Director Revenue Cycle

• Dec 2019 - Present

• Develops, implements, and publishes revenue cycle score card highlighting key performance indicators for central business office as well as any necessary callouts for patient service representatives to enhance overall revenue cycle outcomes • Performs facility audits of clinical, financial, and coding financial information related to denial management, medical necessity documentation, precertification, concurrent authorizations, compliance with Medicare certification/recertification and internal audits • Improves results by reviewing data integrity and clinical documentation resulting in denial rating dropping from 30% to 4% across all service lines • Constantly looking to seek opportunities for process improvement through technology which could be intertwined through EMR to maintain high quality of coding • Determines causation and trends for upfront/back-end denials, and filed appeals, recommends processes for improvements • Collaborates with individual facilities to ensure that facility financial operations efforts are maximizing on coding, increasing reimbursements, accuracy/improvements, using communication and positive working relationships • Works with all facets of the billings system and current processes of claims and remain engaged and knowledgeable of the status of each claim (i.e., quantify exposure or liability reserves; cause/effect of advanced levels of appeals) • Provided group and individual training in person and via web conferencing on a variety of related topics • Evaluates operations for compliance with mandatory policy, procedures, and regulatory requirements

Medical Coding Manager

• Jan 2016 - Aug 2019

• Led coding team of 14 employees which included both surgery and clinic coders as well as coding appeals specialists and therapy posters. • Established, implemented, and maintained a formalized review process that incorporates regular audits (provider, coding, charge posting and documentation adequacy) and coordinates ongoing monitoring with education to provider, coders and collectors. • Provided written reports to senior management with audit/review findings and trend analysis • Worked extensively with senior management and physicians on coding and record accuracy and improvement • Reviewed and recommended changes to policies and procedures to improve coding and data management • Implemented new coding matrices in order to identify bundled procedure codes and reduce denials • Decreased number of outstanding encounters not coded and posted per month end by an additional 24% • Collaborated with IT design database tools to enhance workflow efficiencies and the accuracy of diagnostic data • Developed and coordinated educational and training programs regarding elements of compliance program, such as appropriate documentation, accurate coding, data compatibility, consistency and monitoring for compliance to improve the quality of clinical, financial and administrative data supported

Medical Coding Manager

• Apr 2013 - Dec 2017

Health Information Manager

• May 2011 - Apr 2013