Katherine Lugo

Detail-oriented Healthcare Analyst with 9+ years of experience driving revenue integrity and operational efficiency across hospital systems. Known for transforming complex data into actionable insights that improve billing accuracy, reduce revenue leakage, and support compliance. Adept at bridging clinical and financial workflows to streamline charge capture and enhance reimbursement outcomes.

Trusted collaborator across Revenue Cycle, Finance, and IT teams, with a passion for solving problems before they become trends. Brings a proactive, systems-savvy approach to improving healthcare performance from the inside out.

Healthcare Analyst - WakeMed Health and Hospital - Raleigh, NC (Remote)

(2017-08)

WakeMed Health and Hospital is a 1,003-bed healthcare system with multiple facilities located around the metropolitan area. Level I Trauma Center as designated by the North Carolina Office of Emergency Medical Services.

• Ensured accuracy of CPT/HCPCS codes, descriptions, and pricing to maintain compliance with billing regulations.
• Analyzed billing data to identify missed revenue opportunities, enhancing reimbursement accuracy by 15%.
• Collaborated with cross-functional teams, including physicians and IT, to validate charges and improve documentation processes.
• Developed and delivered training sessions on charge capture processes, fostering a culture of compliance and accuracy.
• Led charge capture analyses to uncover trends, gaps, and billing inconsistencies, contributing to a 15% boost in overall revenue capture through targeted corrective actions.
• Maintain the integrity of the Chargemaster by conducting annual reviews, regulatory updates, and real-time audits, ensuring billing compliance and minimizing reimbursement risk.
• Collaborate closely with Revenue Cycle, Finance, and clinical teams to develop dynamic trending tools and predictive models that support strategic decision-making and revenue forecasting.
• Implement customized system builds and test scripts that proactively prevent billing errors, reducing downstream corrections and enhancing operational efficiency.
• Translate CPT coding and CMS regulatory updates into actionable guidance for clinical departments, simplifying compliance and supporting timely revenue recognition.
• Guide process improvements by auditing charge workflows and addressing breakdowns, leading to a 20% decrease in charge entry errors and improved departmental coordination.
• Serve as a go-to resource for developing and documenting system enhancements, bridging the gap between IT and clinical operations to support continuous process optimization.
• Use data storytelling to drive awareness around revenue performance trends, equipping leadership with the insights needed to act quickly and mitigate financial risk.
• Perform manual charge corrections (CPT/HCPCS, modifiers, revenue codes, units, amounts, service dates, department/location routing, coverage-related details).
• Conduct root-cause analysis on recurring or department-specific charge issues; document patterns and communicate findings to cross-functional project teams.
• Manage ServiceNow tickets with consistent SLA compliance; resolve charge discrepancies, routing failures, missing/duplicate charges, charge capture inconsistencies, and department-specific billing errors.
• Document testing results (pass/fail, screenshots, notes) and share outcomes with cross-functional project teams.
• Support revenue integrity by validating post-fix routing behavior and ensuring alignment with billing and CDM requirements.
• Review Epic Hospital Billing (HB) workqueues daily, identifying and correcting charge errors across inpatient accounts to improve billing accuracy and clean-claim readiness.

Patient Business Specialist - Advent Health Orlando - Orlando, FL

(2014-07 - 2017-07)

• Leveraged a keen eye for data accuracy while registering patients across multiple service lines, laying the foundation for cleaner claims and reducing downstream billing errors by 15%.
• Interpreted complex insurance policies and translated them into actionable financial guidance for patients, directly contributing to a 10% boost in point-of-service collections.
• Took initiative to partner with payers and internal departments, proactively resolving pre-authorization issues and coding discrepancies, which decreased claim denials by 20%.
• Played a key role in maintaining data quality by validating patient demographics and coverage details at intake, supporting more reliable charge entry and smoother revenue cycle operations.
• Educated patients on insurance benefits and financial obligations using language tailored to their level of understanding, which improved satisfaction scores and minimized billing confusion.
• Drove process improvements by identifying trends in authorization delays and denial patterns, sharing findings with leadership to inform workflow adjustments and payer communication strategies.
• Consistently documented detailed memos and account notes, which not only supported billing integrity but also enabled faster issue resolution and improved audit readiness.
• Collaborated across clinical and administrative teams to ensure that financial assessments aligned with clinical services rendered, helping safeguard institutional revenue and compliance.
• Reduced claim denials by identifying authorization and payer discrepancies and communicating corrections proactively.
• Supported revenue cycle operations through detailed account documentation, patient financial guidance, and charge-related issue resolution.

Bachelor of Business - Healthcare Administration - University of Mount Olive (2026-05)

Associate in Applied Science - Medical Office Healthcare - Wake Technical Community College