Experience

ActiCare Health

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Revenue Cycle Manager

  • Apr 2021 - Present

  Managing the revenue cycle operations including insurance eligibility, authorization, registration, charge capture, billing, follow-up, payment posting, and denial management. Establishing a credit card collection program that resulted in additional $1,000,000.00 in reimbursement during the first year. Establishing a patient financial assistance program for the organization. Initiating and enrolling all insurance payments through electronic fund transfers to protect the asset security integrity. Monitored compliance with pertinent contracts, laws, rules, regulations, and various programs that may affect reimbursement.



Sutter Health - Bay Area

• United States
• Hospitals and Health Care
• 400 - 500 Employee

• Billing Operations Manager

  • Aug 2011 - May 2020

  • Managing the billing department for St. Luke’s Healthcare that averages over $2 million monthly patient charges. • Establishing the all-time record for achieving the lowest account receivable outstanding days from 75 to 30. • Establishing the all-time record in collection revenues of $9 million. • Fostering a team spirit in the department resulting in achieving 100% in both Employee of Work, and Culture of Safety survey. • Achieving a 96% compliance audit score in which represents the highest score among community clinics in the Sutter Bay Hospitals system. • Mentoring and coaching a staff of eight clerks including accountability for their performance, schedule workflow of billing and follow up, eligibility, data entry, and cash posting. • Monitoring compliance with pertinent contracts, laws, rules, regulations, and various programs that may affect reimbursement. • Forecasting impact analysis on reimbursement change initiatives. • Generating monthly relative value unit (RVU) reports to measure Physician performance.



Kaiser Permanente

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Pre-Billing Manager

  • 2010 - 2010

  • Managed the pre-billing unit at the hospital client’s site. • Responsible for the performance, schedule, and workflow of seventeen pre-billing staff. • Monitored compliance with pertinent laws, rules, regulations and various programs that may affect reimbursement. • Managed the pre-billing unit at the hospital client’s site. • Responsible for the performance, schedule, and workflow of seventeen pre-billing staff. • Monitored compliance with pertinent laws, rules, regulations and various programs that may affect reimbursement.



Aptium Oncology

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Patient Accounting Manager

  • 2005 - 2010

  • Contributed to the success of revenue cycle operations by improving profit collections by $15 million annually. • Reduced credit balance amount from $2.5 million down to average of $200,000 range. • Managed a staff of 12 Patient Account Representatives and Financial Counselors on a daily billing, collection, and authorization operation. • Monitored and analyzed all activities of the department to help maximize operations revenue. • Initiated and implemented electronic insurance verification throughout the organization to improve efficiency.



La Clínica de La Raza

• United States
• Hospitals and Health Care
• 500 - 600 Employee

• Billing and Registration Manager

  • 2003 - 2005

  Directed a staff of thirty on the daily charge posting, billing, collection, enrollment and registration operation. Coordinated activities with other departments, generated and processed reports, and any statistics relating to the billing, registration, collection and reimbursement activities. Provided recommendation for fee increases and monitored changes in CPT-4 and ICD-9 coeds to ensure compliance. Participated in the development, evaluation, implementation, and revision of the policies and procedures related to registration, billing and reimbursement activities. Created a congenial work environment emphasizing continual staff development, employee satisfaction and maximum production



San Ramon Regional Medical Ctr

• Billing and Registration Supervisor

  • 2000 - 2002

  Supervised the daily registration activities through out the hospital. Directed and monitored the pre-registrations program. Coordinated daily bed assignment with nursing staff according to patient’s diagnosis and/or acuity level. Reconciled census balancing. Screened all inpatient admission for clinical and financial clearance. Fostered a team spirit in the department. Consistently achieved 95 percentile or above in customer service satisfaction. Supervised the daily registration activities through out the hospital. Directed and monitored the pre-registrations program. Coordinated daily bed assignment with nursing staff according to patient’s diagnosis and/or acuity level. Reconciled census balancing. Screened all inpatient admission for clinical and financial clearance. Fostered a team spirit in the department. Consistently achieved 95 percentile or above in customer service satisfaction.