Yolanda Kelly
Brandon,FL
Summary
Dynamic Revenue Integrity Department Manager at USFTGP with a proven track record in process improvement and team leadership. Expert in EDI claim submission and performance metrics, I foster staff development and enhance operational efficiency, driving significant productivity gains and employee engagement. Committed to strategic planning and continuous improvement in healthcare operations.
Overview
37
37
years of professional experience
1
1
Certification
Work History
Revenue Integrity Department Manager
USFTGP
07.2002 - Current
- Streamlined departmental operations, enhancing workflow efficiency and reducing processing times.
- Led cross-functional teams to implement process improvements, increasing productivity and employee engagement.
- Developed training programs for staff, fostering professional growth and ensuring operational compliance with industry standards.
- Collaborated with other departments to ensure seamless coordination in achieving company-wide objectives.
- Analyzed performance metrics, identifying trends that informed strategic decision-making and resource allocation.
- Maintained a professional work environment by addressing conflicts proactively and fostering open communication among staff members.
- Established clear performance expectations for staff members which led to increased accountability.
- Evaluated employee performance fairly and accurately, rewarding hard work while addressing areas needing improvement.
- Enhanced department efficiency by streamlining processes and implementing time-saving strategies.
- Contributed to the creation of long-term strategic plans that aligned with the company''s overall vision and goals.
- Facilitated team meetings to ensure alignment with organizational goals and to foster open communication.
- Fostered a culture of continuous improvement, leading to notable enhancements in staff performance and morale.
- Oversight of EDI claim submission process, claim form edits, secondary claim submission process, and responsibility for electronic data clearinghouses reports to maximize reimbursement.
Department Liaison Supervisor
UMSA
01.1995 - 06.2001
- Facilitated communication between departments to enhance collaboration and streamline operations.
- Developed and implemented processes to improve stakeholder engagement and satisfaction.
- Coordinated training sessions for staff, enhancing knowledge of policies and procedures.
- Managed project timelines, ensuring alignment with strategic goals and objectives.
- Maintained up-to-date knowledge of industry trends, sharing insights with colleagues to drive continuous improvement efforts.
- Maintained a high degree of professionalism at all times, representing the organization with integrity in both internal and external interactions.
- Collaborated closely with department heads to identify opportunities for process improvement initiatives.
- Solved conflicts and addressed issues that occurred between other entities and business.
- Acted as the liaison between upper management and staff members, promoting positive working relationships built on trust.
- Collected and analyzed data and feedback to identify opportunities to improve relationship between other entities and business.
- Aided in the development of training materials, contributing to the ongoing education of team members and improved performance outcomes.
- Proactively identified potential challenges or roadblocks within projects, formulating contingency plans to ensure success.
- Developed effective improvement plans in alignment with goals and specifications.
- Conducted regular reviews of operations and identified areas for improvement.
- Oversaw daily operations, ensuring adherence to safety protocols and efficiency standards.
- Analyzed performance metrics to identify areas for improvement and drive operational excellence.
- Generated reports detailing findings and recommendations.
Medical Coder
UMSA
10.1988 - 12.1994
- Reviewed and analyzed patient records to ensure accurate coding and compliance with regulations.
- Collaborated with healthcare providers to clarify documentation and coding discrepancies.
- Trained junior coders on best practices for coding accuracy and regulatory requirements.
- Implemented coding audits to improve accuracy and reduce claim denials.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Ensured industry regulations and guidelines complianceby staying up-to-date on the latest coding changes.
Education
High School Diploma -
East Bay High School
Riverview, FL06-1979
Skills
- Customer service
- Staff management
- Team leadership
- Team supervision
- EDI Claim Submission
- Performance metrics
- ICD-10 and CPT Coding
- Process improvement
- Workforce coordination
- Strategic planning
- CPC Certified
- Problem-solving
- Training and mentoring
- Task delegation
- Decision-making
- Goals and performance
- Work planning and organization
- Personnel training and development
- Staff development
- Coaching and mentoring
- Relationship building and management
- Employee scheduling
- Motivational leadership
- Staff hiring and retention
- Workflow coordination
- Employee management
- Employee performance evaluation
- Operations management
Certification
CPC Certification
Timeline
Revenue Integrity Department Manager
USFTGP
07.2002 - Current
Department Liaison Supervisor
UMSA
01.1995 - 06.2001
Medical Coder
UMSA
10.1988 - 12.1994
High School Diploma -
East Bay High School