Senior Revenue Cycle Consultant

• Oct 2023 - Present

Senior Revenue Cycle Consultant

• Apr 2023 - Oct 2023

Vice President - Revenue Cycle Operations

• Nov 2020 - Oct 2022

Assigned to Holy Family Memorial - Manitowoc Assigned to Holy Family Memorial - Manitowoc

System Director of Revenue Integrity

• Mar 2017 - Nov 2019

Team Leader - Patient Financial Services

• Jul 2016 - Mar 2017

Manager - Chargemaster, Reimbursement & Pre-Certification

• Feb 2016 - Jul 2016

• Responsible for denial management tracking and communication of identified compliance issues• Review and analyze insurance payer contracts for payment compliance• Provide data analytics for managed care contract negotiations• Utilize Lean tools to improve charging, coding and billing processes through Value Stream Analysis (VSA) and Rapid Improvement Events (RIE)• Assist departments understand budget impact of charge code changes• Conduct ad-hoc audits of charging, billing and reimbursement issues Show less

Chargemaster & Reimbursement Analyst

• Jun 2013 - Feb 2016

• Maintain the 6,000+ line item Charge Description Master database of hospital patient charges• Collaborate with Physicians and Mid-Level Providers on charge creation, charge capture and documentation requirements to support clinic operations• Developed and conduct education sessions for staff at all levels regarding charge capture and compliant charging• Implemented PQRI (Physician Quality Reporting Initiative) measures in multiple family practice clinics• Evaluated Physician RVU metrics for use in compensation structures• Created provider-based charges, fee slips and education for clinic staff regarding new charge process• Maintain charge slips for clinics to ensure revenue capture to optimize profitability• Review and apply CMS guidance in an accurate and timely manner regarding coding, billing and other regulatory changes Show less

Manager - Patient Access & Scheduling

• Oct 2009 - Jan 2011

-Manage a staff consisting of 3 Leads and 57 Patient Access Associates on 3 hospital campuses -Create department specific policies and procedures to improve the Revenue Cycle -Analyze staff training needs and create training and assessment tools -Collaborate with other Iowa Health System affiliates to implement standardized Patient Access software improvements -Utilize Quint Studer Principles to develop and retain staff based on best practice leadership -Maintain accurate and detailed personnel records and identify staff issues that warrant corrective action -Communicate process changes to all staff in a timely manner via email, staff meetings and SharePoint Show less

Chargemaster Analyst

• Jul 2006 - Oct 2009

-Maintain an 8,000+ line item Charge Description Master database of hospital patient charges -Chairperson for the Hospital Audit Committee -Identified $400,000+ in Disproportionate Share (DSH) revenue owed by insurance companies -Assist in Cost Report preparation (bad debt and dual entity reporting) -Prepare and publish yearly charge adjustment file according to Hospital Association standards -Review and analyze managed care contracts for accuracy in payment -Serve as point of contact for managers and staff regarding billing and compliance issues -Developed database for tracking patient concerns and complaints -Implemented Patient Friendly Price Estimate process -Created standardized charge code request process to expedite creation of new charge codes -Process and analyze data for reporting to management and corporate office Show less

Chargemaster Analyst

• Nov 2004 - Jul 2006

-Maintain a 30,000+ line item Charge Description Master database of hospital patient charges-Complete monthly financial reporting for various organizational players-Audit Charge Description Master for accuracy and update based on regulatory changes-Analyze SQL data to complete reimbursement, cost and various other analyses for leadership-Educate clinic managers and department directors on procedure pricing decision policies -Serve as point of contact for employees with questions on SQL data tables Show less

Admissions & Billing Associate

• Nov 2001 - Nov 2004

Registration & Admissions Department-Obtain and/or verify medical & prescription drug insurance -Contact patients to prepare demographic and insurance information prior to patient visits-Review error reports to correct insurance selections based on contract payment terms-Assist in training new associates