Traci Lopez Email and Phone Number

Developed, implemented, and maintained various Operating policies and procedures. Established benchmarks and KPI’s for 8 physician offices. Leveraged technology in support of automation, analyzed top denials, claim rejections, and other reports to effectively and efficiently resolve impacts to efficiency and cashflow. Coordinated training, developed reporting tools, and quality assurance over the various functional areas of responsibility; Provider Enrollment, Full Revenue Cycle (registration, charge entry, payment posting, and denials management)

Analyzed critical operations and KPI’s on an ongoing basis and developed reports that evaluated and demonstrated productivity and performance for a team of 90 located within the US and India related to: Provider Enrollment, Registration, Coding, Payment Posting, and Denials Management with a strong emphasis on quality and training. Conducted quality assessment of patient billing and revenue collection systems to enhance workflows by improving utilization, training of current systems, and exploring new software as needed. Assisted HR and Management with hiring, training programs, disciplinary actions and other employee related issues/concerns as necessary.

Supervised and managed 16 staff and all services relating to coding, documentation and performance. Developed and maintain Best Practices for coding and Physician documentation education. Evaluated equipment and software with IT to enhance staff training, workflow, and functionality. Implemented process and technology training for staff to achieve goals, maintain proficiency, efficiency, compliance and customer service. Conducted quality audits on coders and clinical documentation performance and productivity.

Directed revenue cycle for primary care services including time of service collections, charge entry, cash management, account progression and resolution initiatives for 4 satellite locations. Provided instruction, leadership, and supervision for team of more than 25 employees. Updated system coding/billing data, functionality, electronic workflow processes, and user access.

Responsible for meeting budget and reporting Monthly dashboard metrics. The payor mix included multiple state Medicaid programs, Managed Medicaid, Medicare, and commercial insurance payors. My Teams responsibility included insurance billing and follow-up, customer billing, payment posting, customer service, collections, payor contracting and payor relations. Supervisory responsibilities include process improvement, quality reviews, auditing, interviewing, hiring, and all levels of discipline.

Responsible for analyzing physician documentation and assigning correct charge (CPT/HCPCS) and diagnosis codes for billing and claim submission. Conducted physician documentation education sessions. Analyzed insurance aged trial balance for follow-up, customer service, and refunds. Building internal and external relationships for effective follow-up and collection efforts