Deborah Ruffin, Mba, Cmrs, Wip Email & Phone Number

Cleveland, Oh, Us

Responsible for overseeing and coordinating all revenue activities with a goal of maximizing reimbursement in a cost-effective manner that’s in compliance with federal, state and payer-specific billing requirements. Reviews, designs, and implements processes surrounding billing, third party payer relationships, compliance, collections and other financial analyses to ensure that all revenue cycle functions are effective and properly utilized. Tracks and analyze metrics related to billing discrepancies as well as monitors payment reimbursements; including coding error issues, rates and billing turnaround times to develop sound revenue cycle analysis and reporting. Manages relations with payers and providers to generate high reimbursement and a low level of denials. Creates specific training and development needs for departments and staff as well as evaluates the effectiveness of the training. Also serve as a workplace consultant that will assist other departments when needed.

Cleveland/Akron, Ohio Area

Private agency providing educational, rehabilitative, preventive, and support services for blind and visually impaired individuals in the greater Cleveland area.•Responsible for maximizing revenue throughout the agency. Within 1 year promoted from Central Authorization Billing Administrator to Revenue Cycle Management.•Accountable for the technical capabilities of the Central Billing systems and assist departments in specific revenue procedures when dealing with the State of Ohio and School Districts.•Rebuilt trust and client relationships through responding to concerns, solving problems and providing outstanding customer service.•Oversee all billing function and receivables for the Low Vision Clinic.•Monitor effectiveness of collection efforts and make recommendations•Maintain credentials (CAQH) for the Low Vision Optometrist staff and Occupational Therapist •Review Health Insurance panels•Serve as a subject matter expert to Medicare, Medicaid and Commercial Insurance•Making sure that compliance are being following (i.e. Meaningful-use, Functional Limitation, Reporting) •Assist with training of staff regarding Medical Billing*Training staff on Verification and Eligibility Procedures*Develop Billing and Intake Procedures

Cleveland/Akron, Ohio Area

University Heights, Oh

Marbury & Associates, comprehensive mental health services is a private practice located on the border of University Heights and, South Euclid, Ohio both are suburbs of Cleveland.*Ensure claims are entered and submitted with 48 hours of receipt. Accurately apply payments to patient accounts•Post and reconcile insurance and patient payments. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts•Insure accuracy of insurance claims. Verify correct ICD-9 and CPT codes for a variety of specialties•Transition software over to new ICD-10 format•Set-up practice management software for submission of electronic claims to clearinghouse. Work with clearinghouse to resolve file compatibility issues•Send secondary claims upon processing of primary insurance.•Follow up on Insurance and patient aging. Re-submit insurance claims as necessary. Knowledgeable in timely filing restrictions

Eastlake, Ohio

Working as an evening Adjunct-Instructor I have a wonderful opportunity to facilitate to mostly nontraditional students that are returning to college or coming to college for the very first time.Field of Study – MA & MAA Courses as Business and Marketing CoursesCourse(s):Healthcare Remibursment, Advance Medical Billing and Marketing/BusinessBoth on-ground & online.

Brecksville, Ohio

Home Health Care, Infusion Therapy and Pharmacy Provider*Review system-generated AR reports and payer explanation of payments to identify delinquent client accounts for Home Health and Infusion claims*Responsible for resolving UB04, CMS1500 claims for major Insurance Carriers*Successful in investigating delinquent accounts/denials to determine accuracy of AR, and determine a collectible balance, *Contacted payers on collectible accounts. *Collected outstanding receivables in a timely manner to reduce bad debt and keeping AR under 120 Software: Xpeditor, Emdeon, Availity, Connex, HomecareNet, Mitis Portal and Novologix

Responsible for analysis and reconciliation of commissions and the reporting of the data obtained. Along with improving accounts receivables; focusing on resolution of discrepancies and issues that arises on a daily basis.•Dramatically reduced the monthly reconciliation process; this generated approximately $15,000 in extra revenue.•Decreased account discrepancies with major auto insurance companies; resulted in collecting nearly $50,000 in additional funds during the regular A/R cycle.

Independence, Ohio

Online & On-ground positionsCourse(s): MGT001 Mgmt Supervision, MGT344 Org. Behavior & Ethical, MGT426 Managing Change in the Workplace•Responsible for facilitating Organizational Behavior courses•Complete and submit attendance, grades and other required documentation and/or correspondence in a timely manner •Plan, prepare and deliver classroom lectures

Recruited to spearhead turnaround of underperforming credit operations in the North East Division of this international distributor of electrical and datacom parts and supplies.•Responsible for driving credit performance levels in 3 New York branches as well as Wellington Pennsylvania with total accounts receivable responsibility of $7.5MM; travel monthly•Successful in decreasing DSO from 80 to 48 within 7 months and continue to spearhead operational improvements to decreaseI really enjoyed working at Rexel, due to the company merger which resulting in relocation of division

Joined initially as Reimbursement Specialist and promoted to Special Projects within three months. Accountable for training support staff and supervisory team and driving productivity enhancements.*Reorganized Boston, Massachusetts Medicaid billing, in the Cleveland office*Selected to reorganize BCBSMA billing and compliance areas; operational improvements resulted in substantial revenue growth*Successfully met company’s TQM standards and earned bonus levels monthly*Decreased Accounts Receivable 50%.*Spearhead Long-term Care project - successful in increasing private pay collections by 55%, processing and collecting a backlog of old Medicaid fees and implementing structured practices to maintain a positive cash flow and collect $150K+ weekly. *Assist with preparation of Medicaid applications; worked closely with Long-term Medicaid Unit

Mba, Management

Bachelor Of Science, Business Administration; Management Specialization