• Manage and implement daily operations of the coding team and guiding efficient and effective process for coding, reporting, billing, and claims management• Analytical ability to gather and interpret data to identify discrepancies, trends, or issues, to determine compliance with regulations, policies & procedures and collaborate with internal and external key stakeholders• Develop strategies and conducts business performance analysis by evaluating the ongoing effectiveness of current plans, programs, systems configurations, and initiatives to ensures business needs are being met• Maintains knowledge of applicable coding documentation and billing regulations related to government and commercial insurance, and enhance training guidance for the providers, team, and field operations• Collaboration with Legal and Compliance partners to mitigate attorney client privilege cases• Conducts claim correction projects from analyzing revenue cycle data and trends and communicating results and corrective action with training, operations, and vendors• Partnerships with key stakeholders and vendors with application of best practices drive profitability, performance, and collections and provide communication progress and risks to senior leadership• Provide supervision and development opportunities for associates with performance feedback and evaluations

• Develop, operationalize, and maintain new business development strategy and projects for Adherence and Gap in Care Programs to service the patient population• Enhance, expand, and support the delivery of medication adherence and gap in care programs, such as immunizations and basic screening programs, and tracking of counseling and adherence measures • Generate and maintain reporting/analytic tools and dashboards for the field and leadership to analyze the trends, performance of scripts and sales volume and help drive patient engagements• Operational support by providing answers to questions from the field and gather effective feedback to enhance new and ongoing quality programs • Create and operationalize an ROI Calculator and Cost Comparison tool to identify/assist with business decisions for program expansion and new business development for H&W with ROI and cost savings analysis • Identify and implement KPIs/metrics to drive department and company goals and meet quality of care measures• Cross-functional collaboration and management with vendors to research and create solutions to better service the patients’ healthcare needs, streamline processes for field execution, and implement revenue streams• Continuous updates to platforms and systems to meet both pharmacy teams’ needs and health plan initiatives• Conducts monthly invoice submissions and payment allocation reports • Establish additional revenue streams by contracting with payers, manufacturers, and vendors to deliver reimbursement for Clinical Service offerings• Communicate, educate, and create training tools and resources to support the field and other stakeholders

• Ensures accurate medical billing and coding by applying system development, training, and execute deliverables • Coordinate and communicate with vendors along with creating process workflows within the EMR System to effectively increase revenue and charge capture• Develops strategies and processes to meet healthcare billing and coding requirements and apply best practices• Facilitate and coordinate denials, accounts receivable, and billing/coding projects on charge corrections and missing charge captures• Prepare and distribute monthly reports summarizing the clinic’s financial, performance, and coding activity • Analytical reasoning when identifying trends and apply appropriate steps to resolve actionable items impacting charges and revenue• Manage relationships with internal and external customers to discuss standard performance reports to obtain overall operational/financial goals and objectives• Provides supervision and development opportunities for associates

• Responsible for managing revenue cycle of the major clinical departments• Analyzed multiple P&L line items to assist department managers with decision making tools• Coordinated and communicated with vendors along with creating workflow processes within operations and the systems to effectively increase revenue and charge capture• Established and maintained open communications with department heads, operational staff, physicians account receivable activity, payer trends and provider credentialing• Prepared and distributed monthly executive summary reports summarizing client departments’ financial activity • Demonstrated a strong power of analytical reasoning when identifying trends and took appropriate steps to revolve issues impacting charges and revenue• Facilitated and coordinated denials, accounts receivable, and billing/coding projects on charge corrections and uncollected charge encounters

• Effectively control costs through economical utilization of personnel, materials, and equipment• Delegated to improve organizational effectiveness and maximize organizational strengths• Scheduled patient appointments, staff meetings, and create provider schedules• Accelerated results of new process by effectively building relationships with staff members and patients • Performed appraisals & evaluations and identified staff development needs during hiring and training process • Manage the practice, billing/coding, collections, contract reviews and reconcile & balance monies collected • Performed insurance verifications and maintained claim status, appeals, motor vehicle accidents, workers compensations, rejections, denials, and open A/R