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Skills

Claim edits implementation
Regulatory compliance
Cross-functional team collaboration
Automated coding compliance implementation
Advanced spreadsheet analysis
EHR system integration
Financial variance analysis
Stakeholder relationship management
Denial management strategies
Payment processing

Work Experiences

Achieved results over 11 months.
Analyzed revenue data trends.
Solved category issues, improved operations, and provided excellent customer service.
Completed the project within 15 months.
Collaborated with the compliance department.
Designed a KPI dashboard.
Collaborated with metric customers to determine their needs and deliver system service.
Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
Consulted with legal and compliance teams.
Created a detailed annual revenue report that guided executive decisions, resulting in process changes generating an additional $11 in revenue.

Summaries

Process professional with a strong understanding of numbers who is capable of managing multiple projects with tight deadlines.
Achieved 77% reduction in denials.
Revenue Integrity Analyst is a detail-oriented Revenue Integrity Analyst with 8 years of finance and accounting experience.
Accounting systems and related computer software programs, such as HubSpot and Tableau, are second nature to me.
Dedicated to learning, growing, and succeeding in Miscellaneous.
Costs were consistently reduced while profits were increased.
Through general ledger entries and account reconciliations, dedicated to quickly increasing profitability and reducing expenditures.
Overall morale and productivity are boosted by experience in policy development and staff management procedures.
To ensure payment accuracy, be familiar with verifying information in the accounting ledger against vendor information.
Aligned revenue integrity policies with CMS guidelines.

Accomplishments

Introduced charge capture improvements that reduced late charges by 73% within customer success, increasing overall revenue cycle efficiency.
Audited payer contract performance, identifying underpayments and inconsistencies, leading to regulatory updates and a 22% increase in collections.
Collaborated with team of 16 in the development of system.
Developed and executed a targeted recovery plan for denied claims, successfully reclaiming $9 and reducing overall denial rates by 15%.
Developed and implemented a charge description master (CDM) audit system, leading to 80% fewer errors during claim submissions.
Re-engineered workflow processes for patient billing and collections, reducing outstanding receivables by 37% and decreasing days in accounts receivable by 6 days.
Managed high-volume claim audits for the standard department, identifying an opportunity to recover $14 in missing revenue across two years.
Implemented robust denial management strategies, reducing claim denials by 67% and recovering $18 by overturning previously denied claims.
Spearheaded the redesign of the charge master, leading to a 40% improvement in accuracy and compliance with payer regulations.
Collaborated with clinical and financial teams to align coding practices with billing, resulting in a 23% reduction in claim errors and a smoother audit process.

Affiliations

Association of Clinical Documentation Integrity Specialists (ACDIS)
Healthcare Financial Management Association (HFMA)
Jaycees
Faculty Member or Volunteer, Free Medical Clinic Billing Teams
Association of American Healthcare Administrative Management (AAHAM)
Compliance and Risk Management Advisory Panels
Medical Auditing Standards Committee
Freemason
International Council of Nurses
Continuing Medical Education (CME) courses relevant to revenue integrity

Certifications

Epic Resolute Professional Billing Certification
Cisco Certified Internetwork Expert (CCIE)
Certified Revenue Cycle Representative (CRCR)
EPIC Cadence Certification
Microsoft Certified Systems Engineer (MCSE)
ServSafe
Cisco Certified Network Associate (CCNA)
Health Care Revenue Integrity Certification Harbor & Co.
CompTIA A+ Technician
Lean Six Sigma Certification system

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