TAMMI WILLIAMS
Bellflower,California
Overview
33
33
years of professional experience
1
1
Certification
Work History
Revenue Cycle Analyst/Assistance to Director of Business Office
Alhambra Hospital Medical Center
07.2023 - 03.2025
- Maintained Knowledge of company policies and procedures including ICD9/10, CPT, HCPC codes, Medicare and Medi-cal reimbursement guidelines
- Knowledge and understanding of Division of Financial Responsibility between payers
- Analyzed workflows and understanding policies related to access, billing and claims supported by MEDITECH, FOVEA, PARAGON (EHR) electronic Health record system
- Maintained revenue cycle reports and dashboards
- Compiled, extracted, analyzed denial reports and distributed root cause owners
- Performed data analysis using revenue cycle metrics
- Diverse understanding of revenue cycle operations including patient access, billing, collections, payment/adjustment posting processes and reporting
- Provided thorough data analysis of all A/R behavior, with particular attention to billing, collections, denials management to identify payer trends & patterns
- Compiled data analysis for forecasting and creating trending reports
- Propose possible solutions based on findings
- Worked closely with Revenue Cycle Management, Operations, and Information Systems, ensuring that applications/technologies/workflows function
- Evaluated processes and vendors to determine possible changes needed within Revenue Cycle Operations
- Worked with ancillary departments to educate managers on correct coding, billing, and charging principles
- Analyzed, reviewed daily, weekly and month end financial reports
- Performed financial analysis and record revenue recognition
- Monthly analysis of billing & collections reports to ensure timely billing and maximize collections according to insurance contracts and proactively identify risks and problems impacting hospital cash flow
- Reviewed, analyzed and code diagnostic and procedural information that determines appropriate insurance payments
- Performs analysis of billing/ collections reports to identify trends and implement corrective action items
- Prepared KPI report monthly (ATB reports, Payment reports, DNFB reports, Billing reports, Account Checks report, AR reports
- Submitted yearly reports requested by Auditors (MMCS, OSHPD) upon request
- Assisted staff when needed with claims follow up questions
Provider Service Claims Processing Unit Supervisor
CDSS (California Department of Social Services) / Crystal Stairs, Inc.
Los Angeles, CA
08.2018 - 04.2023
- Mail Room supervision (mail pick up schedule, sorting, scanning) daily
- Incoming claims processing (calculations, returns, holds, and hand-written) daily and monthly
- Create productivity reports, submit stats to staff daily
- Supervise staff on Saturday OT when scheduled monthly
- Prior to export: conduct payment analysis to ensure payment of claims correct
- Export payments (California Department of Social Services Stages 1-3, Bridge funding sources) on-time/end of month as scheduled monthly
- Submitted California Department of Social Services Stage 1 payment information to California Children’s Resource Center portal monthly
- Created / Analyzed Stage 1 exception reports from California Children’s Resource Center to determine root cause for non-payment monthly
- Created /analyzed reports with case management team (authorization issues, missing data entry and incorrect reauthorizations daily to ensure we receive all California Department of Social Services Stage 1-3 Payments with no exceptions
- Monitor Heavy customer service support (front desk walk ins, Mitel Calling Queue Line incoming calls-external/internal daily
- Respond to California Department of Social Services Financial Payment Unit requests for reimbursements (review/submit case management records, previous month’s claims pulled for review etc
- Daily
- California Department of Social Service Stage 1-3 Payment Reconciliation – Created and Analyzed reports of all payments made prior month
- Generation of new claims files for each month (California Department of Services of Social Services Stage 1-3 claims) files sent to outside vendor BDI via portal
- Sent reminder email to the entire Agency of upcoming dates for claims generated
- Unit Trainings: Monthly Payment memo produced for pertinent reminders unique for each claim month (e.g
- Months with holidays = possible prorations) monthly
- Facilitated Department meetings for updates and departmental changes
- Supervision of staff: monitor Mitel calling queue daily, staff check -ins monthly, coaching/training monthly
- Submitted Staff Annual Performance Appraisals
- Attended monthly California Department of Social services meetings regarding Los Angeles County Management Bulletin updates and the budget
- Monthly testing and analysis of CC3 payment applications when system updates occur to ensure bug fixes and upgrades
- Union Provider Payment Inquiries: Analyze/research and create report of root causes/payment resolutions
- Assigned training modules to staff regarding Customer service skills
- Analyze/ Create Calling queue report to determine number of calls received, missed, and transferred monthly
- Submitted KPI’s (Key Point Indicators) to upper management monthly (of claims and dollar amount for each funding source
Project Supervisor
Naviant/Cymetric
Gardena, CA
09.2016 - 02.2018
- Provided assistance/resolution to external/internal clients inquiries
- Prepare reports and logs to determine non-payable and payable claims
- Act as a technical expert regarding financial class responsibility, to answer questions raised by clients and team members
- Maintain a current working knowledge of all healthcare related issues and regulations
- Responsible to report any detected trends, procedural problems to the client recommend resolutions/corrections of the trends and/or problems should also be reported
- Maintain professionalism when interacting with clients
- Analyze and solve problems quickly and thoroughly
- Establish realistic goals and priorities concurrent with organizational objectives
- Adherent to company policies and procedures
- Responsible for reporting violations of company policies and procedures
- Participates in the internal control's self-assessment process
- Ensure concerns with internal control design or performance, process changes that impact control execution are communicated to upper management
Appeals Representative – Managed Care Medical High Dollar Collector
MemorialCare
Fountain Valley, CA
09.2013 - 09.2016
- Work closely with the Business Office Manager to ensure all accounts assigned in my queue are worked and handled in a timely fashion
- Worked closely with payment review Department to ensure accounts are adjusted/written off correctly
- (Saddleback, Orange Coast, Long Beach Memorial, Community Hospital of Long Beach)
- Responsible for over 300- 500 accounts in Epic queue identifying non-commitment payor trends for underpayments/denials
- Reported denials/underpayments (excel spreadsheets) hospital, accounts, charges, # of days aged
- Heavy follow up collection calls to payors to resolve accounts to zero balance
- Prepared and submitted all denial /underpayments appeals
- Follow up on all denials / underpayments to resolution
- Assisted with account projects
- Answer, provide and report payor issues to the Manager on a monthly basis
- Prepare spreadsheets to Manager to implement bulk payment on aged accounts
- Team meeting once a week to discuss payor issues and changes in process/procedures
- Communicate to appropriate departments regarding appeals, issues, implications and decisions
EOB Reviewer/Contracts Coordinator – Temp Agency
Avanti Hospitals
East Los Angeles, CA
04.2013 - 07.2013
- Responsible for 200+ eob’s received daily
- Worked 70- 100 accounts daily reviewing eob’s
- Worked 40-50 accounts with contract issues
- Forward accounts to appropriate collectors for follow up
- Reported daily accounts not paid/ underpaid via spreadsheet to Business Office Director
- Reported monthly to Business Office Director # of accounts denied per contract, hospital and balances
- Submitted adjustments when necessary to resolve the account
- Monthly meetings with Business Office Director to discuss contract issues
- Submitted clinical high dollar appeals to Clinical Nurse
- Reported inpatient clinical appeals to Business Office Director monthly
Appeals Specialist – Temp Agency
Alta Healthcare
Downey, CA
10.2011 - 02.2012
- Showcase query of 1100 or underpaid/ denied Brotman accounts to ensure all accounts were appealed properly and timely
- Provided expertise/general support to teams reviewing, researching, and resolving payor issues
- Analyzes and identifies trends or all appeals/prepare and respond to appeals utilizing showcase query report to track and trend any specific payor issues
- Act as a liaison to payors to communicate specific payor issues
- Responsible for follow up on all appeals until zero balance paid
- Submitted 2n level appeals when needed
- Submitted 1st level clinical appeals to clinical nurse for review
- Responsible for reporting and updating accounts
Lead Collector – Temp Agency
CHW
Burbank, CA
11.2010 - 03.2011
- Responsible for Bad Debt Review
- Train new hires
- Follow up on payor complaints
- Assisted Collectors when needed
- Responsible for reviewing high dollar accounts within 30 days resolution
- Weekly meetings to discuss high dollar issues
- Report on major payor issues to Business Office Supervisor
- Submit/correct adjustments to overlooked accounts
- Assist monitoring staff
Provider Service /analyst (Field)
Arbor Healthcare
Franklin, TN
11.2009 - 11.2010
- Worked closely with Hospital Directors/CEO of various providers to ensure their credit balances were accurate and valid, maintain good relationships to ensure continuous contract with provider in Los Angeles County
- Receive reports from Directors containing credits balances varied
- Report the reason for credit balance to Supervisor
- Report and meet with upper management regarding reason for credit balance discrepancies
- Managed/identified true credit balance via report from various providers
- Monthly report of 10 hospitals from my queue
- Received monthly bonuses for hospitals that reached their hospital receivable goals
Billing /Collection Supervisor
Community Hospital of Long Beach
09.2006 - 05.2009
- Directly responsible for day-to-day operations of the business office
- Assisting/overseeing admitting department
- Total receivables of 65 million in a 200-bed medical center
- Supervising staff of 12 ensuring the department specific processes both internal/external customer’s expectation are met
- Assisted Business office Director with monthly withhold logs for Medi-cal retractions
- Assisted Business office Director with month end process
- Review and Approve charity applications low-income patients
- Set up payment plans for balanced billed patients
- Assisted implementing electronic billing Epremis NDC for both government/ non-government payors
- Restructured business office to meet operational needs to reduce aging and increase cash flow
- Standardized key indicator reports for weekly and monthly operational trends
- Monthly reports (data base created) to track specialty services
- Assisted revenue cycle team to reduce clinical and TAR denials
- Worked closely with Financial Business Analyst on MS4 files
- Assisting of new charge master product Code correct to increase gross revenue, cash flow, and reduce denials
- Review and monitored high dollar accounts
- Reviewed/ monitored monthly productivity reports to track staff progress
- Monthly staff meetings
- Trained new hires
- Reviewed DNFB (dropped not final billed) report to catch issues prior to final billing dropping (inpatient claims particularly)
Billing/Collections Supervisor
Centinela/Freeman/Tenet
Culver City, CA
02.2004 - 09.2006
- Assisted Billing Director with daily operations
- Maintain /complete daily billing reports from health logic billing systems
- Monitor billing staff of 10 employees
- Review/maintain revenue cycle coding report to ensure over 200+ accounts coded correctly
- Review unbilled report to ensure root cause of billing not going out the door
- Prepare revenue cycle coding report to reduce coding issues
- Monitor collection staff of 20 employees
- Approve adjustments daily
- Approve over 200+ accounts payment arrangements
- Conduct monthly staff meetings
- Interview/ train new hires
- Attend monthly department meetings
- Resolve/ assist with patient complaints
- Conducted month end closing of account receivables
- Reviewed high dollar accounts to ensure accurate documentation
- Monitored staff productivity daily
- Monthly staff coaching/counseling regarding productivity
- QA monthly review on account documentation
Appeals/Denials Specialist
Centinela/Freeman/Tenet
Culver City, CA
01.2003 - 02.2004
- Responsible for managing revenue recovery efforts for Managed Care payors
- Appealed eligible accounts within the designated timeframes
- Documented and tracked all on-going issues
- Responsible to follow up over 1700 denials/appeal accounts (Brotman, Centinela, Coastal)
- Ran underpayments reports to identify # of claims and total balance amount using Microsoft Access
- Created Excel spreadsheet to identify outstanding/paid underpayment accounts
- Created Excel payor issue spreadsheets to identify most common payment issues
Non-Government Collection Lead
Centinela/Freeman/Tenet
Culver City, CA
10.2001 - 01.2003
- Responsible for bad debt review and training
- Following up on patient complaints
- Review 1200 high dollar account
- Assist collectors when needed
- Prepare month end account receivable reports for Business Office Director
- Review/finalized/submit adjustments
- Review staff collections queues
- Assist monitoring staff
Collector/UHP Liason
Centinela/Freeman/Tenet
Culver City, CA
04.1999 - 10.2001
- Managing UHP inventory of 1200 accounts
- Review/follow up on over 300+ high dollar accounts
- Conducted monthly meetings with UHP management
- Monitor monthly $650,000 PIP account to ensure open balance accounts are paid
- Submitted excel spreadsheet to identify open balance accounts and credits
- Hand delivered open balance claims to UHP
- Picked up payment from UHP for open balance claims
Senior Managed Care Collector
Centinela/Freeman/Tenet
Culver City, CA
07.1998 - 04.1999
- Responsible to follow up with 1700 managed care accounts
- Aggressive collection calls to payors
- Review/finalize daily adjustments
- Assist Collection Supervisor
- Assist in month end account receivable closing
- Review excel spreadsheet to ensure proper follow up time frames
- Review high dollars daily
- Review/ identify underpayments via excel spreadsheet
Collector
Centinela/Freeman/Tenet
Culver City, CA
08.1992 - 07.1998
- Responsible for 900 accounts
- Heavy aggressive phone collections
- Identify underpayments
- Review high dollar claims
- Assist Admitting Department when needed (patient access, intake)
- Assist Collection Supervisor with month end account receivable closing
- Reviewed excel spreadsheet to ensure proper follow up time frames
Education
High School Diploma -
Woodrow Wilson High
Long Beach, CA06-1983
Skills
- KPI reporting
- Revenue cycle management
- Problem solving
- Communication skills
- Trend analysis
- Attention to detail
- Organization and time management
- Organizational skills
- Analytical and critical thinking
- Analytical thinking
- Decision-making
- Multitasking
- Knowledege of hospital platforms/EHR systems such as Epic,Meditech,MS4,PBar, Cerner, Paragon, Picon, Pathways, Patcom, E-denials, Health logic billing, DSG billing, On-Demand, Meridian,DDE etc
Accomplishments
Employee of the month for 3 months consecutively.
Dedicated employee of the month.
Certification
Certification/ class Microsoft word- Advance
Certification/class Microsoft Excel - Advance
Certifiction /class Microsoft Access- Intermediate
Certification / class Powerpoint
Certifiction / class Outlook
Affiliations
- work out /excersize three times a week.
- Attend first baptist Church
- Yearly donations to Slvation Army
- Participate in Holiday food banks for the homeless
Timeline
Revenue Cycle Analyst/Assistance to Director of Business Office
Alhambra Hospital Medical Center
07.2023 - 03.2025
Provider Service Claims Processing Unit Supervisor
CDSS (California Department of Social Services) / Crystal Stairs, Inc.
08.2018 - 04.2023
Project Supervisor
Naviant/Cymetric
09.2016 - 02.2018
Appeals Representative – Managed Care Medical High Dollar Collector
MemorialCare
09.2013 - 09.2016
EOB Reviewer/Contracts Coordinator – Temp Agency
Avanti Hospitals
04.2013 - 07.2013
Appeals Specialist – Temp Agency
Alta Healthcare
10.2011 - 02.2012
Lead Collector – Temp Agency
CHW
11.2010 - 03.2011
Provider Service /analyst (Field)
Arbor Healthcare
11.2009 - 11.2010
Billing /Collection Supervisor
Community Hospital of Long Beach
09.2006 - 05.2009
Billing/Collections Supervisor
Centinela/Freeman/Tenet
02.2004 - 09.2006
Appeals/Denials Specialist
Centinela/Freeman/Tenet
01.2003 - 02.2004
Non-Government Collection Lead
Centinela/Freeman/Tenet
10.2001 - 01.2003
Collector/UHP Liason
Centinela/Freeman/Tenet
04.1999 - 10.2001
Senior Managed Care Collector
Centinela/Freeman/Tenet
07.1998 - 04.1999
Collector
Centinela/Freeman/Tenet
08.1992 - 07.1998
High School Diploma -
Woodrow Wilson High
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