Tamara Harris
Keller,TX
Summary
Healthcare professional with expertise in CDM, Charge Capture, Auditing, and Compliance in both hospital and consulting environments. Extensive experience with the full revenue cycle, from pre-registration to denials management and collections. I have vast experience working closely with Case Management, HIM, and the Compliance teams, ensuring all regulations and policies are met. Demonstrated leadership and innovative thinking, resulting in Jack Hughston experiencing the lowest AR days in the history of the facility. Led multiple projects from inception to completion. Published author and contributor to MedAssets Coding and Compliance newsletters, including a feature article in August 2015. Knowledgeable of official regulatory guidance surrounding Medicare OPPS, and IPPS. Key contributor to year-end audits and annual cost reports. 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.
Overview
21
21
years of professional experience
Work History
Chargemaster/Charge Capture Specialist
St. Jude Children’s Research Hospital
Memphis, TN
08.2022 - Current
- While maintaining organizational adherence to regulations, policies, and procedures related to appropriately billing third-party payers, the Chargemaster Specialist (CMS), under the supervision of the Revenue Integrity Supervisor, maintains the daily workflow approval process to update the Chargemaster while ensuring that the Chargemaster remains compliant with applicable federal and state guidelines, as well as ensuring that the facility Chargemaster is updated and maintained timely, and that accurate charging and coding are reported with patient billing.
- The Chargemaster Specialist will work with the revenue cycle to ensure an efficient front-end CDM process, resulting in clean, compliant claims.
- This position acts as a liaison, problem solver, and facilitator for Charge Description Master (CDM) issues with administration, insurance companies, charge capture departments (charge reconciliation), Health Information Management, Utilization Review, Managed Care, Corporate Compliance, and Revenue Cycle.
- Stays abreast of current regulations and industry charging and billing guidelines for both federal and state regulations.
- Maintains an extensive working knowledge of the revenue cycle process to aid in the implementation of regulatory standards that assist in cash collection, while accurately complying with billing guidelines.
- Ensure all approved requests are entered accurately and in a timely manner into the CDM, and that entries flow to the Patient Accounting system.
- Maintain daily workflow approvals or rejections of these submissions.
- Coordinate with Directors and Managers both within the Revenue Cycle, as well as Clinical Staff and Information Systems, to identify trends and address issues related to claim rejections or payment denials directly associated with billing information generated by the Chargemaster.
- Assist with the standardization process.
- Analyze CDM standard exception reports.
- Performs analyses, identifies trends, and reviews denials from a revenue cycle relating to payer rejections, and incomplete reimbursements resulting from CDM issues.
- Provides the CDM data file to all necessary internal customers on a monthly and as-needed basis.
- Analyze all requests for additions, modifications, and deactivations to the CDM.
- Coordination of ongoing CDM consistency with revenue-producing departments, which includes maintaining accurate descriptions, coding, and revenue code assignments.
- Monitor for HCPCS, CPT changes, and additions, and billing unit rule changes.
- operations.
- Uses billing analysis software to ensure that appropriate charge capture is occurring within departments; identifies systemic issues with missing charges, and works with the appropriate departments on correcting and preventing such issues.
- Develop and maintain policies and procedures relating to clinical billing and reimbursement to enhance adherence to current regulations.
- Collaborates with appropriate departments to implement solutions to address and resolve documentation and clinical billing appropriateness issues, including suggested corrective action plans.
- Collaborates with clinical billing staff regarding matters affecting compliant clinical billing.
- Possesses and maintains a broad-based understanding of CMS and commercial payor mechanisms, and the role that coding and charging play in clinical operations.
- Facilitates meetings to assess charge capture matters and implement corrective action(s) with clearly identified timelines and assignments of responsibilities.
- Performs periodic monitoring to ensure ongoing compliance with billing and charging protocols.
- Tracks and reports to Revenue Integrity management the results of Revenue Cycle enhancement efforts.
- Performed quality assurance reviews of charge data to ensure accuracy of information entered into system.
Revenue Cycle Manager
West Cancer Center
Germantown, TN
11.2015 - 07.2017
- Develop and implement the operational objectives to tenaciously pursue complete, accurate and timely payment of healthcare collections.
- Responsible for the development and implementation of the A/R departmental policies and strategies.
- Provide leadership and direction to the A/R Supervisor and Representatives to facilitate collections.
- Proactively monitor A/R and develop plans/solutions to reduce AR days and decrease aging categories.
- Utilization of practice management software and denial management software to identify non-payment or underpayment trends, lower denials and decrease adjustments.
Chargemaster Consulting
Robert Half and Associates
Germantown, TN
01.2016 - 05.2016
- Analysis of CDM with all departments, including but not limited to appropriate billing of charges, proper assignment of CPT-4, HCPCS and revenue codes and pricing based on a consistent markup of cost / reimbursement in accordance with regulatory requirements and policies.
Senior Coder and CDM Analyst
MEDASSETS
Alpharetta, GA
01.2014 - 01.2015
- Established and maintained professional relationships with assigned Charge Description Master (CDM) customers by providing quality support of chargemaster maintenance, requests for change and billing inquiries.
- Remotely managed daily and quarterly updates to assigned customers’ CDMs, based on most current regulatory guidance.
- Provided documented responses to customers’ billing inquiries helping ensure regulatory guidelines were followed.
- Prepared, reviewed and interpreted detailed CDM exception reports optimizing revenue and ensuring compliance.
- Managed and performed line item CDM review by determining the application and appropriateness of coding, compliance and other regulatory requirements while minimizing potential risks.
- Contributed to the company publications available to all MedAssets’ clients.
Director of Patient Financial Services
JACK HUGHSTON MEMORIAL HOSPITAL
Phenix City, AL
01.2012 - 01.2014
- Established and implemented the operational objectives mentioned below to successfully maintain a complete revenue cycle resulting in a reduction of AR days from more than 60 down to an average of 35-40 gross AR days.
- Used benchmark data to develop a Revenue Cycle Team and monthly scorecard, improving workflow and ensuring strong financial outcome.
- Maintained accuracy rate of 90% with regards to demographics and insurance information entered by Patient Access.
- Implemented a very successful Early Out program which increased patient responsibility revenue by $90K per month.
- Implemented a pre-certification / pre-authorization process involving Case Management, resulting in significant decrease in denials.
- Implemented and managed efficient insurance and patient accounts receivable processes and ensured accounts aging greater than 90 days remained at a rate below 17% with the exception of Medicare RAC claims.
- Implemented automation of EDI 855 files facilitating all cash and contractual adjustments being posted within the same day.
- Performed in-depth review of hospital claims, ensuring reported services / charges were supported by clinical documentation.
- Analyzed and assessed various clinical charging processes and worked with department Directors, developing policies and procedures to optimize charge capture.
- Organized, developed, and documented CDM, billing, and clinical integrity findings and recommendations for Compliance team.
- Participated in various engagements related to revenue cycle, including CDM compliance reviews, charge capture assessments, and outpatient coding, billing, and documentation audits.
- One such example was a review of the Pharmacy formulas within the Patient Accounting system which resulted in an error rate of less than 1%.
- Educated Department Directors on trends and effects of late charges and worked, ensuring all charges were entered within 3 days.
Patient Accounting Manager / Chargemaster
DECATUR GENERAL HOSPITAL
Decatur, AL
01.2004 - 01.2012
- Coordinated with Credentialing to ensure all Provider Enrollment applications were completed and submitted to payer in a timely manner.
- Implemented a charge capture program for Observation records ensuring observation hours, infusions and injection revenue was optimized.
- Directed improved work flow methods and procedures to ensure KPI goals were met.
- Planned and coordinated monitoring and maintenance of CDM with all departments, including but not limited to appropriate billing of charges, proper assignment of CPT-4 and HCPCS codes and pricing based on a consistent markup of cost / reimbursement in accordance with regulatory requirements and policies.
Education
AAPC Certified Professional Coder – CPC-H - Medical Coding
Wallace State
Hanceville, ALElectrical Engineering -
University of Texas at Arlington
Arlington, TXSkills
- HMS and Siemens systems
- Meditech patient accounting
- Microsoft Office suite
- Cerner and Epic billing
- Revenue cycle management
Accomplishments
- Craneware awarded me the cleanest Chargemaster of all their customes.
References
References available upon request.
Timeline
Chargemaster/Charge Capture Specialist
St. Jude Children’s Research Hospital
08.2022 - Current
Chargemaster Consulting
Robert Half and Associates
01.2016 - 05.2016
Revenue Cycle Manager
West Cancer Center
11.2015 - 07.2017
Senior Coder and CDM Analyst
MEDASSETS
01.2014 - 01.2015
Director of Patient Financial Services
JACK HUGHSTON MEMORIAL HOSPITAL
01.2012 - 01.2014
Patient Accounting Manager / Chargemaster
DECATUR GENERAL HOSPITAL
01.2004 - 01.2012
AAPC Certified Professional Coder – CPC-H - Medical Coding
Wallace State
Electrical Engineering -
University of Texas at Arlington
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