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 sources (e.g. Salesforce, billing software, EMR, payor portals) to support Finance, Billing, Market Access, Product and Marketing projects• 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 software engineers

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• Proficiency in the abstraction of medical reports in Plastic Surgery, General & Pediatric Surgery, Otolaryngology, Orthopedics, Gastroenterology, Dermatology, Neurology, E&M and Radiology

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