Detail-oriented Revenue Cycle Specialist with a systematic nature and good grasp of billing processes. Successful planner and problem-solver. Ready to apply 8 years' experience and take on a challenging role.Developing, monitoring, coaching, and managing staff, ensuring the development of my employees through orientation, training establishing objectives, communication of rules & providing constructive discipline. Able to work with a team or individually with excellent communication skills, and ability to meet deadlines in a fast-paced work environment. Skilled at assessing client needs, working in groups, suggesting ideas that enhance efficiency and maximize performance, implementing technology solutions, and training /supporting end users. Strong Communication & Management skills with Excellent Role-playing capabilities. Establish and maintain contact with Patients, Hospitals, Physicians, Case Managers, and Insurance companies to ensure proper billing occurs. Prepare financial Reports and review Financial Data Utilizing Mind scripts Have extensive experience with medical billing, coding and collections, invoicing accounts, and adjustments.
Hi, I’m
Victoria Deleon
LagoVista,Tx
Summary
Overview
9
years of professional experience
1
Certification
1
Language
Work History
Robert Half AgencyLago Vista, TX
Medical Revenue Cycle Specialist
08.2022 - 06.2023
Job overview
- Evaluated key performance indicators to meet and maintain service level expectations for assigned teams.
- Maintains detailed knowledge of state and federal regulations applicable to assigned areas of responsibility.
- Ensures that current processes are reviewed and updated to meet regulatory requirements.
- Communicates effectively and professionally to all levels within the organization and escalates information to Leadership and internal/external Customers.
- Identifies trends or issues and provides possible solutions.
- Actively participates in PFS projects and system upgrades.
- Has the ability to troubleshoot complex application or operational related issues.
- Takes a broad view when approaching issues using a global lens.
- Has the ability to maintain performance working with tight deadlines.
- Has the ability to work independently and make sound and timely decisions based on experience, facts and process guidance.
- Collaborate with peers and leadership.
- Excellent analytical skills with the ability to spot trends and opportunities.
- Good technical aptitude working with a variety of MS Office products (Word, Excel, PowerPoint, Outlook) and/or ability to learn and develop more advance skills with the various applications.
- Excellent verbal and written communication skills, strong listening skills, critical thinking and analytical skills, problem solving skills, ability to set priorities and multi-task. Ability to communicate with multiple levels in the organization (e.g. associates, leaders, physicians, clinical and support staff).
- Excellent organizational skills including effective time management, priority setting and process improvement.
- Has in-depth knowledge and ability to maneuver efficiently through Healthcare EMR and support systems etc. Strong understanding of systems from an end-user and technical perspective.
- Ability to maintain strong relationships and work collaboratively to positively affect outcomes.
- Assertive and diplomatic communication, proven ability to function on a multidisciplinary team.
Evin’s Personnel Consultants
Human Resources Recruiter
06.2020 - 06.2022
Job overview
- Design and implement overall recruiting strategy, adjusting as necessary with an eye toward best practices
- Prepare recruitment materials and post jobs to appropriate sites and venues
- Plan, market, conduct and attend hiring events as needed
- Source and recruit candidates through various schools, programs, sites and media
- Administer all recruiting efforts to include screening, interviewing, skills testing, extending offers, coordinating pre-employment screening, new hire paperwork, employment verification and onboarding of all new employees
- Maintaining all personnel, benefits, and training files, in accordance with compliance and HR/legal best practices and in accordance with the Employee Handbook
- Assisting with benefits administration including the 401k plan, worker’s compensation, group health insurance and COBRA insurance
- Processing terminations, revoking systems access, and conducting exit interviews
- Manage the internal employee job bid process in compliance with the current collective bargaining agreement
- Conduct HR presentations such as new employee orientations and other training classes
- Track and maintain accurate position and headcount data at all times
- Complete weekly reporting of staffing, turnover/retention.
CONIFER HEALTH SOLUTIONS
Operations Performance Analyst
06.2019 - 05.2020
Job overview
- Gather, interpret, and translate customer needs and translate business problems into requirements that facilitate application development
- Analyze and assess data and product performance to identify issues and ensure appropriate prioritization and compliance with service level agreements
- Build reporting solutions and develop/enhance existing scorecards, dashboards, and other key reports that will be utilized by management to monitor performance and communicate performance to the client
- Develop and maintain standards to measure the effectiveness of all aspects of the revenue cycle, including statistical data for monthly reports (denial reports, late charge reports, etc.)
- Integrate and analyze data from multiple data sources, determine root cause; summarize and prepare monthly materials for discussions with client and finance teams
- Audit and analyze data to verify quality and data integrity
- Provide feedback regarding issues and/or anomalies found during analysis to ensure proper communication both internally and externally
- Serve as resource for special projects and priority assignments as needs are identified during the analysis process
- Prioritize and manage multiple tasks to meet deadlines.
CONIFER HEALTH SOLUTIONS
Billing Supervisor-Hospital
09.2018 - 05.2019
Job overview
- Gather operational and workflow requirements to document, implement and monitor workflow processes
- Identification of root cause(s) of workflow/process incident management
- Creation of designed and approved processes, enhance the automation of the technical workflows, and provide monitoring/stabilization of current business processes
- Identify critical process opportunities for enhancement and propose tangible solutions to avoid repeatable errors
- Document detailed technical design for workflow automation, end user documentation and job aids
- Complete special projects and provide project support as requested by senior leadership.
CONIFER HEALTH SOLUTIONS
Supervisor A/R Collections-Hospital and Appeals
08.2016 - 08.2018
Job overview
- Responsible for all aspects of the day-to-day supervision and leadership of Patient Account Representatives, including but not limited to the Performance Management metrics of collections, productivity, quality, and aging
- Interview candidates and make hiring recommendations and decisions
- Complete monthly quality evaluations
- Monitor staff scheduling and adherence to time and attendance protocol
- Responsible for all aspects of A/R Management, including but not limited to maintaining workload balance, ensuring maximum efficiency, eliminating rework, and reducing cost
- Promptly identify issues and develop action plans to mitigate or resolve
- Train, develop, motivate, and assist subordinates in reaching new levels of skills, knowledge, and attitude
- Effectively maintain a work environment which stimulates and motivates the morale, engagement, and growth of Team
- Identify performance deficiencies and opportunities and implement action plans as needed
- Review and respond timely to requests, including emails, telephone calls, issues, account research and resolution as needed by staff, management, and clients
- Timely completion of accounts referred to the Supervisory Desk by staff or management
- Effectively communicate and interact with subordinates, management, and clients
- Conduct, attend and participate in meetings, conference calls and training sessions, including Management Meetings, Team Meetings, as well as one-on-one monthly meetings with subordinates to provide consistent performance feedback
- Complete the mid-year and year end Performance Management review.
Team Lead A/R Collections-Hospital and Physician Accounts
06.2015 - 07.2016
Job overview
- Responsible for all aspects of insurance follow-up and collections, including making telephone calls, accessing payer websites
- May maintain a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged
- Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary
- Accurately and thoroughly document the pertinent collection activity performed
- Review the account information and necessary system applications to determine the next appropriate work activity
- Verify claims adjudication utilizing appropriate resources and applications
- Initiate telephone or letter contact to patients to obtain additional information as needed
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers
- Edit claims to meet and satisfy billing compliance guidelines for electronic submission
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Proactively identify issues or trending and provide suggestions for resolution
- Aid in coaching and training to staff members, including new hires
- Provide enhanced training and assist staff with techniques to increase production, quality, and collections
- Participate in the new hire peer interviewing process
- Assist in special projects assigned by management.
A/R Collections- Ambulatory and Hospital Accounts
06.2014 - 05.2015
Job overview
- Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys, and team members as needed
- Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions
- Access payer websites and discern pertinent data to resolve accounts
- Utilize all available job aids provided for appropriateness in Patient Accounting processes
- Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account
- Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
- Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities
- Provide support for team members that may be absent or backlogged.
Education
Abilene High School
High School Diploma
University Overview
Skills
- Project management
- Staff management
- Communication skills
- Meeting deadlines
- Client needs assessment
- Group work
- Efficiency enhancement
- Technology solutions implementation
- End user training and support
- Financial reporting and analysis
- Medical billing, coding, and collections
- Coordinating with cross-functional teams
- Employee management and onboarding
- Windows server operating systems
- Microsoft Office
- NextGen
- Kareo
- Crystal
- Medi Touch
- MedAssets
- Citrix
- Paragon
- Epremis
- Cerner
- Ace
- Epic Hyperspace
- Allscripts
- Avionte
- Bullhorn
- Taleo
- Kronos
- SETR
- Workday
- HRIS
- MS Word
- MS Excel
- Power Point
- Healthcare management
- Human resources
- Talent acquisition
- Analytical Problem Solving
- Revenue Cycle Management
- Comparative analysis
- Business Forecasting
- Trends Analysis
Certification
- Epic Certified
Languages
Spanish
Full Professional
References
References
References available upon request.Work Preference
Work Type
Full TimeWork Location
HybridRemoteImportant To Me
Company CultureCareer advancementPersonal development programsFlexible work hoursWork-life balanceStock Options / Equity / Profit SharingPaid sick leaveAdditional Information
Additional Information
Bringing innovation and process implementation to improve company culture, strengthen the efficiency of employee retention and automating training and education for workflow efficiency.
Timeline
Medical Revenue Cycle Specialist
Robert Half Agency
08.2022 - 06.2023
Human Resources Recruiter
Evin’s Personnel Consultants
06.2020 - 06.2022
Operations Performance Analyst
CONIFER HEALTH SOLUTIONS
06.2019 - 05.2020
Billing Supervisor-Hospital
CONIFER HEALTH SOLUTIONS
09.2018 - 05.2019
Supervisor A/R Collections-Hospital and Appeals
CONIFER HEALTH SOLUTIONS
08.2016 - 08.2018
Team Lead A/R Collections-Hospital and Physician Accounts
06.2015 - 07.2016
A/R Collections- Ambulatory and Hospital Accounts
06.2014 - 05.2015
Abilene High School
High School Diploma
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