Open To Work
SHRONICA THOMAS
Oak Park
Summary
- Enthusiastic Healthcare Finance Professional with a history of success in Revenue Cycle and Project Management. Demonstrated proficiency to evaluate and implement lean process workflows for denial management. Extremely knowledgeable in Third Party Payer Guidelines, Medical Terminology and Coding, ICD10, CPT and HCPCS. Proven competence in Front End and Back End processes include Patient Registration, Authorizations, Billing and claim Adjudication for Medicare, Medicaid, BCBSPPO and HMOs for both UB04 and 5010. Accomplished Leader and decision maker, with the ability to organize and multitask. Recognized as an analytical person with a focus on results. Goal oriented, collaborator that accepts and respects diversity. Commitment to service excellence and Innovation. Core Competencies include:
- Compliance, Revenue Integrity
- CDI
- Collections Management
- Physician and Facility Billing
- Operations Management
- Physician Credentialing
- Insurance Contract Negotiations
- Physician Onboarding
- CDM Management
Efficient revenue cycle manager adept at implementing procedural improvements and executing revenue metrics analysis to dive corporate financial objectives. Eager to apply several years of account management to increase revenue and add value to the team.
Meticulous revenue cycle manager pursuing an opportunity to apply strong knowledge of accounts payable and receivable in a clinical environment. Diligent and structured with a proven history of implementing improvements to increase financial performance and achieve company objectives. Offering several years of experience at hospitals.
Diligent revenue cycle manager eager to utilize several years of financial analysis and budget monitoring to bring immediate value to a professional role. Highly skilled in managing billing cycle performance and executing financial reporting to inform stakeholders. Eager to offer a passion for process improvement and an unfailing work ethic to a new organization.
Results-driven Revenue Cycle Manager adept at achieving high productivity and efficiency in operations. Specialize in process optimization, financial analysis, and regulatory compliance to ensure streamlined billing practices. Excel in leadership, problem-solving, and communication, effectively managing teams for peak performance and client satisfaction.
Seasoned Revenue Cycle Manager with deep understanding of financial systems, healthcare revenue cycle management and financial analysis. Proven capability in managing billing functions, improving cash flow and reducing bad debt. Notable strengths are in strategic planning, team leadership and process improvement for increased operational efficiency. This experience has led to impactful improvements in both patient satisfaction and bottom-line results.
Versatile professional adept in financial analysis, audit support, account reconciliations and collections. Proficient in preparing financial statements, monitoring controls and completing closings. Highly detail-oriented, proactive, and diligent.
professional and dedicated team player experienced in overseeing operations of individual and multi-unit facilities. Develops successful programs to improve profitability. Seeking new position with exciting challenges where great skills will be valued.
Skilled professional inspired and motivated to help customers build financial independence.
Seasoned financial manager with broad experience in budgeting, forecasting, and strategic planning. Skilled in optimizing financial processes and leading teams to exceed corporate goals through innovative strategies and efficient resource allocation. Proven track record of enhancing operational efficiency and financial health within diverse organizations. Demonstrated ability to analyze complex financial data and recommend actionable solutions that drive growth and profitability.
Strategic in financial management, thrive on maximizing productivity and efficiency in task completion. Skilled in budgeting, risk assessment, and strategic planning. Excel at communication, problem-solving, and leadership, ensuring seamless operations and team synergy.
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience.
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth.
Experienced in fast-paced environments and adaptable to last-minute changes. Thrives under pressure and consistently earns high marks for work quality and speed.
Responsible and motivated student ready to apply education in the workplace. Offers excellent technical abilities with software and applications, ability to handle challenging work, and excellent time management skills.
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Director of Revenue Cycle
RESILIRE NEUROREHABILITATION
Brighton
09.2024 - Current
- Oversees all aspects of a healthcare organization's billing and revenue cycle, ensuring efficiency, compliance, and maximized revenue collection.
- Review ageing reports and recommend action plans to decrease A/R with the collection team members.
- Assist with insurance payer contracts, perform contract analysis, and contract reimbursement negotiations.
- Monitor unpaid or denied claims to determine necessary actions to assure timely resolution.
- Obtains and submits the necessary documentation required for submitted claims resolution.
- Reviews patient bills for accuracy and completeness of insurance payment and contractual adjustments.
- Anticipates potential billing/reimbursement problems and takes measures to prevent denials.
- Efficiently manage patient complaints and answers billing related questions from patients and insurance companies in respect to collections.
- Monitors unbilled accounts and/or uncoded encounters to reduce any billing delays.
- Working in partnership with the CFO to manage team member performance by providing regular feedback, performance reviews, and one-on-one meetings.
- Participate in overseeing the hiring and training of collection team members.
- Ensures compliance with relevant federal, state, and payor-specific billing requirements.
- Regularly provides leadership team with collection status reports.
- Under the direction of the department CFO works in identifying any payer relation issues.
- Ensure the clinical team is documenting and coding according to coding guidelines.
- Develop KPI- Key Performance Indicators for the revenue team.
- Run Analytical financial reports to identify trends in denials.
- Perform prospective chart audits.
- Provide documentation education to clinical staff.
- Resilire Neurorehabilitation believes in the power of pressing onward to overcome adversity. Resilire Neurorehabilitation melds advanced rehabilitation practices with generations of experience to provide care and treatment for people who have experienced neurological injury. Resilire Neurorehabilitation, now one of the largest and strongest rehabilitation providers of its kind in Michigan. We offer services, care, best practices, and technology in our continued commitment to healing and recovery in an evolving healthcare market.
Consultant: Chief Revenue Officer
PENNACLE HEALTHCARE CONSULTANT, LLC
Oak Park
12.2012 - Current
- Provide directions to clients and operations staff on cash applications, credit balance and refunds, claims and customer service.
- Evaluate productivity to optimize the goals and efficiencies to achieve timely claim submission to maximize third party reimbursement. This includes a review of front end and back-end processes.
- Reviewed and develop and implement company billing policies and training documents.
- Audit chart documentation and verify CPT code for claim submission and reimbursement.
- Conducted Quality Assurance of department staff to ensure compliance with regulations.
- Reduced loss revenue by monitoring writes off and denial reports.
- Review claim issues and work with billing staff to reconcile accounts.
- Performed and provided physician education on clinical documentation and coding to enhance revenue opportunities.
- Provided overall direction and management of revenue cycle initiatives for providers of various specialties.
- Create third party payer insurance tool to assist front-end staff with patient co-payment and coinsurance.
- Contract and Credential providers with Medicare, Medicaid, and Commercial Insurances.
- An Independently owned and operated corporation that provides medical billing services to clients including hospital-affiliated groups, multi-location specialty practices and private practitioners. Pennacle offers a broad range of services to improve healthcare productivity and revenue while enhancing patient care by enabling healthcare providers to document to the highest level of specificity for maximum reimbursement.
Manager of Patient Access
CHILDREN'S HOSPITAL OF MICHIGAN
Detroit
01.2023 - 09.2024
- Responsible for overseeing all functions of the patient access staff (approximately ninety-five staff members) to ensure patient safety and satisfaction as it relates to registration for Admitting, Emergency Department and Specialty Clinics to optimize the facility's financial performance.
- Management of Scheduling, Registration, and Verification Processes through the delivery of high-value patient scheduling, registration, insurance verifications, and communication processes for day-to-day operations for assigned areas of responsibility.
- Assures appropriate staffing levels and adequate supplies and equipment for all areas of responsibility across the Patient Access Department. Works with leadership to develop and encourage innovation of processes and growth of programs.
- Monitor monthly financial reports related to fixed and variable costs within assigned areas of responsibility and provide input into the annual budget.
- Communicates regularly with Revenue Cycle Department to address denials, billing and collections issues and provides input into process improvement.
- Monitors staff productivity and adjusts staffing levels to achieve goals/standards.
- Oversee timekeeping functions for direct reports, approve time off and plans for coverage as needed.
- Works directly with IT department, EHR support, clinical and front office staff to improve communications and documentation efficiencies.
- Assure all staff maintain proper training related to pertinent skills, competencies, standards of behavior, and compliance.
- Conducts systematic performance review of all staff.
- Communicates and facilitates rapport with staff that secure a highly engaged team who consistently achieves patient satisfaction goals.
- Maintains an active presence.
- Identifies process and systematic barriers to the delivery of superior patient experience.
- Participate in monthly leadership and department operations meetings, reporting relevant information back to staff.
- Conducts weekly/monthly staff meetings.
- Assures and promotes the professional growth and development of staff.
- Demonstrates and promotes a work environment that adheres to NHA's performance standards and Values.
- Promotes an environment that stimulates continuous quality improvement initiatives, allowing staff members to contribute to the operational and strategic planning of the Patient Access department.
- Reviews of annual patient satisfaction scores and patient comments and reports results for staff. Initiates follow-up/service recovery as needed based on patient comments.
- Facilitate action plans for staff to improve patient satisfaction scores.
- Analytical - Experience with data analysis, design, workflow, procedures, and problem solving.
- Demonstrated leadership skills and management proficiency to effectively build.
- Analyze department results and implement action plans toward performance improvement.
- Troubleshoot operational problems.
- Serves as a point of contact for situations requiring expertise to resolve complex patient access issues and ensure timely follow up and customer satisfaction.
- Children's Hospital of Michigan is a for-profit, pediatric acute care hospital located in Detroit, Michigan. The hospital has 228 beds and is affiliated with both the Wayne State University School of Medicine and the Michigan State University Medical School.
Billing Manager
MHP- COMPREHENSIVE UROLOGY
Royal Oak
03.2020 - 10.2022
- Net Collections over $90 million dollars increase of $10 million dollars YTD 2022. Reported to the Chief Executive Officer. Manage a team of eighteen billers and two payment posters.
- Perform as a practice expert at the department on all issues relating to billing and intake processes.
- Supervise the billing/intake department operations; perform duties such as charge entry, payment posting, reimbursement management, referral intake and insurance verification, claim submissions, and accounts receivable follow-up.
- Conduct audits of current procedures and processes, discover billing/intake operations areas to improve on and effect the necessary actions.
- Train, allocate work, and resolve problems among billing office personnel.
- Conduct performance evaluation of personnel and recommend necessary actions.
- Provide motivation for employees to achieve their best performance and a high degree of productivity.
- Conduct analysis of trends affecting coding, charges, accounts receivable, and collection, and assign manageable tasks to billing staff.
- Collaborate with other departments to get and analyze additional information about patients to be able to record and process billing effectively.
- Ensure the billing/intake department conducts all its activities in accordance with its overall protocol, and that they comply with payer, State, and Federal requirements, regulations, and guidelines.
- Remain updated on HIPAA and all other health information management issues and regulations.
- Ensure formidable team building and protocol in the billing and intake department by holding biweekly staff meetings.
- Give report on all concerns and issues in the department to the Chief Executive Officer and Chief Operating Officer.
- Monitor accounts receivable dollars and set goals to reduce A/R days.
- Develop, evaluate, approve, or recommend changes in policies, procedures, and staffing levels that affect Patient Accounting.
- Comprehensive Urology is committed to providing convenient, expedited, and cost-effective urologic care applying best practice protocols and state-of-the-art technology. They have over 50 Urologists located throughout Southeast Michigan, with thirty-eight offices conveniently located to serve our patients.
Director Revenue Regeneration
ALLURE MEDICAL
Shelby
06.2019 - 02.2020
- Reported directly to the Chief Financial Officer. Managed a team of ten on shore team members and ten offshore billing team members. Generated revenue for all services provided for over thirty practice locations.
- Evaluate the effectiveness of billing and collection workflow.
- Recommends and Implements changes to policies and procedures as appropriate.
- Accountable for over $80 million gross revenue.
- Maintained A/R days under Medical Group Management Association (MGMA) benchmarks.
- Remove barriers for timely filing and collection of patient accounts and future strategies to improve cash flow, minimize bad debt.
- Complete Electronic Data Interchange and Electronic Remittance Advice enrollments for multiple insurers for various states throughout the USA.
- Project lead for TriZetto Clearinghouse for transitioning ownership from vendor back inhouse.
- Championed A/R workflow to settle high dollar payer balances.
- Weekly billing meetings to review financial data with CFO and CEO.
- Implemented Encoda billing workflow software to assist with rejected, denied and unposted claims.
- Contract negotiations for multiple insurances.
- Credential and onboard new clinical staff with contracted insurers.
- Performed training of new hires and offshore team members.
- Create the Clinical Documentation Improvement department to educate clinical staff to improve coding and documentation.
- Create departmental policies and procedures as needed.
- Founded in 2004 by Dr. Charles Mok, Allure Medical offers services ranging from treating varicose veins to cosmetic non-surgical procedures. Allure Medical successfully opened offices in KY, WI, GA, MN, NC, SC, FL, and MI.
Revenue Cycle Manager
NEMO HEALTH, LLC
Southfield
05.2017 - 05.2019
- Reported directly to Executive Vice President. Managed a team of seventy offshore team members and fifteen onsite billing team members.
- Accountable for over $5 million gross revenue dollars.
- Successfully onboarded over two hundred acquired physicians with NEMO Health.
- Facilitated EDI/ERA enrollments with all insurance carriers for multiple states.
- Project lead for TriZetto Clearinghouse transition to Availity Clearinghouse.
- Championed A/R workflow to settle high dollar payer balances.
- Spearheaded weekly provider meetings to review financial data.
- Processed payroll for staff members utilizing ADP.
- Performed training of new hires and offshore team members.
- Delivered physician education to improve provider documentation.
- Created departmental policies and procedures as needed (includes patient balances collection process).
- An independently owned and operated practice management, electronic health record, and medical billing company, which provides end-to-end revenue cycle management solution for the Podiatry across the United States.
Revenue Regeneration Manager - Behavioral Health Services
HENRY FORD HEALTH SYSTEM
Detroit
04.2006 - 12.2012
- Reported to Director of Finance. Accountable for the daily operations of the Behavioral Health Services Revenue Team, including prioritization of the key areas of activity capture, while maintaining the highest levels of patient, physician, and employee relations.
- Collaborated with Administrators, Clinic Coordinators and Medical Directors for the Department of Behavioral Health Services (5 Psychiatric Outpatient Clinics, Psychiatric Inpatient Hospital, Substance Abuse Facility, Neuropsychology, Consultation Liaison and Brain Stimulation Clinic) regarding collection activity, compliance, revenue opportunities and process improvements. Managed one direct and ten indirect reports including hiring, training, and performance management.
- Used McKesson Claims Administrator Program to process rejected claims and resolve an array of claims issues that affected submission of claims.
- Drove the resolution of unpaid or underpaid claims by monitoring revenue activity reports to validate payments and allowances and verifying payments with third party contracts.
- Maximized charges capture and net revenue opportunities by adhering to comprehensive review process that captured over 1Million in charges with increased collections.
- Evaluated patient volumes and bad debt as compared with the budget and made revenue projections.
- Managed Care Contracting Negotiations and participated in contract negotiations with County and Commercial Payers.
- Conducted Documentation Audits on Inpatient charts ensuring compliance with coding guidelines. Provided recommendations and discussed findings with clinical staff and physicians. Facilitated provider education for CPT, ICD9 and Third-Party Payer guidelines.
- Managed physician billing of Kingswood Hospital Inpatient revenue to meet or exceed Monthly budget of $250,000. Increase inpatient revenue by 20% from 2006-2012.
- Developed and implemented policies and procedures applicable to billing and revenue operations.
- Posted payments of $100,000 for Oakland County PACE program ensuring patient account reconciliation.
- Created claim edits for Behavioral Health Service to prevent claim submission based on provider credentials.
- Conducted Financial Counseling for outstanding Patient Account balances.
- Effectively researched billing requirements and payor guidelines to increase revenue opportunities.
- An 1800-bed, five hospital, fully integrated, non-profit healthcare system; Henry Ford Medical Group: Comprised of one of the nation's largest group practices with over 900 physicians and researchers in 40 specialties.
Office Manager - Critical Care Medicine
DETROIT MEDICAL CENTER-CHILDREN'S HOSPITAL
Detroit
05.1998 - 03.2006
- Reported to the Chief of Critical Care Medicine for Children's Hospital of Michigan. Effectively managed the claims denial process. Monthly processed over $100,000 claims by posting payments and adjustments. Conducted performance and disciplinary evaluations for office support staff.
- Investigated and resolved billing discrepancies for University Pediatricians.
- Monitored budgets for Operations and Capital Expenditures ensuring available funding.
- Wayne State University/CHM managed grants and restricted funds to supplement the budget.
- Facilitated the conformance with various regulatory and accreditation agency requirements.
- Maintained Resident/Fellowship Program and processed all Physician Provider Applications.
- Analyzed data and made recommendations as needed to improve office operations.
- A 228-bed facility dedicated to providing the highest quality of care to children and adolescents. Staff consists of 455 physicians, 125 pediatric specialists, 680 pediatric-trained nurses and more than 240 residents, specialists, fellows, and medical students in training.
Education
Master of Business Administration -
University of Phoenix
LivoniaBachelor of Science - Business Management
Florida Memorial University
Skills
- Compliance
- Revenue Integrity
- CDI
- Collections Management
- Physician and Facility Billing
- Operations Management
- Physician Credentialing
- Insurance Contract Negotiations
- Physician Onboarding
- CDM Management
- Microsoft Office proficient: Excel, PowerPoint, Visio, Project, Access, Basic Project, Analytics
- Business Intelligence- CQL Queries
- TriZetto/Cognizant Clearinghouse
- Availity Clearinghouse
- EPIC- Superuser
- Nextech PM/HER
- TRAKNET PM/ERH
- McKesson
- IDX
- Athena Health
- Centricity PM
- EHS
- Matrix
- Greenway Health
- Sage 50
- Registered tax return preparer (RTRP)
- Certified internal control professional
- Certified internal auditor (CIA)
- Certified government auditing professional
- Fraternal insurance counselor fellow (FICF)
- Chartered life underwriter (CLU)
- Certified public accountant (CPA)
- Chartered management consultant
- Licensed public accountant
- Chartered global management accountant
- Certificate in investment performance measurement
- Financial advisory
- Chartered market technician
- Certified turnaround professional (CTP)
- Certified trust and fiduciary advisor (CTFA)
- Certified credit union financial counselor
- Firm-level financial assessment
- Certificate in investment performance measurement (CIPM)
Certification
- Certified Professional Coder
- LEAN Training for Healthcare
Accomplishments
- Transition Comprehensive Urology from Outsourced Billing Company to in-house billing with a team of ten billers and two posters. Increased revenue from 2020 to 2021 by $3 million. The accounting department noted this was the most profitable year seen in 5 years.
- Operations Team Member for HFHS Philanthropy Community Giving Campaign, surpassed the System's goal of $2 Million in donations by $1 Million in additional donations.
- Developed 1997 Evaluation and Management Documentation Pocket Card.
- Developed 'Good Faith Estimate Document.' Athena Practice launched this document in their system across for all their clients to use for the 'No Surprise Act 2021.'
Phone
cell, (248) 842-0428
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
On-SiteRemoteHybridSalary Range
$130000/yr - $200000/yrTimeline
Director of Revenue Cycle
RESILIRE NEUROREHABILITATION
09.2024 - Current
Manager of Patient Access
CHILDREN'S HOSPITAL OF MICHIGAN
01.2023 - 09.2024
Billing Manager
MHP- COMPREHENSIVE UROLOGY
03.2020 - 10.2022
Director Revenue Regeneration
ALLURE MEDICAL
06.2019 - 02.2020
Revenue Cycle Manager
NEMO HEALTH, LLC
05.2017 - 05.2019
Consultant: Chief Revenue Officer
PENNACLE HEALTHCARE CONSULTANT, LLC
12.2012 - Current
Revenue Regeneration Manager - Behavioral Health Services
HENRY FORD HEALTH SYSTEM
04.2006 - 12.2012
Office Manager - Critical Care Medicine
DETROIT MEDICAL CENTER-CHILDREN'S HOSPITAL
05.1998 - 03.2006
Master of Business Administration -
University of Phoenix
Bachelor of Science - Business Management
Florida Memorial University