RCM services for Patient Aligned Care Team | Mission-Driven | The Institution as Servant

● Spearheading RCM Operations remotely for a fast-paced dermatology clinic with five locations in NY and NJ, overseeing Front Office Operations, Billing, Coding, Accounts Receivable, Patient Access teams, and Credentialing. Managing a team of 12 direct reports and 8 indirect reports.● Ensuring revenue integrity by closely collaborating with clinicians and on-site staff to implement effective billing and coding practices, and regularly inspecting operations and SOPs to recognize and resolve potentially perilous practices.● Reviewing financial reports daily, analyzing variances, and implementing process improvements with data-driven decision-making and budgeting. Specializing in financial reports such as AR aging reports, Revenue Reports, Forecasting, Denial management report, Payment Variance report, Payer Mix report, and Collections reports.Key Achievements:● Reduced denial rate by 20%, increased clean claim rate by 98%, and increased AR performance margin by 35% by driving operations through a data-driven and root-cause analysis approach.● Saved over 40% in administration costs by identifying opportunities to outsource key processes that accelerated performance while reducing costs for the medical practice through robust budgeting and resource planning.● Ensured revenue integrity and drove a revenue increase of approximately 100K per year.● Presented new business opportunities to C-suite executives by integrating technology with healthcare.● Mentored and assisted 10+ executives in achieving management positions in different organizations.

Boosted growth and retention by developing relationships with key decision-makers. Enhanced the website's credibility and drove traffic by handling SEO and link-building campaigns. Conceptualized and executed a business plan to meet the established quotas by designing a SWOT analysis. Promoted services at conferences and meetings by serving as a representative of the company.● Coordinated SEO and website building that helped to drive 40% more traffic.● Visited over 65% of the healthcare clinics and hospitals to expand the network and promote services.

● Oversaw an onsite team of 60 employees, including AR executives, associate trainees, and the billing team, responsible for managing charge entry, coding, and payment posting. ● Managed payment reconciliations, refunds, and recoupments teams.● Utilized in-depth expertise in appeals to facilitate reimbursements for clients.● Managed Accounts Receivables for clients with a cumulative monthly revenue of $8M+..● Collaborated cohesively with management teams from different verticals (Coding, payment posting, billing, AR) in three distinct locations.● Presented and forecasted weekly financial reviews for clients, providing insights on potential impacts on their monthly revenue goals.

● Managed daily operations of the billing department, overseeing tasks such as claim rejections, denial medical coding, follow-up on accounts receivables, denial management, and appeals.● Handled referrals and authorizations for managed care plans.● Maintained current accounts with aging reports and validated payments, resolving variances by reconciling accounts receivable.● Valued and commended as the most productive team member, achieving 99% quality in Accounts Receivables.● Engaged in continuous learning and recognized as the best employee for addressing claims in Worker's Comp, Auto Insurance, Medicare, and Medicaid.