
- Reduced Denials by 50% by improving billing process and managing denials
- Provided ongoing staff training
Consultant
Ni2 Health
Amarillo, TX
02.2017 - 03.2020
- Team lead for computer conversion
- Super User for Cerner Community Works
- Identified various areas for process improvement for strategic plan 2017, Improved Bad Debt processes by Changing Bad Debt Vendors
- Improved Financial Assistance Application Process
- Improved POS collections processes
- Reduce Self Pay by implementation of Retro Medicaid Eligibility
- Responsible for implementation team for conversion to Cerner
- Created and Improve Policies
- Ensured quality measure were sent for ACO
- Improved Processes for Charge Master
- Reduced 3M loss from previous fiscal year
- Managed Provider credentialing to increase cash and reduce denials
- Met with Medicaid Managed Plans monthly to go over monthly denials
- Managed all aspects of Clinic billing and registration
- Created Denial Management Team
- Reduced Denials by 50% by improving billing process and managing denials
- Provided ongoing staff training
- Risk management and supported the revenue cycle team through EMR conversions
- Project lead of non-clinical applications
- Weekly reporting
- Script writing
- Implanting training prior and post go live of conversions
- Lead of revenue cycle optimization prior to conversion
- Supply chain implementations in Cerner/Multiview/GHX
- Charge Services
- DA2 reporting
- Handled 50 calls per day to address customer inquiries and concerns.
Consultant
Regional Medical Center, Dover Fox
Croft, ME
11.2013 - 02.2017
- Team for Implementation of ICD-10 - Processes
- Implementation for over and underpayments team
- Created Revenue Cycle Policies
- Improved overall cash collections 10% Monthly by Improving Productivity
- Implemented Denial Management Team
- Provided ongoing training for staff
- Initiated tasks for building relationships with staff and directors
- Provided training to HIM department
- Met monthly KPI (Key Performance Indicators)
- Implemented Point of Services Collections
- Transitioned New Director
- Implemented New Billing System (Quadax)
- Weekly Report
Director of Multiple Hospital Systems
Pioneer Health Services
Magee, MS
03.2012 - 05.2013
- Multiple System Organization- Critical Access, Nursing Home, Home Health, and Hospice, -Florida, Hawaii and Covington County Initial Contract-Molokai 03/12, Collins 05/12, 9/12- 2 Florida Hospitals
- Systems: CPSI, E-Premis, SSI, EBOS, Siemens Soarian, Healthland, AS400
- Increase in cash by 40% within 6 months
- Decrease in AR within 6 months period for each facility
- Provided ongoing training for staff
- Initiated a task for building relationships with staff and directors
- Implemented Alpha collector software for 10 hospitals and 25 clinics(Still underway)
- Identified trends to improve cash collections and reduce timely adjustments
- Increased awareness with building strong relationship with non affiliated hospitals
- Provided training staff included onsite Business Office Managers
- Provided training to HIM department
- Provided training to Registration Staff
- Mentored colleague to assist with leadership development skills
- Accomplished meeting monthly cash goals every month
- Strengthened client relationship with Pioneer
- Met monthly KPI (Key Performance Indicators)
- Part of Implementation team for new facilities
- Team for Implementation of Paragon System(McKesson)- Processes
- Implementation for over and underpayments team
- Initiated early out program
- Improved Communication between Leaders
- Improved employee morale
- Manage 50 employees
- Manage 4 Supervisors
- Identified various areas for process improvement for strategic plan 2013-2014
- Improved Bad Debt processes
- Improved Financial Assistance Application Process
- Improved POS collections processes
- Reduce Self Pay by implementation of Retro Medicaid Eligibility
- Responsible for implementation team for conversion to McKesson Paragon
Business Office Director
Spooner Health System
Spooner, WI
08.2006 - 07.2012
- Decrease in AR days from 97 to 60 within 12-month period
- Updated charge master which increased cash by $500,000
- Manage Billing, Re-billing, Collections, and Follow-up on accounts
- Contribute to monthly report to CFO for monthly meeting
- Within first week of employment, I was able to Identify and resolve issues affecting reimbursement
- Contract Analysis, after receiving several payments below contract amount
- Contracts were reviewed and dated up to 4 years prior
- Requested ongoing meetings with Contract Manager, to further review opportunities to obtain an updated contract with addition reimbursement.
- In addition, all contracts for Blue Cross, Cigna, United Health Care, Medica, and other small PPOs were reviewed for outdated documents.
Project Director
Receivables Strategy, Inc
Nashville, TN
09.1996 - 08.2006
- A Perot Systems company)
- Multiple
- Oversaw business operations and produced updated status reports outlining each project to meet milestones.
- Hired and managed consultants, contractors and sub-contractors to complete project tasks.
- Developed and oversaw project operations and managed multi-functional issues through resolution.
- Monitored project and program quality to meet audit expectations.
- Orchestrated wide range of projects, improvement strategies, changes implementation, new revenue stream establishment and creative marketing and advertising.
- Traveled to other company locations for temporary assignments, meetings or training.
- Developed project control road map to guide various projects.
Education
Master of Science - Health Administration
University of Phoenix
Tempe, AZ07.2023
Master of Science - Accounting
University of Phoenix
Tempe, AZ07.2021
B. S - Health Administration/Health Management
University of Phoenix
Phoenix, AZ03.2018
Skills
- 25 years Revenue Cycle Management with 10 years HIM management
- Hospital, LTAC, Nursing Home, SNF Ambulatory, Physician, Air and Ground Ambulance
- 10 years as Revenue Analyst
- 10 Project Management
- 5 years EHR Implementation-Cerner, EPIC, Meditech, CPSI,
- COMPUTER SKILLS:
- Hospital Systems:
- PointClickCare, Community Works, Athena, HBOC, Meditech, Premis, SSI, FSS, Affinity, Access Blue, Xactimed, EPIC, WebMD, MEDA, UNYSIS, SMS, Advantage, CPSI, Dairyland, Healthland and Cerner, Quadax, Waystar, Athena, All scripts, Rycan and Trubridge, ModMed, Ahena1, Athena
- Microsoft Proficiency; Excel, Word, PowerPoint, Outlook, One Note, Publisher
- Word Processing: WordPerfect 30-80, Word (all versions), ECG Graphics: Harvard Graphics, PowerPoint, AutoCAD, Versa CAD Spreadsheets: Lotus 1-2-3, Excel 20-80
- Databases: AS200, AS400, AS800, SAM
- Database Managers: Microsoft Access, CA Visual Express, ACT, and Showcase Vista Operating Systems: MS DOS, Windows all versions, Basic
- Accounting: Quicken, Quick Books, Quick Books PRO Communication: Internal and external e-mail, Lotus CC Mail, Outlook Information Retrieval: Various data banks, CD ROM’s
- Languages: Some Lotus, Basic, and FORTRAN
- Hardware: IBM, DELL, Mac/Apple, AT&T, Gateway, TI, and Supercomputer
- Special Projects:
- VA implementation Team (Billing Specialist)
- Billing Project for Healthtech
- Revenue Reviews
- Policy Management
- Records and Database Management
- Planning and Prioritization
- Accounts Payable and Accounts Receivable
- Cash Collection
- Interdisciplinary Meetings
- Employee Performance Management System
- Financial and Operational Reporting
- Payroll Oversight
- Charging Methodologies
- Account Monitoring
- Revenue Metrics Analysis
- Procedure Optimization
- Budget Monitoring
- Revenue Quotas
- Billing Cycle Performance
- Risk Assessment
Affiliations
International Society of Female Professionals
Accomplishments
- Documented and resolved denials which led to increase in cash.
- Achieved increase in POS by introducing Upfront Collections policy for Registration Department.
- Achieved 20% increase in cash by improving denial s by creating a denial management team to meet monthly to review the denials to improve accuracy and efficiency.
- LTAC clean up project, improved AR for 108 to 54 within 6 months
Certification
- Accounting University of Phoenix
Timeline
Revenue Cycle Director
Revelations Consulting
10.2022 - 02.2024
Consultant NearTerm
FASMA
12.2021 - 11.2022
Consultant
HealthTech
02.2020 - 12.2021
Consultant
Ni2 Health
02.2017 - 03.2020
Consultant
Regional Medical Center, Dover Fox
11.2013 - 02.2017
Director of Multiple Hospital Systems
Pioneer Health Services
03.2012 - 05.2013
Business Office Director
Spooner Health System
08.2006 - 07.2012
Project Director
Receivables Strategy, Inc
09.1996 - 08.2006
Master of Science - Health Administration
University of Phoenix
Master of Science - Accounting
University of Phoenix
B. S - Health Administration/Health Management
University of Phoenix
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