Performs analyses of revenue cycle and month-end results. Reviews practice charge trends to identify material changes in payer mix, procedure mix, etc.Develops revenue projections and cash flow. Formally presents billing performance during client meetings in an organized and consistent format providing insightful analytics. Prepares monthly, quarterly reporting packages, additionally, providing ad-hoc reporting as requested (RVUs, referring physician).

Collaborated with service-line leaders and front-line operators to identify the opportunities for value capture through improvements in efficiency/effectiveness.Lead the development and execution of select high priority workplans to capture opportunities and achieve waste reduction.Provided leadership and guidance in the execution and development of various projects for RCM service lines.Assisted in development, maintenance and reporting of Key Performance Indicators through running reporting and analytics, creating summaries of financial impact and current financial status.Analyzed current standard practices and look for ways to create a more efficient and streamlined process. Identified market leading technologies, strategic advantages, and develop business case to support implementation.

• Worked closely with stakeholders to gather, plan, design and analyze product requirements• Created functional requirements in the form of use cases/user stories, business processes and technology requirements• Collaborated with external stakeholders to gather, analyze and prepare recommendations related to production issues and identify opportunities to enhance inefficiencies or systems.• Documented business process inefficiencies with quantifiable metrics in order to capitalize on opportunities through digital automation and transformation• Used comprehensive business analyst techniques and knowledge of internal or external business issues to improve products and solve complex problems• Translated user and market needs into product requirements• Assisted product management with scoping and prioritizing requirements• Worked collaboratively with the engineering and product team to develop and release software solutions• Effectively managed multiple high-profile projects with minimal supervision

• Account activity auditing of internal and external authorization workforce• Established and maintained standardized quality audit documentation and trending, account analysis and reconciliation• Sampled and documented discrepancies in vendor audit results• Prepared recommendations for process improvement and training opportunities• Conducted regular 1:1 feedback with staff/vendors on performance and development related to authorizations• Analyzed departmental authorization findings via reports and charts and presents results to department Manager to assist in process improvement decisions• Facilitated the identification and communication of new audit and reimbursement trends, opportunities, and audit tactics• Analysis of specific payors, including contract language, to prospectively identify effective authorization tactics and missed opportunities• Comprehensive audits of insurance claims payments, including reference to contract payment terms, CMS coding and billing rules, authorizations, and generally accepted coding and claims payment standards• Performed all necessary research to correctly verify claim payment accuracy or denial legitimacy• Assisted Manager with distributing work queues and managing team volumes as needed

Worked with Leadership and Regional Leadership Team as a business consultant/financial advisor to the organization regarding payer denials trends and data.• As Team Leader, responsible for the development, implementation and overall coordination of information of payer denials for Holy Cross Hospital, while supervising a staff of 5 denials and underpayment representatives.• Completed monthly and quarterly team performance evaluations to assess productivity standards and measure them against productivity standards of organization.• Served as Tool Coordinator for Revenue Cycle Management tool for both Patient Access and Patient Financial Services Departments.• Served as a systems analyst to address information management improvements and recommends integrated approaches to collecting, reporting and using financial and operational performance data to support the goals of Holy Cross Hospital.• Participated in System-wide complex projects and lead small projects as needed, while conducting research and denials data analyses and summaries for hospital executives.• Collaborated on various projects and teams to aid in denials prevention for Holy Cross Hospital, including A3 projects, member of ROA team and Coach Trainee for Operational Excellence department.• Assisted Holy Cross Hospital in significantly decreasing denials by payer and recovery of revenue through identifying payer underpayment trends and additional on-going projects.

• Develop strategic marketing plans and budgets to increase clientele and volume structure• Responsible for monthly accounting implementations including invoicing, collections, A/R, A/P, account reconciliation, budgeting, general ledgers, expenditures and more• Liaison between over 100 clients and individual project consultants to thoroughly execute completion of all projects• Facilitate weekly budgetary meetings to calculate projections, growth, new clients and statistical analysis of all projects• Forecast and project new client territories and increase business ventures for marketing growth and future project (s)

• Managed workload for all patient referrals from providers for immediate admissions in conjunction with admissions nurse. • Coordinated the initial determination of a patient/family's eligibility and service needs. • Facilitated working relationship with providers, MDs, other hospice staff, and agencies necessary to initiate hospice services with company. • Verified insurance eligibility and benefits. • Maintained referral statistics and conversion rates to ensure goals are met. • Provided logistical support to various planning committees and teams to ensure smooth transition of admissions processes. • Initial role with company as administrative assistant quickly transitioned to promotion in current position within 6 weeks.

• Based on an alpha split, verified insurance benefits for all elective surgical procedures within the hospital. • Served as financial advisor to educate and inform patients of their financial liability prior to their surgical procedures and set up payment options/arrangements accordingly. • Composed, reviewed and/or disseminated internal and external correspondence for patients' insurance companies to obtain pre-certification and prior authorization for policies. • Screened patients for various surgical areas whether inpatient, outpatient, ambulatory surgery or pre-admit/OB-admit. • Managed MedAssets system, using CPT Coding to create estimates of patient surgical procedures to obtain contractual rates for insurance payments and coordinated patient procedures and processed liability determinations.

• Managed/Supervised 15 patient account specialists, including monthly scheduling, vacation scheduling, and coordinating daily employee functions and workloadEnsured compliance with divisional and departmental standards by working closely with Quality Control group to ensure timely correction of registration errors. • Developed quarterly goals for staff members and documents. • Performed training regarding hospital rules and regulations relative to the mission of the hospital by training staff on compliance with hospital regulations for all employees. • Conducted HR tasks bi-weekly via payroll processing, competency/web portal training and monitoring tardy/absenteeism.• As supervisor, contributed to the success of meeting and exceeding $12k monthly budget for 12 consecutive months.

• Provided executive administrative support to CFO of the Healthcare Consulting Firm which included correspondence with all clientele, filing, schedule coordination, travel arrangements and presentations. • Managed team calendars and meetings as requested. • Prepared track expenditure requests and expense reports. • Conducted routine correspondence, facilitated meetings, conducted conference calls, handled multiple deadline-oriented projects, and developed prospective client- proposals with high levels of accuracy and confidentiality.

• Designed and managed an up-to-date organizational system of patient intake forms, office memorandums, invoices, attorney/insurance letters to companies. • Managed quality communication, customer support and conducted representation for each physician by transmitting messages, scheduling new/existing patient appointments, scheduling patients for consultations, x-rays, lab tests, etc. • Maintained patient confidentiality by enforcing HIPAA guidelines, knowledge of ICD-9 and CPT codes using HCFA-1500 claim forms. • Maintained compliance with all court ordered subpoenas for medical records in a timely manner.• Conferred with reputable attorney's regarding ongoing patient cases, medical bills/records.• Approved travel expenses and reimbursement requests. • Drafted meeting agendas, supplied advance materials and executed follow-up for meetings and team conferences. • Processed all incoming and outgoing bill/payment transactions.