Yyyyyy x. yyyyyy

Seeking opportunity as Revenue Cycle Director with Orthopedic Physician Associates

Healthcare Business Office Management ~ Revenue Cycle Management

Professional Fee Coding ~ E&M Coding ~ Team Leadership ~ Auditing & Analysis

         Substantial experience in managing all facets of healthcare office operations including hiring/staffing, training, performance management, medical billing, coding, accounts receivable, and HIPAA compliance.

         Proficiency in the complete spectrum of revenue cycle management encompassing data entry, adjustments, responding to billing inquiries, auditing, comprehensive analysis, and facilitating collections.

         Adept at reporting, reviewing, and auditing reimbursements from third-party payors in accordance with stringent regulatory, accounting, and contractual rules and regulations.

         Meticulous, resourceful, and quality-focused with considerable talents in staff supervision, department management, coaching, training, driving process improvements, and educating staff and providers.

         Certified expert in evaluation and management (E&M) coding and professional fee (pro-fee) coding.

         Excel at advising upper management in optimal course of action for large-scale claim resolution.

         Substantial technical expertise spans Epic, Meditech, Misys, Medical Manager, Medisoft, Nuco Cubs, Practice Mate, ChartMaxx, Practice Partner, Encoder Pro, STAR, AccelaCAPTURE, Kronos, and Microsoft Office Suite (Word, Excel, PowerPoint).

Aerotek Staffing / Skagit Valley Hospital, 2014 to 2016

Production Coder

         Interpreted, analyzed, and corrected daily charges for numerous hospital departments, handled coding-related billing denials, abstracted pro-fee hospital charges for physicians, and accurately coded pain management hospital day surgeries.

Medigain, 2014

Medical Billing / Appeals Specialist

         Methodically appealed third tier denials and administered high-dollar accounts for payment resolution.

         Proficiently used Epic and Advanced MD practice management software to resolve accounts.

Diamond Medical Billing Services Inc., Bellevue, WA, 2012 to 2013

Revenue Cycle Director / Owner

         Spearheaded full-scope business operations for medical billing company comprised of 20 personnel.

         Joined forces with large multi-million dollar client to recover $200M in accounts receivable.

         Applied dynamic leadership talents toward hiring, training, mentoring, and directing top talent.

         Devised practical workflows and assembled business manuals to optimize efficiency, consistently enforced adherence to HIPAA regulations, and educated clients in coding and revenue cycle management.

Valley Medical Center, Renton, WA, 2011 to 2012

Coding Technical Coordinator (Supervisor)

         Hired and trained new staff, functioned as advisor to revenue cycle and charge entry teams, and delegated assignments to eight employees at central business office.

         Played an integral role in establishing physician compliance program for 185 physicians featuring E&M retrospective audits and provider education.

         Successfully located $100K in revenue by proactively conducting back-audits of missing and lost charges.

Continued ►

Professional Experience continued Yyyyyy x. yyyyyy Page 2 of 2

Swedish Medical Center, Pediatric Specialty Care Clinic, Seattle, WA, 2010 to 2011

Clinic Coder II

         Performed E&M auditing of physician charges and delivered informative PowerPoint presentations to advise and educate physicians in 1995 documentation guidelines.

         Coded pro-fee surgeries performed in hospital according to NCCI edits using Encoder Pro application.

         Recouped $62K by systematically conducting back-audit of unposted surgical cases.

         Instrumental in seamlessly transitioning clinic from using Misys software to Epic.

Valley Medical Center, Renton, WA, 2010

Coder / Abstractor II

         Investigated high-dollar unpaid accounts due to physician coding errors or omissions, and abstracted according to rigorous coding guidelines.

Office Team / Lynx Medical Systems, 2009 to 2010

Pro-Fee Coder

         Achieved or surpassed productivity targets in auditing ER charges and coding up to 120 claims daily.

Healthcare Resource Group / Valley Medical Center, Renton, WA, 2009

Coder

         Proficiently coded between 80 and 100 claims per day within family practice comprised of 32 physicians.

Digestive Health Specialists, Tacoma, WA, 2009
Medicare Accounts Receivable

         Researched unpaid claims and audited denials at multi-location practice comprised of 45+ physicians.

Tri-Med Ambulance, LLC, 2008

Medical Billing Department Supervisor

         Exhibited excellent managerial skills in training, coordinating and managing 10 personnel, authoring job descriptions, and restructuring department to ensure key metrics were attained for $10M in A/R.

         Championed monthly orientation program to inform and educate EMTs in Medicare payment guidelines.

MedData, 2007 to 2008

Medical Billing Manager

         Managed A/R across multiple databases requiring constant communication and cooperation with teams at outsourced company in India. 

Additional Experience:

Accounts Receivable, AIM Healthcare, Inc. (Providence / Swedish Hospital Billing Department), 2006 to 2007

Accounts Receivable, Med+Temps (Retina & Macula Specialists-Tacoma), 2005 to 2006

Office Manager, Peter Somoff Pro Shops, Mill Creek/Tacoma, WA, 2004 to 2005

Medicare Accounts Receivable, Digestive Health Specialists, Tacoma, WA, 2002 to 2004

Office Manager, Pediatric Cardiology of Alaska, Anchorage, AK, 1999 to 2002

Medicare / Medicaid Biller, Anchorage Medical & Surgical, Anchorage, AK, 1999

Billing Manager, Alaska Urological Associates, Anchorage, AK, 1996 to 1999

Certified Professional Coder

Certified Evaluation and Management Coder

Member of AAPC (American Academy of Professional Coders)

Presented Coding s Impact on the Revenue Cycle at 2014 conference

Education Officer for First Hill Chapter, 2012 & 2013