Yatice Cooper
Dallas,TX
Summary
Accomplished Revenue Cycle AR Manager with a proven track record at NurseCore, enhancing financial performance and compliance across healthcare settings. Expert in AR audits and strategic planning, coupled with outstanding leadership and problem-solving abilities. Achieved significant improvements in revenue optimization and process efficiencies, leveraging expertise in AR billing and team development.
Overview
19
19
years of professional experience
Work History
CP-Senior Manager PFS HH & Hospice
AdventHealth
05.2024 - Current
- Manages the day-to-day operations of the home health and hospice insurance verification, authorizations, billing, and collections.
- Monitors and manages the revenue cycle metrics for home health and hospice branches related to billing and collections, including days in AR. reduction, improved cash collections, reduced aging, and fewer denials.
- Responsible for monitoring and mentoring of PFS Managers and assistance with escalated issues.
- Monitors billed and unbilled claims to ensure timely submission of claims.
- Manages AR aging and cash collection to ensure financial targets are met while working to reduce the level of AR write-offs and bad debt.
- Assists in analyzing financial trend reports in areas of adjustment reasons, denial reasons, billed claim totals, accounts receivable, held revenue, and late or retro charges to business units to expedite the revenue cycle.
- Coordinates training for PFS staff on all departmental policies and procedures.
- Ensures all billing tasks are performed in adherence with CMS regulations and compliance for Federal payers and adherence to system contract terms for other 3rd party payers.
- Supports the PFS Director with assigned projects and tasks and other duties as assigned.
- Coordinates with Managed Care on updates to payer projects and payer contracts and new builds in Epic.
- Coordinate and present Home Health and Hospice slide presentations monthly for the Revenue Cycle Council.
AR Billing Manager
NurseCore
02.2018 - 05.2024
- Oversaw daily operations of home health & hospice services Revenue Cycle Department, implemented strategic plans for departmental efficiency, managed recruitment, onboarding, training processes and new hire training, and facilitated organizational change
- Conducted regular audits, managed payroll, billing and collections processes along with denials management and appeals and collaborated with clinical directors on documentation standards
- Acted as point person for billing-related inquiries to assist various departments
- Provided training on coding updates, changes in billing guidelines, clearinghouse and EDI rejections and new software applications
- Identified and fixed issues with EDI transmittals to payers and from payers thru835's,837's,277's
- Familiar with810,820,855,856,864,997's for purchase orders transmittals for vendor office supplies etc
- Conducted AR team meetings discussing current and past AR needs and or concerns
- Handled monthly report submissions to COO and VP reporting dept
- Overall monthly numbers for month end close
- Performed root cause analysis for denials received from insurance companies or other payers
- Conducted regular audits of financial records to identify errors or inconsistencies in data entry or documentation
- Built relationships with internal departments such as clinical staff and finance department to ensure smooth workflow
- Coordinated with IT personnel to troubleshoot technical issues related to billing software systems
- Managed accounts receivable aging report ensuring accurate reconciliation of all transactions
- Collaborated with third-party payers to resolve payment discrepancies and ensure timely reimbursement
- Ensured compliance with federal and state regulations for health care reimbursement policies
Regional AR Billing Manager
Buckner International
12.2015 - 02.2018
- Oversaw daily operations of home health & hospice services Revenue Cycle Department, implemented strategic plans for departmental efficiency, managed recruitment, onboarding, training processes and new hire training, and facilitated organizational change
- Performed root cause analysis for denials received from insurance companies or other payers
- Conducted regular audits, managed denials and appeals processes, payroll, billing processes, and collaborated with clinical directors on documentation standards
- Assisted with billing and EDI transmittals thru clearinghouse
- Conducted AR team meetings discussing current and past AR needs and or concerns
- Handled monthly report submissions to COO and VP reporting dept
- Overall monthly numbers for month end close
- Provided training on coding updates, changes in billing guidelines, and new software applications
- Conducted regular audits of financial records to identify errors or inconsistencies in data entry or documentation
- Built relationships with internal departments such as clinical staff and finance department to ensure smooth workflow
- Coordinated with IT personnel to troubleshoot technical issues related to billing software systems
- Managed accounts receivable aging report ensuring accurate reconciliation of all transactions
- Collaborated with third-party payers to resolve payment discrepancies and ensure timely reimbursement
- Ensured compliance with federal and state regulations for health care reimbursement policies
AR-Billing Manager
Pinnacle Anesthesia
08.2007 - 12.2015
- Managed the Corporate Skilled Nursing Facility Billing department, developed and maintained departmental policies and procedures, facilitated interdepartmental collaboration, and provided coaching and training to staff on billing processes and collections
- Investigated billing errors or discrepancies reported by providers or patients and with billing of claims, invoices and purchase orders thru the clearinghouses and EDI transmittal responses
- Analyzed reimbursement policies and procedures to ensure compliance with state, federal and other regulatory requirements
- Researched new payment models such as value-based care initiatives that can be implemented in order to improve reimbursements
- Assisted in developing annual budgets based on projected revenue from reimbursements
- Collaborated with various departments within the organization to resolve issues related to reimbursements
- Negotiated contracts with insurance companies while ensuring that all legal requirements are met
- Managed complex projects requiring multiple resources from different functional areas within the organization
- Performed detailed reviews of claims to identify potential problems or discrepancies
- Oversaw the analysis of accounts receivable (AR) to identify negative trends, conducted comprehensive training for clinical associates on billing practices and regulations, facilitated the resolution of Medicare, Medicaid, and Workers' Compensation claims issues, and maintained compliance through regular HIPAA training sessions and coordination with EDI and clearinghouses
- Coordinated with external vendors regarding invoice processing, rate negotiations, contract renewals
- Identified opportunities for cost savings through analysis of current reimbursement rates
- Conducted periodic audits of accounts receivable data for accuracy and completeness of information
- Investigated billing errors or discrepancies reported by providers or patients
AR Reimbursement Supervisor
SNF-Senior Care Centers
09.2005 - 07.2007
- Performed detailed reviews of claims to identify potential problems or discrepancies
- Utilized knowledge of medical coding systems to audit reimbursement data and process adjustments accordingly
- Maintained up-to-date knowledge of industry standards, regulations, best practices, trends, and changes related to reimbursement management
- Provided training and guidance to staff on proper claim submission methods according to payer guidelines
- Developed strategies for improving collections efficiency while minimizing denials due to incorrect coding
- Created metrics tracking system for monitoring payments from third-party payers against contractual agreements
- Managed a team in accounts receivable, maintained compliance with Days Sales Outstanding (DSO) targets, facilitated cash flow by coordinating with the Cash Department, and partnered with the clinical team to verify the integrity of Resident Utilization Group (RUG) data in system records
Education
Lean Six Sigma White Belt - Project Management
Aveta School of Business
Dallas, Tx03.2012
Bachelor's - Healthcare Administration
University of Phoenix
01.2012
Nursing
El Centro College
08.1996
Skills
- Revenue Cycle Management
- AR Audits
- AR Billing
- EDI Transmittals
- Billing Procedures
- Regulatory Compliance
- Strategic Planning
- Financial Performance Improvement
- Revenue Cycle Training
- Provider Enrollments
- Revenue Optimization
- Performance Metrics
- Staff Training
- Conflict Resolution
- Claims Management
- Team Leadership
- Denial Resolution
- Cash Flow Management
- Account Reconciliation
- Medical Billing
- Healthcare Industry Knowledge
- Process Improvement
- Software Proficiency
- Data Analytics
- Problem Solving
- Denials Management
- Medical Collections
PROFESSIONAL OVERVIEW
Seasoned Revenue Cycle Director with a25-year track record in revenue cycle management and regional billing activities in various healthcare sectors, seeking to leverage extensive experience in AR audits, Medicare cost reporting, and strategic planning. Expert in leading teams, developing and managing physician practices, overseeing front-end operations and achieving KPIs in billing and collections. Renowned for driving revenue performance, monitoring service level indicators, and reaching revenue cycle objectives. Proficient in operations management, generating revenue cycle reports, showcasing healthcare industry knowledge, implementing revenue cycle improvements, and enhancing analytical skills. Skilled in conflict resolution and team management. Conducted AR team meetings discussing current and past AR needs and or concerns. Handled monthly report submissions to COO and VP reporting dept. overall monthly numbers for month end close.
Timeline
CP-Senior Manager PFS HH & Hospice
AdventHealth
05.2024 - Current
AR Billing Manager
NurseCore
02.2018 - 05.2024
Regional AR Billing Manager
Buckner International
12.2015 - 02.2018
AR-Billing Manager
Pinnacle Anesthesia
08.2007 - 12.2015
AR Reimbursement Supervisor
SNF-Senior Care Centers
09.2005 - 07.2007
Lean Six Sigma White Belt - Project Management
Aveta School of Business
Bachelor's - Healthcare Administration
University of Phoenix
Nursing
El Centro College
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