Summary
Overview
Work History
Education
Skills
Timeline
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Sonia Restrepo

Bronxville

Summary

Accomplished Director of Physician Financial Services at St Joseph's Health System Reporting to the VP, Chief Revenue Officer. Responsibilities include professional billing for the healthcare system, coding, credentialing, customer service, payment posting, financial counseling and payer relations functions in professional side of the organizations for approximately 450 providers. Adept in Oracle Health (Cerner Millenium) and strategic planning, significantly enhanced operational efficiencies and revenue growth. Spearheaded AI coding implementation and led revenue cycle optimizations, achieving a 23% increase in physician charges. Strong communication skills with a unique ability to inspire positive change with a wide range of experience in the development and implementation of policies and procedures that have successfully increased cash flow and reduced accounts receivables.

Overview

16
16
years of professional experience

Work History

Director of Physician Financial Services

St Joseph's Health system
03.2019 - Current
  • Oversee professional billing and collection trends across the organization.
  • Successfully transitioned system-wide EMR as Operational Team Lead for network practices. Responsible for design, testing, workflow validation, rollout, and metric capture for dashboard reporting.
  • Directed closure of legacy professional billing system (Athena) for the Physician Enterprise, decreasing the outstanding AR to from $25M within one year to $4M.
  • The yield improved by 10.1 percentage points on services since 2023 has realized $12.3M of additional cash collections as compared to the baseline.
  • Decreased days in A/R from 72 to 41 within eighteen months; now at 40 days within organization.
  • Designed and implemented provider coding education and coding audit policies for 450 providers.
  • Redesigned the physician coding team into one streamlined department, reducing coding denials by 27%, implementing AI (Computer Assisted Coding) coding across the organization.
  • Increase revenue for the physician medical group in 2024 by 14% from 2023 with AI coding.
  • Redesigned payer credentialing team to maximize reimbursement for the onboarding of 450 new physicians & opening of 45 new clinics in 2022 through 2024. Leading to an increase in charges of $3 Million monthly.
  • Streamlined workflows by automating processes and reducing FTE hours by 14K and accelerating cash by $1M.
  • Collaborated with business office vendor to ensure health plans are paying in accordance with contracted rates with over $2.6M collected as a result of identified underpayments.
  • Built informatics team for greater reporting capabilities and nimbleness across the organization.
  • Manages department budgets and ensures operating expenses are within budget.
  • Implemented standardized revenue cycle monthly financial performance meetings with the department chairs of each service line.
  • Responsible for measuring, monitoring, and meeting key performance indicators and departmental goals in accordance with established policies and procedures by the organization.
  • Ensures compliance with applicable laws and regulatory standards is met by the organization.
  • Leader of Physician Revenue and Reimbursement Committee for review of best revenue cycle practices for the physician side of the organization.
  • Develops and builds relationships across various departments working with leadership and service line stakeholders to develop goals for service lines and programs.
  • Spearheaded new business development initiatives that drove revenue growth.

Revenue Cycle Manager

St Joseph's Health system
03.2014 - 03.2019
  • Responsible for the accounts receivable of physician billing physician practices with $6 million in monthly revenue.
  • Led initiative to revise the departmental workflows, which resulted in an increase of 23% in physician charges.
  • Participated in an organizational-wide initiative to optimize physician credentialing, which resulted in an increase of payments of 16%.
  • Oversaw the design and implementation of the Cerner millennium for over 200 ambulatory practices.
  • Delivered monthly KPI's to the departmental chairman and executive team on all matters pertaining to physician revenue and denial trends.
  • Provide account receivable analytical support and developed operational recommendations in order to improve reimbursement.
  • Created workflows to capture inpatient physician billing.
  • Support clinical team members with revenue cycle procedures and address any issues as needed.
  • Routinely collaborate with department directors/managers to correct problems and improve patient services.
  • Conducted regular audits of financial records to identify errors or inconsistencies in data entry or documentation.
  • Provided training on coding updates, changes in billing guidelines, and new software applications.
  • Built relationships with internal departments such as clinical staff, finance department., to ensure smooth workflow.
  • Utilized data analytics to identify areas of improvement within the revenue cycle process.
  • Oversaw daily operations of the revenue cycle department including scheduling resources.
  • Coordinated with IT personnel to troubleshoot technical issues related to billing software system.

Senior Executive Account Manager

MD Everywhere, Inc.
06.2009 - 04.2013
  • Responsible for the accounts receivable of physician billing for large hospitals and multi-physician practices with $30 Million in revenue, including credentialing, denial management, and the third party follow up.
  • Coordinated the implementation of new clients using EMR, third party applications, and MD Everywhere applications.
  • Provided front and back end assessments and collaborated with clients in order to recommended financial strategies that increase revenue for clients.
  • Supported and trained clients in the use of all applications to optimize front-end processes, billing flow, and reimbursement to clients.
  • Acted as a liaison between MD Everywhere and clients in the coordination of daily activities and special projects.
  • Formulated monthly and yearly financial reviews for executive teams.
  • Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
  • Monitored and guided revenue cycle operations.
  • Coordinated with other internal departments and customers to keep operations running smoothly and solve both routine and complex problems.
  • Analyzed market trends and competitor activity to identify opportunities for improvement.
  • Demonstrated strong problem-solving skills to resolve customer complaints efficiently and effectively.
  • Identified areas of improvement within existing accounts, resulting in increased customer satisfaction ratings.
  • Maintained up-to-date knowledge of industry standards, best practices, and new technologies.
  • Utilized excellent communication and interpersonal skills to build relationships with clients and stakeholders, by working closely with all levels of administrative and clinical personnel.

Education

Masters in Business Administration - HealthCare Management

Capella University
Minneapolis, MN
04.2024

Bachelors/ Master of Science - HEALTHCARE ADMINISTRATION

University of Phoenix
Phoenix, AZ
06.2021

Nationally Certified Insurance and Coding Specialist -

Medlink
01.2012

Skills

  • Operations Management
  • Strategic Planning
  • Data Analysis
  • Budget management
  • Leadership Development
  • Athena Health
  • Microsoft Office Suite
  • Analytical thinking
  • KPI Tracking
  • Financial Reporting
  • Coaching and mentoring
  • Oracle Health/ Cerner Millennium
  • EZDI Computer Assisted Coding
  • Bilingual in Spanish

Timeline

Director of Physician Financial Services

St Joseph's Health system
03.2019 - Current

Revenue Cycle Manager

St Joseph's Health system
03.2014 - 03.2019

Senior Executive Account Manager

MD Everywhere, Inc.
06.2009 - 04.2013

Bachelors/ Master of Science - HEALTHCARE ADMINISTRATION

University of Phoenix

Nationally Certified Insurance and Coding Specialist -

Medlink

Masters in Business Administration - HealthCare Management

Capella University

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Sonia Restrepo