Megan Smith Email & Phone Number

Spokane, Washington

Renton, Wa

As the Director of Revenue Recovery, I ensured the compliance of state and federal regulations related to hospital/professional billing and regulatory and commercial pre/post payment audits as well as: • Successfully integrated RN Case Manager and Audit Coordinator into PFS with a focus of claim review to ensure appropriate patient class • Directly managed staff responsible for Medicare and commercial short stay DNB resolution, concurrent review of observation hours and avoidable days… Show more As the Director of Revenue Recovery, I ensured the compliance of state and federal regulations related to hospital/professional billing and regulatory and commercial pre/post payment audits as well as: • Successfully integrated RN Case Manager and Audit Coordinator into PFS with a focus of claim review to ensure appropriate patient class • Directly managed staff responsible for Medicare and commercial short stay DNB resolution, concurrent review of observation hours and avoidable days • Managed back-end medical necessity/experimental audits and appeals, Medicare RAC, level of care and DRG audits • Established workflow for compliant billing of administrative days for HCA and Managed Care financial classes • Regularly partnered with several departments and clinics to provide education for optimization of workflow to decrease denials and increase clean claim rate Reduced monthly preventable denial percentage by 7% in 2016-2017 Increased and maintained monthly clean claim rate for both professional and hospital to 97% and 95% respectively• Implemented two underpayment systems; most recently Epic Contract Manager, and directly managed the team responsible for the recoupment of dollars on underpaid claims; collecting $2.5M+ in underpaid accounts since 2015• Co-developed and implemented combining HB/PB insurance follow up and billing workflows in Epic to improve consistency of account resolution for patients • Developed Quality Assurance program in 2016 to provide real time feedback to staff and identify training needs Since implementation, monthly department average increased from 87% to >95% with >85% of staff achieving a score of 97% or better• Developed Monthly Operations Report to provide consistent communication to Vice President of the Revenue Cycle and Chief Financial Officer • Responsible for annual Performance Improvement initiatives Show less

Renton, Wa

As the Manager of insurance follow up, I was solely responsible for all hospital insurance billing, follow up and collections as well as: • Managed all hospital follow up and billing activities, including AR analysis, financial class assignments, design and implementation of follow up projects/campaigns • Managed October 2012 Epic implementation from McKesson STAR for HB follow up and billing• Developed 75+ workflows and procedures using Visio and Microsoft Word • Responsible… Show more As the Manager of insurance follow up, I was solely responsible for all hospital insurance billing, follow up and collections as well as: • Managed all hospital follow up and billing activities, including AR analysis, financial class assignments, design and implementation of follow up projects/campaigns • Managed October 2012 Epic implementation from McKesson STAR for HB follow up and billing• Developed 75+ workflows and procedures using Visio and Microsoft Word • Responsible for unionized team development; hiring, discharge and improvement of team members • Participated in 2013 union contract negotiations • Partnered with Epic Technical Support bi-weekly for system enhancements to improve workflows • Established DNB workflow, job description and hired up front Third Party Liability specialist Addition of this position increased monthly TPL cash collections by $150K• Created Revenue Specialist position; an exempt position focusing on balances >$50K• Implemented monthly one on one program to provide regular feedback for staff • In collaboration with Epic, developed productivity report in Epic which fed into Excel productivity tracking workbook • Drafted Monthly Operations Report for joint venture; reporting outstanding AR, denial percentages, clean claim rate and payer trends affecting the line of business • Designed and implemented Epic denial root cause workflow Show less

• Acted as liaison for Providence and Swedish hospital facilities• Lead end of month conference calls with client to discuss monthly metric results for AR outstanding, denials received, cash collections and adjustments • Trained hospital department staff in proprietary NUCO CUBS system • Managed and resolved client and/or patient concerns• Creation of monthly trending report package outlining denial volumes for prevention • Drafted monthly communication report for Senior… Show more • Acted as liaison for Providence and Swedish hospital facilities• Lead end of month conference calls with client to discuss monthly metric results for AR outstanding, denials received, cash collections and adjustments • Trained hospital department staff in proprietary NUCO CUBS system • Managed and resolved client and/or patient concerns• Creation of monthly trending report package outlining denial volumes for prevention • Drafted monthly communication report for Senior Director and Chief Operations Officer Show less

• Implemented Customer Contact Center in 2006; insourced self-pay and increased staff from 25 to 80+ FTEs • Drafted 50+ workflows in support of contact center implementation • Developed 12 week training course for new hires with emphasis on hospital systems, policies and procedures • Developed Contact Center monthly report package with call volumes, average handle time and abandonment rates • Created monthly one on one that included real time call monitoring for quality… Show more • Implemented Customer Contact Center in 2006; insourced self-pay and increased staff from 25 to 80+ FTEs • Drafted 50+ workflows in support of contact center implementation • Developed 12 week training course for new hires with emphasis on hospital systems, policies and procedures • Developed Contact Center monthly report package with call volumes, average handle time and abandonment rates • Created monthly one on one that included real time call monitoring for quality, personalized phone metrics and attendance • Programed and managed weekly dialer campaigns on self-pay accounts Show less