Ruby C. Simmons Cpb-Approved Instructor,Cpb,Cdbs,Cdc Email & Phone Number

Malden, Ma, Us

Boston, Ma, Us

RCM Subject Matter Expert for medical/dental providers and private practices. Specializing in A/R clean up. Get paid in 30 to 45 days or less.· Assess and analyze the entire revenue cycle process of an organization.· Identify areas of inefficiency, revenue leakage, or process gaps within the revenue cycle.· Develop and implement strategies to optimize revenue cycle performance and increase cash flow.· Provide guidance and recommendations on best practices for revenue cycle management.· Collaborate with cross-functional teams to streamline workflows and improve communication between departments.· Evaluate and recommend improvements to billing and coding processes to ensure accurate and timely reimbursement.· Conduct audits and reviews to ensure compliance with regulatory requirements and coding guidelines.· Offer training and education to staff members on revenue cycle management practices and procedures.· Implement technology solutions, such as revenue cycle management software, to automate processes and improve efficiency.· Monitor and track key performance indicators (KPIs) to measure the effectiveness of revenue cycle initiatives and identify areas for further improvement.· Stay updated with industry trends, changes in regulations, and emerging technologies related to revenue cycle management.

Salt Lake City, Utah, Us

Assist as Medical Biller and Consultant for RCM Consultation.· Assess and analyze the entire revenue cycle process of an organization.· Identify areas of inefficiency, revenue leakage, or process gaps within the revenue cycle.· Develop and implement strategies to optimize revenue cycle performance and increase cash flow.· Provide guidance and recommendations on best practices for revenue cycle management.· Collaborate with cross-functional teams to streamline workflows and improve communication between departments.· Evaluate and recommend improvements to billing and coding processes to ensure accurate and timely reimbursement.· Conduct audits and reviews to ensure compliance with regulatory requirements and coding guidelines.· Offer training and education to staff members on revenue cycle management practices and procedures.· Implement technology solutions, such as revenue cycle management software, to automate processes and improve efficiency.· Monitor and track key performance indicators (KPIs) to measure the effectiveness of revenue cycle initiatives and identify areas for further improvement.· Stay updated with industry trends, changes in regulations, and emerging technologies related to revenue cycle management.

Develop and deliver training programs on Soarian Systems, a healthcare information system used for patient management, electronic health records (EHR), and revenue cycle management.· Conduct needs assessments to identify training requirements and gaps in knowledge or skills.· Design training materials, including user manuals, job aids, and interactive modules, tailored to the specific needs of end-users and their roles within the organization.· Facilitate training sessions, either in-person or virtually, to educate users on the functionality, features, and workflows of Soarian Systems.· Provide hands-on demonstrations and simulations to guide users through system navigation, data entry, and retrieval processes.· Offer ongoing support and troubleshooting assistance to users, addressing their questions, concerns, and technical issues related to Soarian Systems.· Collaborate with subject matter experts and system administrators to ensure training content aligns with organizational policies, procedures, and regulatory requirements.· Monitor and evaluate the effectiveness of training programs through assessments, feedback, and performance metrics, and make necessary adjustments for continuous improvement.· Stay updated with the latest releases and updates of Soarian Systems and incorporate relevant changes into training materials and sessions.· Participate in system upgrades, testing, and implementation projects, providing training expertise and user acceptance testing support.· Serve as a liaison between end-users and system developers/vendors, relaying feedback, enhancement requests, and usability concerns to improve the overall user experience of Soarian Systems.

Wyomissing, Pa, Us

Assigned to projects as needed. Perform validation of data for client system conversion from multiple legacy systems (CPSI, GE Centricity, Allscripts, Meditech, Soarian) project. Review and analyze end-user testing in the test and production billing system to verify the system is working properly. Attend client and vendor team meetings. Performed ePMI project for patient data conversion from Allscripts to EPIC maintaining consistent and accurate patient data.• Advise on workflow corrections• Keep a positive relationship with vendors and clients.• Perform end-user testing with the team• Create tickets in SharePoint• Performed data conversion• Maintain accurate patient date conversion in systems.

Boston, Ma, Us

Provide analytical support to resolve various high exposure operating and workflow issues in support of the Professional Billing Office. Lead assessments and develop action plans to resolve problems identified by the Managers and Director. Create a positive, constructive, and supportive relationships between the team members within the PBO, IT and other personnel needed to resolve issues. Take the lead on identifying, establishing, implementing, and monitoring business and financial related processes that contribute to the successful operations of the PBO.• Work cooperatively with PBO employees and managers for the purpose of achieving departmental goals and ensuring maximum revenue and cash flow benefit.• Lead the change control process to facilitate requests from departments to add/change/delete operational and system flows• Work with Management and Practices Leaders to review potential issues and develop detail action plans for resolution.• Develop work plans and lead project timelines to complete assigned projects in the most timely and efficient manner possible.• Perform various assessments, analytical research, and support including, but not limited to root-cause, analyses, cost/benefit analyses, and financial projections.• Identify opportunities to improve the revenue cycle and suggest improvements to PBO leadership and assigned departments. Work to institute improvements in a timely manner.• Effectively communicate issues and results via multiple media including in-person meetings, workgroups, verbal communication, email, and presentations.

Boston, Ma, Us

Manage the revenue cycle from a systems perspective. Utilizing system enhancements within GE Centricity/EPIC PB and Optum Claims Manager to better assist claims management and workflow. Assure that requests for system updates are tested and implemented properly. Collaborate outside vendors, Practice and Ops team on workflow issues and process improvement, business system analysis, ETM /EPIC Support on system build issues, workflow creation, and changes, and Optum Claim Management on CM system update Flag, Custom Flag creation and Flag issues. End-user testing of any EPIC, CM, SDK (Allscripts) and GE interfacing where billing system is affected. business system analysis, Updating, and building of CM 5.4 Future Production. EPIC superuser and certification.•• Responsible for investigating, troubleshooting and logging of Issue/PROs/Service Now tickets and escalation to pertinent areas, I.e. IT, EPIC Support Team• Create a request for new and updates to system/ Edit Creation or updating/Claim edits. • Research CM issues and process improvement with Claim Management on CM Flag issue, updating of rulesets and custom flags. • Update users to access, work file and views in GE/Work Queues in EPIC.• Manage Change Control and IT/PBO meetings.• End-User testing/User acceptance testing for GE/EPIC and Claims Manager.

Jacksonville Beach, Florida, Us

Manager Optum Claims Manager System from a revenue cycle perspective. Helping EPIC PB claims to flow properly through the CM and EDI vendor. Creating, updating and managing flag and custom flags. Troubleshooting of CM flag/edits. Create and Testing of the edit, Updating business operations of new upgrades to CM. • Create flags, End-user testing.• Upload KB, LCD, and NDC• Analyze and complete ServiceNow tickets

East Boston, Ma, Us

Acting Director for ten months. Managed 18- 27 employees within the Patient Account Department, which included Billing, Coding, and Collection Specialists to ensure the complete, accurate, and timely billing of patient account charges to the appropriate source, prompt receipt, and application of payments and quick resolution of problems that occur. Assisted with Director duties for seven months. • Makes certain that the Patient Account Department functions effectively, ensuring that maximum cash flow is maintained.• Reviews and analyzes the revenue cycle process for assigned practices to identify problems, trends, and opportunities for improvement and ensure maximized revenue and timely collections.• Assists in the development and production of management reports for practices covering all aspects of clinical billing activities, including payments, denials, write-offs, collections, performance to budget, controllable loss, etc.• Work registration and member enrollment to discuss/resolve registration/charge entry, referral, patient relations, coding, and process questions.• Work with team to resolve all reimbursement claim edit work queues and keeps all edits work files under a manageable level by closely monitoring, feedback, and following up with internal staff and department contacts.• Create and implement new processes and policies. Conduct and develop training processes for staff in the EPIC system, EDI, batching charges, billing charges, and following of other processes. • Handle customer service issues before escalation to CFO. • Assist billers with working and follow-up of work queue and denial issues. • Work with physicians and other division staff to answer the question, clarify the process and help with training.• Ensures that Patient Account’s staff adheres to Health Center and departmental policies.• Keep self and staff abreast of any changes in state and federal government programs, as well as all other third-party payers.

Boston, Ma, Us

• Conduct monthly department meetings to review monthly charges, payments, and adjustments with BOM’s, supervisors and billing specialists.• Reviews and analyzes the revenue cycle process for assigned practices to identify problems, trends, and opportunities for improvement and ensure maximized revenue and timely collections.• Assists in the development and production of management reports for practices covering all aspects of hospital and professional billing activities including payments, denials, write-offs, collections, performance to budget, controllable loss, etc.• Assist in setup of new private practices/clinics/satellites into IDX system, creation of billing areas, updating of new CDM/CPT codes to encounters/PK charge entry systems, work with enrollment to ensure doctors are properly enrolled in insurance plans.• Work with the referral, case management, and departments to obtain prior and retro authorizations for specialized services. • Work with practices to discuss/resolve registration/charge entry, referral, patient relations, coding, and process questions.• Work with team to resolves all reimbursement TES edit work files and keeps all edits work files under a manageable level by closely monitoring, feedback and follow up with internal staff and department contacts.• Create and implement new processes and policies. Conduct and develop training processes of staff in the SMS system, EDI, and RCO Siemens system, reading codes, correction of TES edits, batching charges, billing charges and following of other processes. • Prepared monthly status reports and billing scorecard illustrating billing information, charges, outstanding issues, and individually assigned to rectify those problems to upper PFS management.• Handle hospital and physician customer service issue before escalation to department BOM• Assist departments and data entry with registration and charge entry when needed.

Boston, Ma, Us

Responsible for implementing and maintaining close relationships with TMC departments. Developing and maintaining front end billing practices that will enhance reimbursement; promote satisfaction with billing services; provide a communication link between the departments and the billing office, and assist the departments to maximize reimbursement.

Baltimore, Md, Us

Supervised 4 Coordinator, Collection of high dollar revenue for BCBS 500k and above, trained and supported staff. Work with Account Manager and BCBS representative to follow up on claim processing issues.

Baltimore , Md, Us

Baltimore , Md, Us