• Managed end-to-end revenue cycle process at Roswell Park Comprehensive Cancer Center, optimizing revenue generation and reducing denials.• Implemented strategies to improve cash flow and ensure compliance with healthcare regulations.• Led and mentored a team of revenue cycle professionals, providing guidance and fostering collaboration.

Healthcare revenue cycle subject matter expert with experience in multiple functional areas such as patient access, revenue integrity, systems IT, and patient financial services. Collaboratively work with the client management executives, operational leadership, and client leadership to identify client and operational improvements using data analysis and industry best practice knowledge in revenue cycle.KEY ACCOMPLISHMENTS• Directed resolution of $3.4M claim rejection error by identifying the core issue and finding an effective solution that produced outstanding capital gain.• Generated revenue increase of 30% ($1.8M monthly) by performing detailed analysis of A/R, billing methods, and initiating new strategic processes and procedures.• Enhanced efficiency by writing Standard Operating Procedures (SOP) and outlining precise and detailed claim submissions.• Established and maintained effective relationships with staff, patients, and community groups.• Ensured staff compliance with State and Federal regulations.• Increased revenue accrual by analyzing variations in collection forecasts, actual collections, and revising billing procedures.• Improved billing accuracy through a collaborative relationship with IT and ensuring UB04/837/HCFA 1500 changes are completed accurately and on time.• Maintain 98% first-pass clean claim acceptance rate• Revised KPIs to increase cash collection and decrease denials and write-offs.• Decreased Claim rejections by 68%

ESSENTIAL DUTIES AND RESPONSIBILITIES• Implement process and technology training for staff to achieve goals, maintain proficiency, efficiency, compliance, and customer service.• Ensure data accuracy accountability for divisional financial performance, charging methodologies and capture, and revenue enhancements.• Effective development, implementation, monitoring, and communications of goals, objectives, budgets and expected performance outcomes.• Analyzed critical operations on an ongoing basis, and developed reports that evaluated and demonstrated productivity and performance gains.• Provided instruction, leadership, and supervision for a team of more than 20 employees.• Responsible for the collection, aging, establishing write-off standards, and claim denial management.• Evaluated effectiveness of the process, recommended and implement changes to policies and procedures• Responsible for hiring, firing, and disciplinary actions within the department.• Decreased billing cycle turnaround time by 40% by implementing automation into the process.• Improved productivity and decreased backlog by 25% within the first 3 months

ESSENTIAL DUTIES AND RESPONSIBILITIES• Responsible for the completed revenue cycle totaling $16 million in charges per month including credentialing, and third-party follow-up.• Analyzed the top denials for each provider, practice, and hospital group and identified solutions to increase cash and decrease A/R days• Increase clean claim reimbursement from 65% to 80% by working with clearinghouse and payers to ensure all claims were received in a timely manner and processed according to contract rates and provisions.• Reduced claim rejections from 39% to 15%• Analyzed risk management analysis for denial trends & KPI’s• Overhauled policies and procedures to eliminate unnecessarily and standardize processes• Maintained quality levels by conducting random charge/billed/coding audits and working with the team to resolve issues• Trained physicians and leads to ensure compliance on correct coding and documentation practices• Monitored revenue process against benchmark back-end metrics and accounts receivables targets.• Coordinated efforts across all departments to decrease billing/coding errors.• Improved productivity and decreased backlog by 25% by working closely with registration, billing, and collection departments to determine opportunities for improvement• Responsible for monthly financial reports and KPI statistics for review of productivity standards• Revised Revenue Cycle Dashboard that includes KPI’s in measuring against best practices• Reconstructed process scorecard and coaching tools for Executive Management Team, which included key performance metrics towards work efficiency, high-quality performance, and strategic plan for business improvement.

ESSENTIAL DUTIES AND RESPONSIBILITIES:• Acted as a liaison between clients (Insurance Carriers), technology, accounting, and other business lines within the organization.• Managed and facilitated communications on all business requests and issues to ensure client programs were operating with maximum efficiency and profitability.• Agile Project Management and SDLC knowledge used to communicate both business needs and technical product information.• Daily interaction with various levels of management; both internally and externally, providing effective communications with staff level up through senior leadership.• Strong client and service orientation, with a high level of passion for service excellence.• Served as the intake point for multiple client issues and prioritized issues working closely with clients and the technology team.• Prepared, maintained, and distributed client status reports; both internally and externally.• Hosted recurrent client status meetings and work sessions as needed for program requirements review; communicated status to the management team.

Essential Duties and Responsibility • Conduct an Impact analysis of the facility's future state of operations.• Set up training for end users of applications• Project Management of Vendor application• Aid in educating the organization about HIT, and help assess readiness. Where organizational issues, computer skills, or general knowledge about HIT need improvement, work with the organization to correct issues, build skills, and acquire improved understanding.• Conduct workflow and process mapping analysis to identify potential functions for the type of HIT support being sought, such as electronic health records (EHR)• Oversee the tasks, timelines, and resources necessary to implement the EHR, ensuring that the project stays on time and on budget.• Maintain an issues resolution log, escalating issues as appropriate.• Coordinate all vendor implementation activities• Apply updates as applicable, evaluate and recommend upgrades and enhancements, and work with users to develop reports and other uses of HIT data