Jane Padillo, Ccs, Cpc Email & Phone Number

Austin, Texas, US

• Conducts complex data analysis & interpretation in a fast-paced team environment using Snowflake (SQL), Python, Power BI, Microsoft Excel, Google Suite and other business intelligence tools with data from a myriad of.
• Ideates, designs and builds data models in Snowflake (SQL) & Power BI from ground up, empowering stakeholders to make data-driven decisions and subsequent project implementation
• Identifies opportunities for process improvements, converts those into actionable revenue-driving projects & implements aforementioned projects to completion
• Automated revenue cycle processes (e.g. API development, web scraping, PDF manipulation for MR/appeal packet compilation and automated faxes), and scaled up by onboarding & co-managing an RCM automation team of.

Austin, Texas, US

• Responsible for driving performance in operations related to reimbursement, conducting data analysis and providing direction and oversight of processes impacting revenue and payor contracts
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function
• Works closely with cross-functional teams to oversee operations activity and tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met
• Develops key metrics, workflows, trends, and performance improvement opportunities and leads weekly meetings to review aforementioned items

Los Angeles, CA, US

• Interviewed medical coding candidates
• Provided team members with coding guidance and instruction on more difficult & atypical reports

Los Angeles, CA, US

• Abstracted from medical reports, utilizing extensive knowledge of CPT codes, ICD-10, ICD-9 & HCPCS as well as varying payer coding guidelines
• Performed rigorous claims and medical records analysis to optimize reimbursement
• Authored payor appeal letters after reviewing and obtaining peer-reviewed journal citations and physician approval, resulting in a 95% denial overturn success rate
• Functioned as coding educator and coding liaison between physicians & revenue cycle team; attended weekly physician's conference
• Knowledge of a wide array of payer policies including but not limited to Medicaid, Medicare, Medicare Advantage & Commercial Payers
• Knowledge in various billing & electronic health record applications & database management including Cerner, Athena Health, EMDAT & Optum Encoder

Cary, NC, US

• Ensured coding accuracy of claims as well as an efficient and balanced A/R
• Addressed insurance denials and appealing for payments where appropriate
• Served as patient relations representative for revenue cycle issues

• Accurately billed & coded the appropriate ICD-10-CM, ICD-9 & CPT codes from medical reports
• Organized continuing education seminars for the entire billing & coding department
• Spearheaded the knowledge management of international employees' training curriculum

Master'S Degree, Data Analytics

Certificate, Medical Billing & Coding

Bachelor Of Science (Bs), Registered Nursing/Registered Nurse