Description
SUMMARY OF QUALIFICATIONS * Keenly analytic and results oriented revenue cycle professional with 19 years of experience in Healthcare Systems, Patient Accounts, Early-out Collections and Analyzing Accounts Receivables * Core knowledge and expertise with federal/state and HIPPA privacy and security regulations of payer contracts * Health information technology and changes related to health care reform, and Medicaid expansion * Verifiable ability to meet deadlines without compromising quality while offering meticulous attention to detail * Unparalleled ability to multitask, prioritize, and managed a team and work well under pressure with minimal supervision * Negotiate contracts with insurance agencies and the ability to meet satisfactory terms * Exemplary leadership skills, self-motivated and able to adapt and thrive in a diverse environment * Advanced expertise includes NextGen 5.8 Realmed Prezi/Visio Medicaid Manager Jaspersoft PowerPoint Meditech Centricity Microsoft Office Welligent EHR Epic Availity RCM HIGHLIGHTED ACHIEVEMENTS * Assist Revenue Cycle Director, IT Administrators to recover underpayment of 340B contraceptive supplies from Illinois Department of Human Services, which resulted in additional $2 million dollars reimbursement * Promoted to Systems Manager within 6 months of being hired at Planned Parenthood of Illinois * Improved business strategies that brought in five 10 year contract for new client business Notable Skills * Strong understanding of revenue cycle, coding, and reimbursement methods within healthcare system (especially, Commercial Payers) HMO, Managed Care Organization (MCOs), Medicaid, Medicare Part B, 340B Pharmacy Billing, Illinois Breast Cervical Cancer (IBCCP) billing, Title X Family Planning Program, Medicare And Medicaid Credentialing and billing * Knowledge of medical terminology, ANSI X 12 Standard and CMS Crosswalk for Physician, Hospital, and Rehabilitation * Maintains and updates the Pay Source File Document on Issue-Trak software Strong understanding of various software methodologies and medical terminology, 837I/P, 835, 277, and 999 reporting
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