Sheila Woods, CHFP,CRCR,CSPR,CSBI,CSAF
Patient Financial Service Manager at Curry Health Network- Claim this Profile
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Bio
Credentials
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Certified Healthcare Financial Professional (CHFP)
Healthcare Financial Management Association (HFMA)Oct, 2023- Oct, 2024 -
Operational Excellence
Healthcare Financial Management Association (HFMA)Oct, 2023- Oct, 2024 -
15 Secrets Successful People Know about Time Management (getAbstract Summary)
LinkedInMay, 2022- Oct, 2024 -
Managing Your Time
LinkedInMay, 2022- Oct, 2024 -
Project Management Foundations: Ethics
LinkedInOct, 2021- Oct, 2024 -
Certified Specialist Accounting and Finance
Healthcare Financial Management Association (HFMA) -
Certified Specialist Business Intelligence
Healthcare Financial Management Association (HFMA) -
Certified Specialist Payment & Reimbursement
Healthcare Financial Management Association (HFMA) -
HFMA's Certified Revenue Cycle Representative (CRCR)
Healthcare Financial Management Association (HFMA)
Experience
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Curry Health Network
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United States
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Hospitals and Health Care
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1 - 100 Employee
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Patient Financial Service Manager
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Sep 2023 - Present
I am responsible for overseeing all aspects of the Patient Financial Services department. I provide leadership and direction to the PFS team, ensuring the efficient management of patient accounts, billing, customer services, insurance follow-up, collections, denials management, and cash management. My role involves strategic analysis and system design to optimize payment and reimbursement. Additionally, I play a pivotal role in the hiring, promotion, and processes within the department while… Show more I am responsible for overseeing all aspects of the Patient Financial Services department. I provide leadership and direction to the PFS team, ensuring the efficient management of patient accounts, billing, customer services, insurance follow-up, collections, denials management, and cash management. My role involves strategic analysis and system design to optimize payment and reimbursement. Additionally, I play a pivotal role in the hiring, promotion, and processes within the department while maintaining a commitment to delivering excellent customer service in all patient accounting inquiries. Leadership: Led and supervised all functions, activities, and staff within the PFS department, fostering a patient and family-centered care environment. Directed day-to-day operations, managed budgets, and oversee human resource management, including policy recommendations and account adjustments. Key Performance Indicators: Tracked, monitored, and reported various PFS and Patient Accounting metrics and key performance indicators to analyze and improve departmental performance. Provided leadership and guidance to staff in achieving individual key performance indicators and productivity goals. Customer Service: Ensured the provision of high-quality customer service in all departmental functions, adhering to collection policies and procedures, including private pay collections and bad debt assignment. Revenue Integrity: Collaborated with the DRCS and HIM Manager to ensure accurate and appropriate revenue capture for services provided to patients. Ensured billing accurately reflected charges to payers and patients. Provided information and reporting on late charges, lost charges, and coding for all services. Continuous Improvement: Actively participated in identifying and implementing continuous improvement initiatives within the PFS department. Engaged staff and stakeholders in process improvement, facilitated improvement teams, and stayed updated on industry best practices. Show less I am responsible for overseeing all aspects of the Patient Financial Services department. I provide leadership and direction to the PFS team, ensuring the efficient management of patient accounts, billing, customer services, insurance follow-up, collections, denials management, and cash management. My role involves strategic analysis and system design to optimize payment and reimbursement. Additionally, I play a pivotal role in the hiring, promotion, and processes within the department while… Show more I am responsible for overseeing all aspects of the Patient Financial Services department. I provide leadership and direction to the PFS team, ensuring the efficient management of patient accounts, billing, customer services, insurance follow-up, collections, denials management, and cash management. My role involves strategic analysis and system design to optimize payment and reimbursement. Additionally, I play a pivotal role in the hiring, promotion, and processes within the department while maintaining a commitment to delivering excellent customer service in all patient accounting inquiries. Leadership: Led and supervised all functions, activities, and staff within the PFS department, fostering a patient and family-centered care environment. Directed day-to-day operations, managed budgets, and oversee human resource management, including policy recommendations and account adjustments. Key Performance Indicators: Tracked, monitored, and reported various PFS and Patient Accounting metrics and key performance indicators to analyze and improve departmental performance. Provided leadership and guidance to staff in achieving individual key performance indicators and productivity goals. Customer Service: Ensured the provision of high-quality customer service in all departmental functions, adhering to collection policies and procedures, including private pay collections and bad debt assignment. Revenue Integrity: Collaborated with the DRCS and HIM Manager to ensure accurate and appropriate revenue capture for services provided to patients. Ensured billing accurately reflected charges to payers and patients. Provided information and reporting on late charges, lost charges, and coding for all services. Continuous Improvement: Actively participated in identifying and implementing continuous improvement initiatives within the PFS department. Engaged staff and stakeholders in process improvement, facilitated improvement teams, and stayed updated on industry best practices. Show less
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South Piedmont Community College
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Higher Education
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100 - 200 Employee
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Member of the Board of Advisors
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Jan 2021 - Present
I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject… Show more I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject matter expert in RCM, offering insights, recommendations, and guidance to the program lead and faculty. Curriculum Development: Collaborate with the program lead and faculty to review and update the curriculum, ensuring that it reflects current industry standards, trends, and best practices in RCM. Industry Trends: Stay informed about the latest developments, technologies, and regulatory changes within the RCM field and share this information with the program team. Networking: Facilitate connections with industry professionals, potential guest speakers, and organizations that can provide real-world perspectives and opportunities for students. Program Enhancement: Suggest ways to enhance the program's effectiveness, including identifying areas for improvement and proposing innovative solutions. Student Engagement: Participate in activities that promote student engagement, such as mentoring, guest lectures, or career development workshops. Assessment: Collaborate on the assessment and evaluation of the program's outcomes and recommend improvements based on feedback and data. Professional Experience: Extensive experience in Revenue Cycle Management, preferably in a managerial or leadership role, with a track record of success. Industry Knowledge: In-depth knowledge of industry standards, regulations, and best practices related to RCM in healthcare or relevant sectors. Show less I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject… Show more I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject matter expert in RCM, offering insights, recommendations, and guidance to the program lead and faculty. Curriculum Development: Collaborate with the program lead and faculty to review and update the curriculum, ensuring that it reflects current industry standards, trends, and best practices in RCM. Industry Trends: Stay informed about the latest developments, technologies, and regulatory changes within the RCM field and share this information with the program team. Networking: Facilitate connections with industry professionals, potential guest speakers, and organizations that can provide real-world perspectives and opportunities for students. Program Enhancement: Suggest ways to enhance the program's effectiveness, including identifying areas for improvement and proposing innovative solutions. Student Engagement: Participate in activities that promote student engagement, such as mentoring, guest lectures, or career development workshops. Assessment: Collaborate on the assessment and evaluation of the program's outcomes and recommend improvements based on feedback and data. Professional Experience: Extensive experience in Revenue Cycle Management, preferably in a managerial or leadership role, with a track record of success. Industry Knowledge: In-depth knowledge of industry standards, regulations, and best practices related to RCM in healthcare or relevant sectors. Show less
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EHR Concepts
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United States
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Hospitals and Health Care
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1 - 100 Employee
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Project Consultant
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Mar 2023 - Sep 2023
As a Cerner Consultant and Subject Matter Expert (SME) and implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting workflows. Additionally, consulted with… Show more As a Cerner Consultant and Subject Matter Expert (SME) and implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting workflows. Additionally, consulted with clients on comprehensive service line workflows, including current state and future state, and worked with them to determine how the system will be designed, built, and tested. As an advisor, worked closely with clients to customize and tailor their unique requirements, using strong expertise in healthcare billing and claims process workflow. Collaborated with cross-functional teams to identify opportunities for improvement and carve out the path to solutions. Focused on customer success through developing trusting relationships and always choosing to do the right thing. Identified, resolved, and reported solution status, risks, and issues to client and project leadership, coached clients on data collection and system design requirements, and analyzed to determine optimal solution build and implementation. Actively participated and provided recommendations on key Revenue Cycle metric improvements, including DNFB days, clean claim rate, and AR Days, and provided clients with recommendations on reporting around these metrics. Demonstrated knowledge of revenue cycle back-end best practice workflows, familiar with key design principles and current/future state planning, and participated in revenue cycle optimization projects, leveraging Cerner RCM tools to improve financial performance and patient satisfaction. Stayed current with industry trends and best practices in revenue cycle management, sharing insights with the team and driving continuous improvement. Show less As a Cerner Consultant and Subject Matter Expert (SME) and implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting workflows. Additionally, consulted with… Show more As a Cerner Consultant and Subject Matter Expert (SME) and implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting workflows. Additionally, consulted with clients on comprehensive service line workflows, including current state and future state, and worked with them to determine how the system will be designed, built, and tested. As an advisor, worked closely with clients to customize and tailor their unique requirements, using strong expertise in healthcare billing and claims process workflow. Collaborated with cross-functional teams to identify opportunities for improvement and carve out the path to solutions. Focused on customer success through developing trusting relationships and always choosing to do the right thing. Identified, resolved, and reported solution status, risks, and issues to client and project leadership, coached clients on data collection and system design requirements, and analyzed to determine optimal solution build and implementation. Actively participated and provided recommendations on key Revenue Cycle metric improvements, including DNFB days, clean claim rate, and AR Days, and provided clients with recommendations on reporting around these metrics. Demonstrated knowledge of revenue cycle back-end best practice workflows, familiar with key design principles and current/future state planning, and participated in revenue cycle optimization projects, leveraging Cerner RCM tools to improve financial performance and patient satisfaction. Stayed current with industry trends and best practices in revenue cycle management, sharing insights with the team and driving continuous improvement. Show less
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Oracle
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United States
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Warehousing
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1 - 100 Employee
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Professional Consultant
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Mar 2023 - Sep 2023
As a Cerner Consultant and Subject Matter Expert (SME) on the New York State Office of Mental Health (OMH) implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting… Show more As a Cerner Consultant and Subject Matter Expert (SME) on the New York State Office of Mental Health (OMH) implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting workflows. • Built and configured Cerner patient accounting and Soarian financial solutions, conducted testing, implementation, and post-go-live modifications. Additionally, consulted with clients on comprehensive service line workflows, including current state and future state, and worked with them to determine how the system will be designed, built, and tested. • As an advisor, worked closely with clients to customize and tailor their unique requirements, using strong expertise in healthcare billing and claims process workflow. Collaborated with cross-functional teams to identify opportunities for improvement and carve out the path to solutions. Focused on customer success through developing trusting relationships and always choosing to do the right thing. • Everything Soarian (Scheduling/Financials/Workflow/Master files/Printing). • Identified, resolved, and reported solution status, risks, and issues to client and project leadership, coached clients on data collection and system design requirements, and analyzed to determine optimal solution build and implementation. Actively participated and provided recommendations on key Revenue Cycle metric improvements, including DNFB days, clean claim rate, and AR Days, and provided clients with recommendations on reporting around these metrics. Show less As a Cerner Consultant and Subject Matter Expert (SME) on the New York State Office of Mental Health (OMH) implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting… Show more As a Cerner Consultant and Subject Matter Expert (SME) on the New York State Office of Mental Health (OMH) implementation project: Provided daily system support, incident management, and troubleshooting to ensure a successful revenue cycle implementation from the current state through post-go-live. Consulted with clients on all revenue cycle workflows applicable to their needs, including pre-billing claims workflows, claims follow-up workflows including denial management, and cash posting workflows. • Built and configured Cerner patient accounting and Soarian financial solutions, conducted testing, implementation, and post-go-live modifications. Additionally, consulted with clients on comprehensive service line workflows, including current state and future state, and worked with them to determine how the system will be designed, built, and tested. • As an advisor, worked closely with clients to customize and tailor their unique requirements, using strong expertise in healthcare billing and claims process workflow. Collaborated with cross-functional teams to identify opportunities for improvement and carve out the path to solutions. Focused on customer success through developing trusting relationships and always choosing to do the right thing. • Everything Soarian (Scheduling/Financials/Workflow/Master files/Printing). • Identified, resolved, and reported solution status, risks, and issues to client and project leadership, coached clients on data collection and system design requirements, and analyzed to determine optimal solution build and implementation. Actively participated and provided recommendations on key Revenue Cycle metric improvements, including DNFB days, clean claim rate, and AR Days, and provided clients with recommendations on reporting around these metrics. Show less
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Gunnison Valley Health
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United States
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Hospitals and Health Care
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100 - 200 Employee
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Interim HIM Director/Interim HIPPA Privacy Officer/Consultant
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Aug 2022 - May 2023
I have been responsible for overseeing the overall management of medical records, coding, and health information processes. My expertise includes the development and implementation of health information policies and procedures consistent with accrediting and regulatory agency standards, ensuring that the Medical Records department maintains patient records in compliance with state and local laws and regulatory requirements. I have defined, developed, maintained, and implemented policies and… Show more I have been responsible for overseeing the overall management of medical records, coding, and health information processes. My expertise includes the development and implementation of health information policies and procedures consistent with accrediting and regulatory agency standards, ensuring that the Medical Records department maintains patient records in compliance with state and local laws and regulatory requirements. I have defined, developed, maintained, and implemented policies and processes that promote consistent, practical health information management practices while minimizing risk and ensuring the confidentiality of protected health information (PHI) across all media types, including electronic and paper records. My role included providing oversight for safeguarding and updating active and inactive patient medical records and ensuring that medical correspondence and information releases are in compliance with regulatory requirements. My role required ongoing compliance monitoring activities and working with organization administration, legal counsel, and external parties to represent the organization's health information interests in legislation, regulation, and standards governing medical records, coding, and reimbursement activities. I promoted compliance with federal and state laws relating to medical records within the organization and related entities, and maintained knowledge of applicable medical record privacy laws and accreditation standards. I served as a resource on health information management practices and standards, ensuring the availability, confidentiality, integrity, privacy, quality, and security of patient health records. With my experience and expertise, I have played a crucial role in ensuring that the HIM processes and practices are up-to-date and compliant with accrediting and regulatory agency standards. Show less I have been responsible for overseeing the overall management of medical records, coding, and health information processes. My expertise includes the development and implementation of health information policies and procedures consistent with accrediting and regulatory agency standards, ensuring that the Medical Records department maintains patient records in compliance with state and local laws and regulatory requirements. I have defined, developed, maintained, and implemented policies and… Show more I have been responsible for overseeing the overall management of medical records, coding, and health information processes. My expertise includes the development and implementation of health information policies and procedures consistent with accrediting and regulatory agency standards, ensuring that the Medical Records department maintains patient records in compliance with state and local laws and regulatory requirements. I have defined, developed, maintained, and implemented policies and processes that promote consistent, practical health information management practices while minimizing risk and ensuring the confidentiality of protected health information (PHI) across all media types, including electronic and paper records. My role included providing oversight for safeguarding and updating active and inactive patient medical records and ensuring that medical correspondence and information releases are in compliance with regulatory requirements. My role required ongoing compliance monitoring activities and working with organization administration, legal counsel, and external parties to represent the organization's health information interests in legislation, regulation, and standards governing medical records, coding, and reimbursement activities. I promoted compliance with federal and state laws relating to medical records within the organization and related entities, and maintained knowledge of applicable medical record privacy laws and accreditation standards. I served as a resource on health information management practices and standards, ensuring the availability, confidentiality, integrity, privacy, quality, and security of patient health records. With my experience and expertise, I have played a crucial role in ensuring that the HIM processes and practices are up-to-date and compliant with accrediting and regulatory agency standards. Show less
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Jones Memorial Hospital
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Hospitals and Health Care
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100 - 200 Employee
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RCM Consultant
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Aug 2022 - Apr 2023
As a Sr. (RCM) Analyst, in a contract (PRN Flex hours) role, I am responsible for assisting the RCM Client Success team in monitoring client financial data and performance metrics. My primary objective is to identify areas for operational improvement and revenue growth while decreasing the percentage of denials and improving collections on claims. My job responsibilities include: Analyzing Charges, Payments, Encounters, A/R, and denials data for our clients to decrease the percentage… Show more As a Sr. (RCM) Analyst, in a contract (PRN Flex hours) role, I am responsible for assisting the RCM Client Success team in monitoring client financial data and performance metrics. My primary objective is to identify areas for operational improvement and revenue growth while decreasing the percentage of denials and improving collections on claims. My job responsibilities include: Analyzing Charges, Payments, Encounters, A/R, and denials data for our clients to decrease the percentage of denials, improve collections on claims, and identify practice trends. Developing tools and methodologies to monitor, analyze, and forecast revenue cycle trends. Collaborating with data management consultants, Client Success stakeholders, and operations leadership, researching client performance trends/issues, and providing forensic insight into data requests. Identifying opportunities to improve revenue and collection performance through analysis of charges, claim denials, payments, accounts receivable, and escalated client metrics. Monitoring operational key performance indicators to identify the root cause of poor performing metrics and make recommendations for improvement. Serving as a subject matter expert within Meditech, and necessary analytic tools. Developing strategies to capture additional data for better insight into performance improvement opportunities. Assisting management in developing meaningful reports and summaries that provide support to the RCM Client Success team. Leveraging management reports identifying areas for operational improvements and efficiencies for clients throughout their RCM lifecycle. Generating standard and custom statistical and analytical reports as requested by RCM Leadership using the Patient Accounting Systems, Microsoft Excel, SQL, and/or Qlik. Completing Ad Hoc report request as assigned by management. Conducting detailed research into data and performance changes as identified and requested. Show less As a Sr. (RCM) Analyst, in a contract (PRN Flex hours) role, I am responsible for assisting the RCM Client Success team in monitoring client financial data and performance metrics. My primary objective is to identify areas for operational improvement and revenue growth while decreasing the percentage of denials and improving collections on claims. My job responsibilities include: Analyzing Charges, Payments, Encounters, A/R, and denials data for our clients to decrease the percentage… Show more As a Sr. (RCM) Analyst, in a contract (PRN Flex hours) role, I am responsible for assisting the RCM Client Success team in monitoring client financial data and performance metrics. My primary objective is to identify areas for operational improvement and revenue growth while decreasing the percentage of denials and improving collections on claims. My job responsibilities include: Analyzing Charges, Payments, Encounters, A/R, and denials data for our clients to decrease the percentage of denials, improve collections on claims, and identify practice trends. Developing tools and methodologies to monitor, analyze, and forecast revenue cycle trends. Collaborating with data management consultants, Client Success stakeholders, and operations leadership, researching client performance trends/issues, and providing forensic insight into data requests. Identifying opportunities to improve revenue and collection performance through analysis of charges, claim denials, payments, accounts receivable, and escalated client metrics. Monitoring operational key performance indicators to identify the root cause of poor performing metrics and make recommendations for improvement. Serving as a subject matter expert within Meditech, and necessary analytic tools. Developing strategies to capture additional data for better insight into performance improvement opportunities. Assisting management in developing meaningful reports and summaries that provide support to the RCM Client Success team. Leveraging management reports identifying areas for operational improvements and efficiencies for clients throughout their RCM lifecycle. Generating standard and custom statistical and analytical reports as requested by RCM Leadership using the Patient Accounting Systems, Microsoft Excel, SQL, and/or Qlik. Completing Ad Hoc report request as assigned by management. Conducting detailed research into data and performance changes as identified and requested. Show less
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YAKIMA VALLEY MEMORIAL HOSPITAL
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United States
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Medical Practices
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1 - 100 Employee
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RCM Consultant
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Dec 2021 - Jul 2022
As a Operations Manager in a contract (PRN Flex hours) role, I bring extensive experience in managing billing processes and utilizing SSI claims editor system to create custom edits and generate reports to track and manage trends. I collaborate with clients to prioritize edits and develop action plans to understand the root cause of edits and take corrective actions to release claims. Additionally, I provide recommendations to improve processes and avoid future edits. With proficiency in the… Show more As a Operations Manager in a contract (PRN Flex hours) role, I bring extensive experience in managing billing processes and utilizing SSI claims editor system to create custom edits and generate reports to track and manage trends. I collaborate with clients to prioritize edits and develop action plans to understand the root cause of edits and take corrective actions to release claims. Additionally, I provide recommendations to improve processes and avoid future edits. With proficiency in the Soarian Revenue Cycle solution, I am experienced in Soarian Financials implementations and serve as a Subject Matter Expert for revenue management EBEW work list configuration. I provide support for post-activation, including testing and training, and assist with general troubleshooting and issue resolution. I maintain documentation of training materials, prepare written deliverables, and perform analysis, design, and documentation of current and future state workflows based on customer requirements. Show less As a Operations Manager in a contract (PRN Flex hours) role, I bring extensive experience in managing billing processes and utilizing SSI claims editor system to create custom edits and generate reports to track and manage trends. I collaborate with clients to prioritize edits and develop action plans to understand the root cause of edits and take corrective actions to release claims. Additionally, I provide recommendations to improve processes and avoid future edits. With proficiency in the… Show more As a Operations Manager in a contract (PRN Flex hours) role, I bring extensive experience in managing billing processes and utilizing SSI claims editor system to create custom edits and generate reports to track and manage trends. I collaborate with clients to prioritize edits and develop action plans to understand the root cause of edits and take corrective actions to release claims. Additionally, I provide recommendations to improve processes and avoid future edits. With proficiency in the Soarian Revenue Cycle solution, I am experienced in Soarian Financials implementations and serve as a Subject Matter Expert for revenue management EBEW work list configuration. I provide support for post-activation, including testing and training, and assist with general troubleshooting and issue resolution. I maintain documentation of training materials, prepare written deliverables, and perform analysis, design, and documentation of current and future state workflows based on customer requirements. Show less
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Cerner Corporation
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United States
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IT Services and IT Consulting
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700 & Above Employee
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Site Lead | Veterans Affairs EHRM Learning Team Engagement Owner
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Jul 2019 - Jun 2022
• Supported the Veteran Affairs Electronic Health Record Modernization (EHRM) program. • Facilitate the assessment, alignment, and optimization of patient accounting /functional areas to meet OEHRM deployment requirements. • Work directly with local CPAC leads to ensure critical/functional capabilities are in place for the deployment of EHRM. • Configuration knowledge in scheduling build and templates as well as the various Masterfiles required for patient access… Show more • Supported the Veteran Affairs Electronic Health Record Modernization (EHRM) program. • Facilitate the assessment, alignment, and optimization of patient accounting /functional areas to meet OEHRM deployment requirements. • Work directly with local CPAC leads to ensure critical/functional capabilities are in place for the deployment of EHRM. • Configuration knowledge in scheduling build and templates as well as the various Masterfiles required for patient access registration. • Configuration knowledge master files such as health professionals, encounter providers, encounter locations, accommodation charge rules, manage Soarian Financials organizations master files. • Worklist automation and knowledge with linking primary encounters • patient access configuration knowledge for all appointment types, outpatient services and various inpatient services: labor and delivery, ED, treatment series, enterprise scheduling, patient check-in/out and encounter automation etc. • Develop and execute unit, system, and integrated test scripts if identified to resolve open issues. • Work with various end users to ensure resolution will meet the business needs. • Understand and train end users on worklists and error log remediation. • ServiceNow for Ticketing • Provide recommendations on key RevCycle metric improvements, including DNFB Days, CCR, AR Days. • Experience with configuration tools or settings needed for desired outcomes in the Patient Accounting space, including pft_tools, ProFit Claim Manager, ProFit Business Manager, and RevCycle Maintenance as it relates to Work Item design/build. • Oversee optimization and uplift projects for Cerner clients • Created and maintained project workplans and collaborated with key internal and external stakeholders. Show less • Supported the Veteran Affairs Electronic Health Record Modernization (EHRM) program. • Facilitate the assessment, alignment, and optimization of patient accounting /functional areas to meet OEHRM deployment requirements. • Work directly with local CPAC leads to ensure critical/functional capabilities are in place for the deployment of EHRM. • Configuration knowledge in scheduling build and templates as well as the various Masterfiles required for patient access… Show more • Supported the Veteran Affairs Electronic Health Record Modernization (EHRM) program. • Facilitate the assessment, alignment, and optimization of patient accounting /functional areas to meet OEHRM deployment requirements. • Work directly with local CPAC leads to ensure critical/functional capabilities are in place for the deployment of EHRM. • Configuration knowledge in scheduling build and templates as well as the various Masterfiles required for patient access registration. • Configuration knowledge master files such as health professionals, encounter providers, encounter locations, accommodation charge rules, manage Soarian Financials organizations master files. • Worklist automation and knowledge with linking primary encounters • patient access configuration knowledge for all appointment types, outpatient services and various inpatient services: labor and delivery, ED, treatment series, enterprise scheduling, patient check-in/out and encounter automation etc. • Develop and execute unit, system, and integrated test scripts if identified to resolve open issues. • Work with various end users to ensure resolution will meet the business needs. • Understand and train end users on worklists and error log remediation. • ServiceNow for Ticketing • Provide recommendations on key RevCycle metric improvements, including DNFB Days, CCR, AR Days. • Experience with configuration tools or settings needed for desired outcomes in the Patient Accounting space, including pft_tools, ProFit Claim Manager, ProFit Business Manager, and RevCycle Maintenance as it relates to Work Item design/build. • Oversee optimization and uplift projects for Cerner clients • Created and maintained project workplans and collaborated with key internal and external stakeholders. Show less
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Brightwood College
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Higher Education
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700 & Above Employee
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Member of the Board of Advisors
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Feb 2017 - Sep 2020
I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject… Show more I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject matter expert in RCM, offering insights, recommendations, and guidance to the program lead and faculty. Curriculum Development: Collaborate with the program lead and faculty to review and update the curriculum, ensuring that it reflects current industry standards, trends, and best practices in RCM. Industry Trends: Stay informed about the latest developments, technologies, and regulatory changes within the RCM field and share this information with the program team. Networking: Facilitate connections with industry professionals, potential guest speakers, and organizations that can provide real-world perspectives and opportunities for students. Program Enhancement: Suggest ways to enhance the program's effectiveness, including identifying areas for improvement and proposing innovative solutions. Student Engagement: Participate in activities that promote student engagement, such as mentoring, guest lectures, or career development workshops. Assessment: Collaborate on the assessment and evaluation of the program's outcomes and recommend improvements based on feedback and data. Professional Experience: Extensive experience in Revenue Cycle Management, preferably in a managerial or leadership role, with a track record of success. Industry Knowledge: In-depth knowledge of industry standards, regulations, and best practices related to RCM in healthcare or relevant sectors. Show less I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject… Show more I am an Advisory Board Member for Revenue Cycle Management (RCM) and play a critical role in providing expert guidance and strategic advice to the college program lead, faculty, and staff in the field of RCM. I leverage my extensive industry knowledge and experience to enhance the educational program's curriculum, ensure alignment with industry best practices, and contribute to the overall success and relevance of the program. Responsibilities: Advisory Role: Act as a subject matter expert in RCM, offering insights, recommendations, and guidance to the program lead and faculty. Curriculum Development: Collaborate with the program lead and faculty to review and update the curriculum, ensuring that it reflects current industry standards, trends, and best practices in RCM. Industry Trends: Stay informed about the latest developments, technologies, and regulatory changes within the RCM field and share this information with the program team. Networking: Facilitate connections with industry professionals, potential guest speakers, and organizations that can provide real-world perspectives and opportunities for students. Program Enhancement: Suggest ways to enhance the program's effectiveness, including identifying areas for improvement and proposing innovative solutions. Student Engagement: Participate in activities that promote student engagement, such as mentoring, guest lectures, or career development workshops. Assessment: Collaborate on the assessment and evaluation of the program's outcomes and recommend improvements based on feedback and data. Professional Experience: Extensive experience in Revenue Cycle Management, preferably in a managerial or leadership role, with a track record of success. Industry Knowledge: In-depth knowledge of industry standards, regulations, and best practices related to RCM in healthcare or relevant sectors. Show less
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TruBridge
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United States
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Hospitals and Health Care
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300 - 400 Employee
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Revenue Cycle Coordinator
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May 2018 - Jul 2019
I collaborated with sales representatives to drive successful Revenue Cycle Management (RCM) implementations and transitions to the Implementation Team. I conducted kick-off meetings with clients and assessed their current workflow to determine the best approach for implementation. I designed and created a project plan for each client, using a master template, and scheduled and conducted regular weekly checkpoints to ensure consistent and successful RCM processes. I coordinated training… Show more I collaborated with sales representatives to drive successful Revenue Cycle Management (RCM) implementations and transitions to the Implementation Team. I conducted kick-off meetings with clients and assessed their current workflow to determine the best approach for implementation. I designed and created a project plan for each client, using a master template, and scheduled and conducted regular weekly checkpoints to ensure consistent and successful RCM processes. I coordinated training schedules, documented all training and significant conversations in the RCM Implementation Salesforce record, and tracked and monitored client status throughout the implementation project. Additionally, I reviewed project plans with clients, assigned tasks and responsibilities, and submitted additional tasks to respective departments using Salesforce. I scheduled and conducted training sessions with clients utilizing GoToMeeting and facilitated clearinghouse, lockbox, and credit card enrollments. Finally, I managed the post-go-live implementation relationship, activity, and account development, and transitioned clients fully to the RCM team upon completion of implementation and go-live. Show less I collaborated with sales representatives to drive successful Revenue Cycle Management (RCM) implementations and transitions to the Implementation Team. I conducted kick-off meetings with clients and assessed their current workflow to determine the best approach for implementation. I designed and created a project plan for each client, using a master template, and scheduled and conducted regular weekly checkpoints to ensure consistent and successful RCM processes. I coordinated training… Show more I collaborated with sales representatives to drive successful Revenue Cycle Management (RCM) implementations and transitions to the Implementation Team. I conducted kick-off meetings with clients and assessed their current workflow to determine the best approach for implementation. I designed and created a project plan for each client, using a master template, and scheduled and conducted regular weekly checkpoints to ensure consistent and successful RCM processes. I coordinated training schedules, documented all training and significant conversations in the RCM Implementation Salesforce record, and tracked and monitored client status throughout the implementation project. Additionally, I reviewed project plans with clients, assigned tasks and responsibilities, and submitted additional tasks to respective departments using Salesforce. I scheduled and conducted training sessions with clients utilizing GoToMeeting and facilitated clearinghouse, lockbox, and credit card enrollments. Finally, I managed the post-go-live implementation relationship, activity, and account development, and transitioned clients fully to the RCM team upon completion of implementation and go-live. Show less
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Talisman Solutions Incorporated
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United States
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Hospitals and Health Care
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Senior Operations Manager
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Jan 2017 - Apr 2018
• Management position in charge of directing and coordinating the overall functions of the medical billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. • Oversaw the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management. • Soarian experience w Scheduling/Financials • Athena IDX (Provider… Show more • Management position in charge of directing and coordinating the overall functions of the medical billing and coding office to ensure maximization of cash flow while improving patient, physician, and other customer relations. • Oversaw the operations of the billing department, encompassing medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management. • Soarian experience w Scheduling/Financials • Athena IDX (Provider maintenance/locations). • Analyzed trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff and revise policies and procedures. • Soarian Financial upgrades/enhancement/workflows • provide technical application solutions for assigned business areas. • Work with Business Analysts to understand the customer’s product-specific requirements and configuration and translate them to technical design specifications and data flow from which programs are developed and coded. • Codes, tests, debugs, implements, and documents programs or technical configurations. • Interact with Business and clinical representatives during the software build or configuration and testing process. • Perform technical application configuration and configure /run reports at user request. • Assist in resolving support calls escalated by the Service Desk. • Identify the common causes of the defects, prioritize them, and systematically remove them so that they do not reoccur in further development work.
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Practice and Provider Credentialing Manager
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Dec 2015 - Jan 2017
I managed the provider enrollment with payers, including performing credentialing and re-credentialing functions for all providers on a national and state level with managed care companies, payors, and/or insurance carriers for new physicians and start-up practices. I collaborated with clinical, ancillary, compliance, and finance department management teams to ensure compliance and revenue integrity with government, payer, and charge capture requirements. I maintained credential files in the… Show more I managed the provider enrollment with payers, including performing credentialing and re-credentialing functions for all providers on a national and state level with managed care companies, payors, and/or insurance carriers for new physicians and start-up practices. I collaborated with clinical, ancillary, compliance, and finance department management teams to ensure compliance and revenue integrity with government, payer, and charge capture requirements. I maintained credential files in the required format to meet Joint Commission, CMS, and legal presentation requirements and maintained accurate data in the credential database and permanent credential files. I collaborated with medical staff and leadership to ensure credentialing and processing standards are being met and established and maintained long-term working relationships with healthcare providers. Additionally, I oversaw all aspects of the HIM operational processes, including incomplete record management, HIM transcription, release of information (RIO), record retrieval and reconciliation, pulling/filing/retrieval of medical records, tumor registry, trauma registry unbilled reporting, and birth certificates. I identified trends in operational performance and identified process improvement opportunities and worked collaboratively with Medical Staff and Facility Leadership to comply with standards and guidelines enforced through the Medical Staff Bylaws/Rules and Regulations. My role required the creation and maintenance of CAQH accounts and NPPES/PECOS accounts, network contract negotiations, FQHC/RHC/CAH, and provider onboarding, training, and direct support for the providers' overall credentialing process. • Provider onboarding, training and direct support for the overall credentialing process of the providers. • Established and maintained long-term working relationships with healthcare provider. • Created and maintained CAQH accounts and NPPES/PECOS accounts. • Network contract negotiations, FQHC/RHC.
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MD Anderson Cancer Center
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United States
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Hospitals and Health Care
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700 & Above Employee
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PBS Billing Manager
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Dec 2013 - Dec 2015
As a manager, I was responsible for interviewing job candidates and preparing performance evaluations and action plans for individual staff and team leads. I conducted quality assurance checks and monitored team workloads and productivity while also holding meetings with staff members to deliver results related to productivity and quality, discussing coaching and development needs as required. Additionally, I compiled consistent reporting statistics to document team performance, examined… Show more As a manager, I was responsible for interviewing job candidates and preparing performance evaluations and action plans for individual staff and team leads. I conducted quality assurance checks and monitored team workloads and productivity while also holding meetings with staff members to deliver results related to productivity and quality, discussing coaching and development needs as required. Additionally, I compiled consistent reporting statistics to document team performance, examined reimbursement and denial patterns within assigned AR to recognize trends and suggest and implement innovative solutions. I also assessed opportunities to improve internal workflows and ensured that the best methods and tools were utilized while maintaining strong client relationships, addressing issues and needs delivered by clients and providing accurate feedback to both the client and departments. Finally, I ensured that all team members adhered to internal company policies and procedures. Show less As a manager, I was responsible for interviewing job candidates and preparing performance evaluations and action plans for individual staff and team leads. I conducted quality assurance checks and monitored team workloads and productivity while also holding meetings with staff members to deliver results related to productivity and quality, discussing coaching and development needs as required. Additionally, I compiled consistent reporting statistics to document team performance, examined… Show more As a manager, I was responsible for interviewing job candidates and preparing performance evaluations and action plans for individual staff and team leads. I conducted quality assurance checks and monitored team workloads and productivity while also holding meetings with staff members to deliver results related to productivity and quality, discussing coaching and development needs as required. Additionally, I compiled consistent reporting statistics to document team performance, examined reimbursement and denial patterns within assigned AR to recognize trends and suggest and implement innovative solutions. I also assessed opportunities to improve internal workflows and ensured that the best methods and tools were utilized while maintaining strong client relationships, addressing issues and needs delivered by clients and providing accurate feedback to both the client and departments. Finally, I ensured that all team members adhered to internal company policies and procedures. Show less
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Prognosis Health Information Systems (PHIS)
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United States
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Hospitals and Health Care
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Clinical Client Manager/Implementation and Training
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Jun 2012 - Dec 2013
I designed and implemented effective business strategies to achieve revenue cycle goals while interacting with all levels of management and both internal and external customers. I formulated and delivered training programs on billing software, financial systems, and practice management systems to enhance the company's strategies and objectives. I managed issue resolution through a help desk environment, including EMR and EHR practice management systems, third-party interfaces, and various… Show more I designed and implemented effective business strategies to achieve revenue cycle goals while interacting with all levels of management and both internal and external customers. I formulated and delivered training programs on billing software, financial systems, and practice management systems to enhance the company's strategies and objectives. I managed issue resolution through a help desk environment, including EMR and EHR practice management systems, third-party interfaces, and various databases by providing troubleshooting, data evaluation, data conversion, and research. I also served as an IT liaison to consultants, vendors, and other healthcare professionals, provided in-office and remote technical assistance, and developed user training aids to train end-users in workflow and the use of the application. I reviewed claims to ensure payment was made according to the fee schedule, and contractual adjustments were appropriately applied. As a Training and Go-Live Support Lead, I was responsible for developing and managing training plans, schedules, curriculum, content localization, readiness phase, and trainers/super users. I identified claims processing issues, troubleshooting problems and questions from end-users during training, go-live, stabilization, and ongoing support. I notified management to alleviate further claims processing delays and handled or delegated any client issues that arose, ensuring timely and effective handling of the issues. Furthermore, I created and implemented all necessary internal reporting for senior management, interfaced with team members as necessary to plan, build, implement, and test the application, and addressed first-line help desk support calls from both clients and internal users. Overall, my expertise in business strategy, training, and technical support allowed me to improve healthcare infrastructure optimization initiatives while maintaining compliance guidelines and policies to enhance client revenue. Show less I designed and implemented effective business strategies to achieve revenue cycle goals while interacting with all levels of management and both internal and external customers. I formulated and delivered training programs on billing software, financial systems, and practice management systems to enhance the company's strategies and objectives. I managed issue resolution through a help desk environment, including EMR and EHR practice management systems, third-party interfaces, and various… Show more I designed and implemented effective business strategies to achieve revenue cycle goals while interacting with all levels of management and both internal and external customers. I formulated and delivered training programs on billing software, financial systems, and practice management systems to enhance the company's strategies and objectives. I managed issue resolution through a help desk environment, including EMR and EHR practice management systems, third-party interfaces, and various databases by providing troubleshooting, data evaluation, data conversion, and research. I also served as an IT liaison to consultants, vendors, and other healthcare professionals, provided in-office and remote technical assistance, and developed user training aids to train end-users in workflow and the use of the application. I reviewed claims to ensure payment was made according to the fee schedule, and contractual adjustments were appropriately applied. As a Training and Go-Live Support Lead, I was responsible for developing and managing training plans, schedules, curriculum, content localization, readiness phase, and trainers/super users. I identified claims processing issues, troubleshooting problems and questions from end-users during training, go-live, stabilization, and ongoing support. I notified management to alleviate further claims processing delays and handled or delegated any client issues that arose, ensuring timely and effective handling of the issues. Furthermore, I created and implemented all necessary internal reporting for senior management, interfaced with team members as necessary to plan, build, implement, and test the application, and addressed first-line help desk support calls from both clients and internal users. Overall, my expertise in business strategy, training, and technical support allowed me to improve healthcare infrastructure optimization initiatives while maintaining compliance guidelines and policies to enhance client revenue. Show less
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Community
