Revenue Cycle Operations Management Healthcare Professional with 15
years experience
PERFORMANCE PROFILE
Revenue Cycle Operations Management Healthcare Professional with 10 years experience performing operational assessments of financial and clinical departments with a focus on documentation and coding, revenue capture, care delivery and quality reporting. Experienced establishing
relationships with department heads and serving as subject matter expert on analytics and revenue generation.
PROFESSIONAL COMPETENCIES
In depth knowledge of federal, state, managed care reimbursement, regulatory provisions, policy development, and governmental audits * Experienced in the following revenue cycle functions: Physician Billing, Hospital Billing (including Article 28), Patient Access and Admitting, Charge Integrity, Coding Guidelines Denials Management and Recovery, Patient Accounting, and/or Patient Financial Services, Medical Record Documentation, Clinical Documentation, Managed Care * Exceptional interpersonal skills demonstrating the ability to gain the confidence and respect of senior executives and accustomed to taking an active role in executing engagements Finance, Cost Analysis, Project management skills, Charge Master(CDM), EMR, Charge Capture, Claims Processing, Unbilled, Denials, Reimbursement Methodologies, Managed Care Contract, Root Cause Analyses and Solutions, ICD, Current Procedural Terminology (CPT), Alpha Numeric Healthcare Common Procedure Coding System (HCPCS), Diagnosis Related Groups (DRGs), Ambulatory Payment Classification codes (APCs), Revenue Codes, Medical Billing, Medical Coding, Appeals, RBRVS, Commercial, Medicare, Medicaid & 3rd Party Payors, New York State and Medicare Fee-For-Service (FFS) reimbursement policies, Workflow processes, Medical necessity
TECHNOLOGICAL SKILLS
EPIC Hospital Billing(HB) Resolute, Craneware Toolkit , MedAssets CodeCorrect, AllScripts EPSi, Tableau Analytics, PowerPivot, Microsoft SQL Server, VBA, Microsoft Word/ Access /Excel/ PowerPoint/ Project/ Visio, SPSS, Oracle