Manager of Revenue Cycle - Big Bend Hospice
(2017-05)
Oversee and manage entire revenue cycle including billing, coding, collections, and denial management.
- Manage relationships with external vendors for practice management software and clearinghouse vendor.
- Communicate professionally with various payers.
- Manage, develop, and mentor all revenue department staff, including billers and coders.
- Responsible for management and maintenance of billing and practice management software platform as it relates to billing and coding.
- Provide up to date education for clinical, billing, and coding staff on coding and error trends.
- Develops, evaluates, implements, and revises policies and procedures related to billing, coding, reimbursement activities and improvement strategies.
- Reconcile all receivable and revenue reports and work closely with the finance department in the development of the monthly financial statements.
- Manage and update the charge master based on the current CMS fee schedule and negotiated contracts.
- Conduct monthly analysis of Medicare/Medicaid/Third Party Payers.
- Responsible for the generation and management of revenue, patients, visits, and credentialing metric reports.
- Review and resolve issues related to claim generation and rejected/denied billings.
- Commit to the highest level of business and patient confidentiality possible adhering to all HIPAA and security guidelines when accessing and sharing patient information.
- Technical expert for Matrix, Netsmart and RXNT billing systems.
- Stays abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
- Maintains appropriate internal controls over accounts receivable and the revenue cycle management process.
- Monitors accounts sent for collection and reimbursements from insurance companies and other third-party payers.
- Reviews, monitors, and evaluates third party reimbursement and research variances.
- Participates in the development of coding and billing strategies, evaluates processes relative to revenue cycle and make recommendations while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid, Medicare, and specified 3rd Party Payors as well as HRSA or other grantors).
- All other duties as assigned.
Supervisor/ Community Liaison - Webster Wellness Complex, LLC
(2007-05 - 2017)
- Composed and transmit correspondence as requested.
- Filed patient and administrative files.
- Collected co-pays and prior balances.
- Communicated with patients and providers.
- Opened, organized & distributed mail.
- Executed business strategies and tactics to drive growth for the organization.
- Scheduled, canceled, and rescheduled surgical procedures and clinical appointments.
- Verified insurance and verification of patient demographics.
- Retrieved medical records and delivered to appropriate providers or departments.
- Scheduled meetings for all employees; escorts visitors to staff members' offices.
- Composed and distributed inter-departmental (e-mail, documentary and voice) ensuring timely delivery and receipt of important information while at the time maintaining confidentiality.
- Managed & executed recruitment efforts to meet staffing requirements.
- Provided reports on a timely basis.
- Increasing business with current clients/customers and developing new clients/customers for Webster Wellness Complex, LLC.
- Planning and conducting networking activities and events on behalf of Webster Wellness Complex, LLC.
- Completed administrative duties (new hire & termination) in a timely manner.
- Forwarded telephone calls appropriately and followed up on return calls.
- Entered charges, payments, and balancing the day in the computer.
- Performed other duties or special projects as assigned.
