Saifee G
Sr. Manager Revenue Cycle Operations
Houston,TX
Summary
Seasoned revenue cycle professional with a versatile leadership style specializing in end-to-end revenue cycle optimization, process and performance improvement, business intelligence, implementation and project management with a keen ability to identify opportunities for improvement, define comprehensive solutions and develop a road map to success that is tailored to client needs.
Overview
15
15
years of professional experience
3
3
years of post-secondary education
Work History
Sr. Manager Revenue Cycle Operations
R1 RCM
Houston, Texas
01.2024 - Current
- Managed Middle and Backend Revenue Cycle operations for Sutter Health Hospitals and Medical Group based in California.
- Collaborated with leadership on regular basis on opportunities for ongoing operational efficiencies, Billing, Coding, Cash Inflow, AR and Denials Management.
- Maintained cash over target for Professional Billing despite various challenges during Change Healthcare Outrage.
- Established and maintained strong relationship with client and stakeholders, ensuring long-term partnership.
- Build EPIC Reports and Dashboards for Physicians using Tableau and CUBEs reporting for Physicians Charges, Charge Lag, Coding Modifications, Payments, AR and Denials.
- Reduced Pre-AR days in EPIC from 11 days to 3 days target by managing a cross functional project by engaging with front, middle and backend teams by creating SOPs and EPIC Workflow for various teams driving CFBs.
- Reduced AR Days from 60 to 50 days while maintaining avoidable write-offs within target.
- Established and maintained Physician Sentiments Project partnering with client leadership and Clinic Operations by developing various project charters based on Physician needs.
- Managed the team to reduce overall denials for Professional Billing team by developing various EPIC claim edits and rules, resulting in 15% reductions in Initial denials.
- Partnered with Managed Care and various Payer relations to resolve payer disputes related to denials and underpayments, resulted in resolving 15% overall underpayment disputes.
- Managed and maintained various onboarding new physician groups acquired by client by partnering with various client and R1 stakeholders.
- Acted as a primary contact for Physician group leaders for high escalations from patients or departments.
Manager Revenue Cycle Operations
R1 RCM
Houston, TX
01.2021 - 12.2023
- Managed overall Front-End Revenue Cycle Operations for Rush University Hospital and Medical Group based in Illinois
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Achieved departmental goals by developing and executing strategic plans and performance metrics.
- Established Monthly Reporting Packages for various Specialty Groups for their Market Performance and presenting it department leaders on monthly basis.
- Responsible for reviewing and resolving high escalations from clients, engaging with stakeholders by providing detailed SBAR in timely manner.
- Managed Patient Access teams for RUSH Medical Group to oversee the workflows from patient scheduling to registration.
- Reduced overall front-end denials by 18% partnering with Registration, Authorizations and Physician Liaisons by developing EPIC workflows for each team.
- Led teams both onshore and offshore global teams to implement R1 technologies across the board that lead to the productivity increase and deduction in denials.
Payment Various Analyst
Houston Methodist Hospital
Houston, TX
11.2019 - 12.2020
- Managed and maintained EPIC Work Queues, determining PB Claims Underpayments by reviewing payer contracts and working with Managed Care and Payer Disputes Departments, leading an increase in cash flow by 20% by resolving various BCBS and Aetna underpayment disputes.
- Partnered with Physician Liaisons on improving various physician coding behaviors driving payer underpayments or denials.
- Created EPIC templates and shortcuts for Physicians to submit their charge tickets, improving clean claim rates by 10%.
- Increased efficiency by streamlining data analysis processes with CUBEs and Clarity reporting and implementing automation tools.
Sr. Account Receivable Collector
Houston Methodist Hospital
Houston, TX
08.2017 - 10.2019
- Established proactive communication with third-party payors to address high-dollar outstanding claims (<$50K)for Primary care and specialty groups, ensuring timely resolution of unpaid claims and by documenting detailed analysis in every account.
- Create first and second level appeals for Medicare, Medicaid, Managed Care and various commercial payers for various denials, resulting in additional payments for various outstanding claims.
- Partnered with Nurses and Physician Liaisons to resolve various Authorization and Medical Necessity denials by proactively working on recurring patients schedules to avoid future denials.
- Mentored various new team members by providing and educating EPIC workflows and SOPs.
- Maintained accurate records of all collection activities, ensuring compliance with industry standards and regulations.
Budget Analyst
DM Clinical Research
Houston, TX
03.2016 - 07.2017
- Facilitated cross-department communication to ensure consistent understanding of budgetary goals and constraints.
- Examine budget estimates for clinical trials for completeness, accuracy and conformance with procedures and regulations.
- Provide advice and technical assistance with cost analysis, fiscal allocation and budget preparation.
- Supported the creation of auditing, reporting and contract modeling tools for enhanced analysis, facilitating continues improvement
Account Manager
Exact Business Support
12.2009 - 01.2016
- Managed Multi Specialty groups not limited to Internal medicine, Pulmonary, Rheumatology, Cardiology and Neurology across various states of United States.
- Managed entire Billing and Backend Operations, resulting increase in Cash inflow and reduction in AR and denials.
- Provided comprehensive reporting on account performance, enabling data driven decisions for clients.
- Increased client satisfaction by building strong relationships and addressing their needs promptly.
- Successfully resolved escalated issues, preventing potential loss of valuable clients while maintaining positive relationships with all parties involved.
- Maintained high client retention rate by providing exceptional customer service and anticipating client needs.
- Managed a team of 20 FTEs working in entire Revenue Cycle Operations.
- Managing and mentoring employees, responsible for hiring and retention process.
- Developed payer scorecard to monitor payer performance and improve negotiation process.
- Responsible for maintaining Providers CAQH and Credentials with Medicare, Medicaid and various commercial payers.
Education
MBA - Finance
University of Karachi
01.2012 - 12.2014
Skills
Reporting management
Cross-functional team coordination
Team building
Team leadership
Process improvement
Project planning
Analytical skills
Customer service
Complex Problem-Solving
Timeline
Sr. Manager Revenue Cycle Operations
R1 RCM
01.2024 - Current
Manager Revenue Cycle Operations
R1 RCM
01.2021 - 12.2023
Payment Various Analyst
Houston Methodist Hospital
11.2019 - 12.2020
Sr. Account Receivable Collector
Houston Methodist Hospital
08.2017 - 10.2019
Budget Analyst
DM Clinical Research
03.2016 - 07.2017
MBA - Finance
University of Karachi
01.2012 - 12.2014
Account Manager
Exact Business Support
12.2009 - 01.2016
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