Revenue Cycle Resume Samples

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B Eichmann

Brain

Eichmann

62438 Greenholt Court

Phoenix

+1 (555) 292 5201

62438 Greenholt Court

Phoenix

Phone

p +1 (555) 292 5201

Experience Experience

Philadelphia, PA

Revenue Cycle Coordinator

Philadelphia, PA

Leuschke Group

Philadelphia, PA

Revenue Cycle Coordinator

Work with coding staff to resolve coding related denials
Partner with clinical leaders, admitting departments and physicians related to securing payment on hospital accounts from third party resources and/or patients
Responsible for improving and maintaining an efficient revenue for the department
Monitors high dollar and aging accounts (unbilled, denials, follow-up) in systems for escalation with departments (DNFB, XClaim, Revenue Recover, RTS)
Develops and maintains efficient working relationships
In partnership with CBO, follow-up on claim status and appeals including interaction with the payors
Reviews and ensures departments are reconciling charges on a daily basis

Chicago, IL

Revenue Cycle Mgt Analyst

Chicago, IL

Wuckert-Haley

Chicago, IL

Revenue Cycle Mgt Analyst

Reporting at CBO monthly operations meetings
Complies with departmental and company-wide policies and procedures
Create new reports for the RCM Auditing Dept, Contract Revenue Dept, Billing Dept and Business Systems Dept; train said departments on running reports and troubleshoot future issues or modifications
Support and Training, by providing ongoing support to the CBO RCM Revenue Cycle Analysts
Distribute Deposit Report of current month’s deposits, including previous day’s Lockbox and EFT transactions, along with monthly projection of receipts by region
Responsible for balancing tie outs from billing and patient accounting systems (GPMS, NextGen,
Monthly Reporting, Analysis, and Trending

present

Houston, TX

Revenue Cycle Optimization Manager

Houston, TX

Jakubowski, Grimes and Mills

present

Houston, TX

Revenue Cycle Optimization Manager

present

Develop work plans, project tasks and manage projects in accordance with budget
Provide feedback to management concerning possible problems or areas of improvement
Perform other duties as assigned by management
Development of options and recommendations for client improvement
Provide informed feedback to Optum and client executives including assessments of processes, standards, suggestions and improvements
Interim management
Office Process and Performance Assessments

Education Education

Bachelor’s Degree in Accounting

University of San Francisco

Bachelor’s Degree in Accounting

Skills Skills

Possesses the ability to build trusting relationships with multiple Client Executives at all levels and for numerous unique customers
Possesses analytical ability sufficient to work in a data-heavy environment and to identify trends in the data
Possess business acumen with an emphasis on: effective communication (i.e., listening, written and verbal), negotiation, influencing decision makers, business planning, strategy, problem solving, decision making and time management skills
Policies & Procedures – demonstrates knowledge and understanding of organizational policies, procedures and systems
Customer Orientation – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
Communication – communicates clearly and concisely, verbally and in writing
Tactical Execution – oversees the development, deployment and direction of complex programs and processes
Understanding of the market, trends, competition, and key pain points for hospital executives
Financial Management – applies tools and processes to successfully manage budget

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15 Revenue Cycle resume templates

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Manager of Revenue Cycle Integrity Resume Examples & Samples

Certified Professional Coder – CPC
5 years of billing experience in a physician, ambulatory setting, and/or clinic setting
Experienced CPT, ICD9-10, and HCPC coding experience
Experience with professional fee coding systems, charge code mapping, Third Party Billing audits and regulatory compliance
EMR/EHR Experience – minimum of 2 years’ experience with one or more EMR/EHR software systems
Healthcare Experience – minimum of 5 years’ experience in the healthcare industry
Strong knowledge of medical insurance billing and collections including Medicare, Medicaid, Managed Care Products (HMO, PPO, etc.) and other third party guarantor voucher process
Excellence in solving difficult problems relating to revenue cycle functions, coding, billing and collections relating to clinical documentation and coding errors
Demonstrated ability to educate Physicians/Clinical Staff on required billing, coding and clinical documentation requirements
Develop training materials and facilitate staff training on regulatory changes that impact billing and reimbursement
Strong knowledge of medical insurance billing and collections with CPT, ICD, HCPC coding
Excellent written and verbal communication skills with all staff levels and backgrounds

Xerox Revenue Cycle Consulting Resume Examples & Samples

Employment Type: * Full-time (preferred) or Project Based depending on client needs and employee preference
Travel: * Up to 80% travel may be required. Consultants live anywhere in the U.S. (remote) and travel to the project (client site)
Position Overview: *
Provide Consulting Services to clients concerning the following: *

VP-revenue Cycle Resume Examples & Samples

10+ years of experience in hospital finance w/ a particular focus on system-wide initiatives for revenue cycle management and systems
Strong budgeting skills
Demonstrable leadership abilities

Healthcare Revenue Cycle Senior Manager Resume Examples & Samples

Ability to lead and develop others
Strong organizational, time management and analytical skills
Ability to work overtime as job and peak business deadlines require
Ability to travel up to 80% as needed (travel can be much less depending on location of office)
Positive, professional attitude and proactive approach to work
Ability to work independently on various work assignments as needed
Minimum of 5 years experience in healthcare revenue cycle and/or finance settings (with consulting experience preferred, but not required)
Must have a solid reputation and references with previous clients, contacts, co-workers, etc
Strong organizational, time management and analytical skills – with an entrepreneurial attitude

Healthcare Senior Sales Revenue Cycle Resume Examples & Samples

Aggressive sales and marketing minded disposition
Organized, with ability to manage campaigns, drive meaningful conversations for our thought leaders and manage the sales process to close
Ability to think of innovative ways to drive messaging into a focused market
Ability to sell over $3M in revenue and manage a $7M-$10M pipeline
Ability to adapt to demand creators and market quickly

Consulting Senior Associate Healthcare Revenue Cycle Advisory Services Resume Examples & Samples

Maintain and develop a high degree of expertise in revenue cycle operations, technical processes, and reports
Support our management team in executing project work plans, including qualitative and quantitative tasks and analytics, to provide high quality client service delivery
Act as part of the support team on projects to prioritize work tasks, ensure project milestones and deadlines are met, and ensure work products meet quality standards
Assist Directors and Managers in scoping and planning multiple projects
Develop and manage relationships with new and existing clients
Bachelor's degree in Accounting, Finance, Business or other related field
3+ years of Healthcare consulting experience for Hospitals and large Physician groups
Expertise in Patient Access and/or Patient financial services portions of the Revenue Cycle
Experience in Denial Management Reporting(Ensure accurate capture of and reporting on denials to allow the organization to understand where and why claims are being denied and focus on how to reduce denied claims over time)
Proven track record in improving process functions and financial performance
Experience in leading or working with performance improvement workgroups
Strong technical and analytical skills, particularly related to analyzing, summarizing and interpreting large data files
Provide project support and potentially serve as subject matter expertise in utilizing Business Intelligence tools
Experience in using QlikView software (or similar platform) is a plus
Willing and able to travel 75%

Consulting Manager Healthcare Revenue Cycle Advisory Services Resume Examples & Samples

Analyze and communicate financial and operational data to clients for decision-making and strategic planning
Manage and execute project work plans, including qualitative and quantitative tasks and analytics, to provide high quality client service delivery
Manage and direct support staff on projects to prioritize work tasks, ensure project milestones and deadlines are met, and ensure work products meet quality standards
Assist Directors in scoping and planning multiple projects
5+ years of Healthcare consulting experience for Hospitals and large Physician groups
Expertise in Patient financial services / Patient Accounting portion of the Revenue Cycle (including, but not limited to: Cash acceleration, Clean Claims, Insurance follow-up, Payment posting, Self Pay and Bad Debts Policy, Denial Management, Detailed mapping of adjustment codes, Revenue leakage)
Proven track record in improving process and financial performance in revenue cycle operations
Proven experience in managing client service teams and client relationships
Working knowledge with query, extract, transformation and load (ETL) from common database platforms (SQL) and experience with ETL tools such as Talend or CSIS is desired
Ability and willingness to travel nationwide 75%

Consulting Manager Healthcare Revenue Cycle Advisory Services Resume Examples & Samples

5+ years of Healthcare consulting experience with expertise in Revenue Cycle performance / process improvement in the patient financial services area of Hospitals
In addition: 2+ years of direct industry experience in revenue cycle management, operational process improvement, implementation/design, data mining and detailed analytics
Strong expertise in Denial Management Reporting and Resolution
Understanding of bundling, ICD-10, Value-Based Purchasing, and other Health Care initiatives

Director of It-revenue Cycle Resume Examples & Samples

Required: Bachelor’s degree in computer science or equivalent experience in a related field or equivalent applicable work experience
Preferred: Master’s Degree in Health Administration and/or Business Administration degree
Required: Seven or more years of experience in the implementation and support of revenue and access solutions in the ambulatory healthcare environment
Required: Five or more years of leadership experience in ether the manager or director level

Revenue Cycle Auditor Resume Examples & Samples

Collaborate with leadership to ensure an appropriate risk based approach to internal control audits
Perform a comprehensive and ongoing evaluation and documentation of operational processes and key internal controls
Work with departmental management to develop and update internal control documentation(process narratives, risk control matrices, etc.) periodically to include any new key internal controls or processes identified
Perform audits on an ongoing basis ensuring compliance with applicable regulations and established PRMO policies and procedures
Develop test plans to verify process effectiveness, accuracy, and completeness for specific internal controls
Prepare accurate and thorough work papers and audit documentation to support the audit findings
Identify internal control deficiencies and recommend remediation to strengthen the control environment
Engage with process owners and managers in the timely remediation of these deficiencies.Identify root-cause of audit issues identified and process anomalies as determined through testing procedures
Perform routine review of audit outcomes with management of assigned departments
Effectively present findings in both face-to-face and small group settings with peers and management
Prepare and present management reports as required
Identify, as a result of internal control audits performed, additional process improvement opportunities and assist in the redesign of those processes
Perform proper planning to execute the required test steps by established deadlines with minimal supervision
Prioritize assignments, apply sample size guidelines appropriately and provide constant and clear feedback to management and the process owners
Develop and maintain effective working relationships with team members,business process owners, management and other customers
Review revenue cycle policies and procedures, providing timely and appropriate feedback to departmental management
Participate in integrated audits, process redesign, and other projects as requested

Manager, Msrdp Revenue Cycle Resume Examples & Samples

Develops strategy based upon MSP Revenue Management Data and Reporting Committee vision and works to achieve goals long term; applies an excellent understanding of physician reimbursement policy and coding methodologies including, but not limited to AMA, CMS and specialty societies, to the physician practice for compliant documentation, coding and billing
Monitors the government reimbursement policy landscape to ensure that affected Departments are aware of emerging policy issues in order to take advantage of opportunities and identify potential threats that could impact the revenue cycle
Analyze data and develops an overall approach for trending issues, report findings, applying timely and constructive feedback, continued education and training (as the "content expert") for revenue cycle staff, clinic staff, and billing providers
Directs and supports auditors assigned to complete professional billing compliance audits, as well as ad hoc audits requested by management; prepares department summaries based upon audit findings and works closely with applicable providers/staff/management for continued performance improvement
Assists with internal and external audits including notification and reporting results to Director, Department Chair, and/or Department/Division Compliance Officer; works with billing and compliance staff to identify root cause of billing errors and take corrective action (such as Edit Administration Committee requests and staff or provider education)
Attends and participates in reimbursement and compliance activities and department meetings; facilitates problem resolution sessions where multiple departments and/or clinical or business areas are involved

Revenue Cycle Supervisor Resume Examples & Samples

Maintain current and thorough understanding of dialysis reimbursement and industry norms
Award-winning education and training across multiple career paths to help you reach your potential
Minimum of two years’ related supervisory experience strongly preferred
Intermediate proficiency in MS Word and PowerPoint; advanced proficiency and analytical ability in Excel

Senior Revenue Cycle Management Analyst Resume Examples & Samples

Analyze, and summarize reports and operational data to identify trends and ways to improve operational efficiency, productivity, and financial performance
Provide reporting data to management and others in oral and written form
Identify root causes and take appropriate steps
Perform additional process reviews as directed by the Manager; identify opportunities for improvement and implement changes as directed
Other duties and responsibilities as assigned including but not limited to
Attend team meetings, phone conferences, and training as needed
Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
Demonstrated experience with electronic billing and accounts receivable systems preferred
Outstanding project management skills
Business process redesign experience required
Advanced computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required; experience developing spreadsheets and databases required; experience with MS Access preferred, experience with Tableau preferred
Demonstrated interpersonal, collaborative, and relationship-building skills; ability to interact positively with teammates at various levels across the company
Demonstrated time management skills and ability to handle multiple priorities with shifting time frames, and meet deadlines; self-starter with high degree of initiative, urgency, and follow through
Able to work independently and as a member of a team and to foster a positive work environment
Demonstrated strengths in organizational, follow-through, analytical, reasoning, critical thinking, and problem solving skills

Revenue Cycle Report Analyst Resume Examples & Samples

Creating and generating both volume and revenue cycle reporting
Experience communicating daily/weekly with both customer and leadership teams
Strong analytical skills specific to customer revenue cycle and volume activity
Working knowledge of company products and company function
Marketing and/or service policies and procedures
Excellent written and verbal communication as well as telephone skills
Monthly invoicing and procedure code analysis

Revenue Cycle Senior Analyst Resume Examples & Samples

Provide revenue cycle management services in all areas of revenue cycle operations which includes
Bachelor's Degree in Business, Finance, or Healthcare
5+ years most recent work experience in Revenue Cycle including patient access, financial analysis, patient finance, or consulting in a senior level position
Intermediate level proficiency with Excel, Word, PowerPoint
Ability to Travel 25-50%
Healthcare Consultant
Intuitive and skilled at problem solving

Revenue Cycle Senior Consultant Resume Examples & Samples

Assess the customer charge master and charging process
Identify potential performance improvement opportunities or best practices and make recommendations to clients on how to integrate new process/best practice into current workflow
Provide consulting services to clients in all areas of the healthcare revenue cycle with a focus on the charging process
Understand clinical coding scenarios for hospital ancillary departments (e.g., Radiology, Laboratory, Pharmacy, Rehab)
Understand hospital and physician Medicare and Medicaid billing and coding
Understand governmental and third party reimbursement policies
Ability to write a monthly newsletter and present quarterly to clients
Ability to understand complex billing and coding requirements and educate clients on them
Develop work plans, project tasks and manage projects in accordance with budget
Document findings, impacts and recommendations within assessment deliverables; responsible for the revenue cycle sections within each deliverable
Identify client barriers in achieving operational excellence
Understand client business metrics and results
Evaluate and analyze client data to understand trends in all areas of the operation
5+ years experience with charge master principles and the relationship to coding, billing, compliance in a hospital setting
Knowledge of CPT/HCPCS coding required
Knowledge of CMS regulations, HCPCS, ICD-9 and UB Revenue Codes with the ability to effectively interpret, communicate and educate others
Requires work experience involving an understanding of hospital charging practices and governmental coding requirements; o Solid understanding of revenue cycle workflow in the hospital and ambulatory environment (registration, scheduling, coding, billing, contracting)
3+ years of healthcare consulting/management experience or leadership experience in provider organization
Ability to travel 50-75%
Master's Degree in Business Administration or related field preferred
Medical record coding or patient accounting experience preferred

Supervisor, Revenue Cycle Resume Examples & Samples

Supervises daily operations and performs activities of Patient Accounts, including billing, follow-up, denial management, cash application, support services and collection referral
Proactively reviews payer aging reports and establishes achievable goals for AR reduction and/or cash acceleration. Notifies Senior Leadership of potential systemic issues and high risk/high exposure situations. Recommends solutions for resolving aging receivables
Minimum of two (2) years progressively responsible experience to ensure familiarity with patient accounting and/or patient registration
Proficiency in Excel and Microsoft applications
Must be available to work M - F business hours with some overtime as needed
Knowledge of basic accounting principles, business administration, and computer systems as normally acquired through completion of two (2) years of college, business or technical school
Outstanding written and verbal communication skills with the ability to articulate departmental policies and procedures clearly too all levels of staff
Ability to handle multiple situations simultaneously and to exercise sound judgment

Revenue Cycle Optimization Front End Associate Director Resume Examples & Samples

Bachelor's Degree or equivalent experience required
Revenue cycle consulting experience, such as revenue cycle outsourcing, interim management or performance improvement
Prior Revenue Cycle hospital based provider consulting or revenue cycle management experience preferred

Healthcare Revenue Cycle Assessment Consultant Resume Examples & Samples

Owns a specific work stream of the end to end assessment and full due diligence processes at a single potential client site
Prepares first draft of the benefits based on the high level assessment and full due diligence efforts
Displays ability to effectively communicate within the Revenue Cycle Solution Design team as well as externally
Provides operational subject matter expertise in the development of sales materials in preparation for initial and ongoing client conversations
Attends industry conferences and acts as a subject matter expert for Optum 360
Presents to small/ moderate sized groups well and has the ability to adjust message to audience (CFO, CEO or VP of Revenue Cycle)
Exemplifies Optum360 values of integrity, respect, collaboration, innovation, and excellence across all activities
Enables achievement of Optum360 goals for growth, execution, customers, and people
Strong proficiency in Microsoft Office Suite including Excel, PowerPoint and Visio
Revenue Cycles
Patient Access
Health Information Management/Revenue Integrity/Coding/Clinical Documentation Improvement
Patient Business Office
Advanced degree

Healthcare Revenue Cycle / IT System Analyst Resume Examples & Samples

Troubleshoot a wide range of issues for both Optum360 implemented solutions as well as 3rd party applications being used by our E2E operation teams
Identify and initiate resolutions to user problems and concerns associated with application (hardware and software)
Partner with functional teams and interact with E2E operation teams as well as vendors to find solutions for application issues and problems
Provide standardization and consistency across our solutions
Responsible for various configuration documents and tools that are used to manage the solutions (i.e DDS, Admin tools, DMS, Workflow config, User provisioning)
Bachelor's degree in a technical field or equivalent experience
3+ years healthcare revenue cycle experience (Patient Access focused)
3+ years IT troubleshooting / client support experience
1 year SQL experience (basic queries)
Understands HL7 basics (ADT messages)
Software development - Programming and scripting languages
MS Office (Including Word, Excel, PowerPoint)
Knowledgeable with patient access tools (Insurance verification, Medical necessity check, Patient Estimation, Financial Counseling)
MedeAnalytics Patient Access Intelligence experience
IIS log analysis
Network Topology
Workstation/Desktop Utilities
Reporting Tools
Previous experience in an Agile environment
Claim knowledge

VP, Middle Revenue Cycle, HIM Operations Resume Examples & Samples

Delivers profitable top line revenue growth by supporting the development and delivery of effective operational performance and services for End to End Revenue Cycle Client
Contributes to on-going collaboration and dialogue to ensure strategic alignment, set rules-of-the-road for how the Health Information Management functions engage and resolve conflicts and issues
Leads, directs and develops Health Information Management, Clinical Documentation Improvement and Charge Description Master operational teams; continually assesses skills and acts to improve the talent and effectiveness of the team
Keeps the organization informed of client needs, product requirements, competitive information, account specific initiatives and other knowledge essential for our business efforts; push the organization to act to deliver capabilities that enable growth
Integrates operational teams to align with Optum360 and client organizational goals and objectives
Collaborates with Optum360 executive team to develop strategy for change management based on details of the proposed changes and the effects on clients and other stakeholders
Leverages effective change management strategies based on details of operational changes and effects on stakeholders
Leverages effective training programs for employees and clients on new processes and services offered and implemented
Provides analytical consultation and leadership to Optum360 executive team regarding revenue management operational development, with a focus on effective performance and business growth
Works with the Services and Technology Solutions teams to develop a business strategy that maximizes value for Optum360
Oversees the RFP, selection, contracting and implementation process of relevant vendors in collaboration with the appropriate Optum360 executives and local client leadership teams
Maintain knowledge of applicable laws, regulations and trends
Develops and manages new and existing client relations, including maintaining customer satisfaction
10+ years’ experience in hospital Revenue Cycle Operations
Experience leading large diverse teams
Experience effectively facilitating large scale organizational change
Develop and design operational best practices with desired outcome to improve patient care
Broad knowledge of modern revenue cycle management, systems, practices and principals
Expert level knowledge of billing and regulatory compliance practices
Expert knowledge of Health Information Management, Coding, and Clinical Documentation Improvement regulatory compliance practices
Proactively questions current practices; ability to identify root cause and corrective actions and drive improvement
Ability to deal effectively with ambiguity
Excellent communication skills, both written and verbal; acts as champion
Ability to interact successfully with numerous client organizations
Effective human resource management abilities including the ability to develop leadership talent
Ability to ensure a high level of employee and client satisfaction
Effective organizational, planning, controlling, scheduling and multiple project management ability
Demonstrated success with management reporting, metrics and goal setting
Ability to work independently, achieve tight deadlines and take initiative on multiple projects
Knowledge of and experience with revenue cycle applications
Experience overseeing for revenue cycle systems in a multi-system setting
Experience managing Revenue Cycle related technology implementation

Revenue Cycle Optimization Associate Director Resume Examples & Samples

Revenue cycle assessments
1+ years’ experience working in hospital revenue cycle department as a director or supervisor (patient access, patient financial services)
3+ years of revenue cycle consulting experience, such as revenue cycle outsourcing, interim management or performance improvement
In-depth knowledge of the complete healthcare revenue cycle

Revenue Cycle Senior Analyst Resume Examples & Samples

Alignment of client processes and Optum technology
Interim management
Provide subject matter expertise to clients in all areas of the healthcare revenue cycle which includes
Minimum of 3 years’ experience in the Healthcare revenue cycle
Experience and comfort working at all levels of a health care organization
Ability to lead, direct and motivate others

Revenue Cycle Optimization Front End Associate Resume Examples & Samples

1+ years of experience developing Quality Assurance plans
Revenue cycle experience in performance improvement assessment and implementation
A high degree of self-motivation, versatility and flexibility

Revenue Cycle Optimization Associate Resume Examples & Samples

Revenue cycle assessments for: hospitals, health systems, diagnostic laboratories
Reimbursement and managed care
Minimum of 2 years’ experience in revenue cycle management with at least one year in laboratory revenue cycle management
Expert in MS Word and Excel and Visio
Knowledge of laboratory and hospital based IT systems
Ability to travel 70 - 80%
Expert in Outlook and PowerPoint

Senior Hospital Revenue Cycle Workflow Consultant Resume Examples & Samples

Demonstrates clearly and effectively Optum360s’ RWS application suite benefits and best practice model to ensure integration into the clients processes and systems
Proactively identifies project concerns, and communicates timely and effectively to the Project Manager, Director of Product Management, and/or Senior Product Consultant
Oversees Senior Product Consultants and Product Specialists assigned to the client and ensures seamless integrated communication with the client
Reviews Sales assessment document and any other client information to determine scope of the project and identify and proactively address any potential implementation concerns
Participates in introduction call, scoping visit, and discovery visit to review current workflow , analyze operational processes, and determine future state best practice workflow and operational processes
Primary responsibility for completion of the Business Requirement document, and participates in the Project Charter completion and Technical Business Requirement
Works with cross functional teams across the overall E2E project to ensure alignment and is proactive in identifying process and technology improvements that will support Optum360 SLA’s, both
Works with Clients and Product to provide business requirements and stories for Product Enhancement Functionality
Participates in weekly project meetings with member of the deployment team (internal and external) to review the project plan, and evaluate progress; provides input throughout the implementation and post implementation process
Assists with developing Training for our E2E clients using our technology
On time successful deployment of RWS applications
Adherence to Optum360 Best Practice Standard Operating model within deployment or appropriate variance approval
Client Satisfaction with deployment and configuration of technology
Achievement of Optum360 SLA’s
Minimum 10 years in Revenue Cycle Management, with heavy involvement in technology deployment , provider or vendor experience
Technical knowledge of Revenue Cycle Operations
Experience managing large scale projects where deadlines are met or ahead of schedule

Supervisor, Revenue Cycle Solutions Resume Examples & Samples

Minimum 2 years of experience working in a medical claims billing environment handling insurance denials/appeals
Minimum 3-5 years experience in a supervisory or management role in healthcare
Knowledge of ICD-10, CPT, and HCPCS coding required
5+ years experience performing supervisory work or other leadership role
Experience with managing several aspects of the revenue cycle highly desired
Working knowledge of managed care, Medi-Cal, and Medicare eligibility, authorization and billing requirements a plus
Working knowledge of denial reason codes, payor appeal processes, payor contracting, and how to effectively communicate with insurance companies
Certification in medical billing and/or medical terminology
Able to interpret various contracts and health plans
Must have demonstrated ability to work in a highly complex environment, able to communicate with clients (including patients, payors, clinicians and physicians) effectively
Demonstrated ability to remain professional, even when working through difficult situation
Demonstrated ability to effectively research and resolve claim payment issues
Establishes a pleasant environment by using a pleasant tone of voice and maintaining composure at all times
Demonstrate a concern for needs and expectations of clients and customers
Encourage teamwork and collaboration to bring about win/win situations for the organization and staff
Ability to organize work flow and set priorities
Ability to communicate effectively and diplomatically with clients, physicians, payors, health care business executives and the general public
Able to analyze and problem solve
Ability to guide, lead, coach and mentor
Must have a working knowledge of Microsoft Office programs, including Excel, Word, Access or similar programs

Certified Revenue Cycle Associate Resume Examples & Samples

Minimum coding certification of CPC-H
Experience is MediTech and XClaim, preferred
Working knowledge of Microsoft PC applications (Outlook, Word, Excel)

Senior Revenue Cycle Coordinator Resume Examples & Samples

Advanced knowledge of accounting, healthcare, and general office procedures
Advanced knowledge of the Maryland and DC Reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues
Advanced knowledge of the HSCRC, DRG and APC payment reimbursement
Advanced knowledge of common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOB’s
Advanced in Microsoft Office
Requires strong organizational skills to complete financial applications, insurance verification, billing, and collection processes within acceptable time frames
Requires solid communication skills to clearly and concisely communicate verbally and in writing with peers, superiors, payers, physicians, ancillary departments, etc
Ability to adapt to urgent deadlines or rapidly changing priorities and maintain composure in high stress situations
Requires leadership ability to guide and advise others without having line management authority
2-3 years’ experience in accounts receivable

Revenue Cycle Coordinator Resume Examples & Samples

Basic knowledge of accounting, healthcare, and general office procedures, preferred
Basic knowledge of the Johns Hopkins Health System or other Healthcare related policies and procedures, preferred
Knowledge of most common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOB’s, preferred
Requires analytical skills to assist in preparing reports monthly or as needed utilizing department software applications
Requires minimal assistance in completing billing and continual follow up on accounts
Expected to have prior keyboard and internet navigation knowledge and experience
Ability to adapt to urgent deadlines and priorities
Ability to show professionalism when working with management peers and team members
0-1 years’ experience in accounts receivable
Requires ability to understand, interpret, evaluate, and resolve basic customer service issues
Intermediate knowledge of accounting principles which directly impacts the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances and adjustments and financial class changes
Knowledge of medical terminology, preferred
Moderate understanding knowledge of the Revenue Cycle specific to JHM
Requires knowledge of common revenue cycle accounts receivable terms, common business practices, and statute of limitations as it pertains to billing, appeals, payer requests, payments, retractions, and EOB’s
Requires knowledge of billing, collection, and telecommunications software, including LAN-based claims editing applications
Requires knowledge of Federal regulations and requirements
Ability to identify and know the different requirements for the various types of insurance plans
Understands common terms used daily in carrying out tasks
Intermediate knowledge of Microsoft Office
Requires intermediate organizational skills to complete financial applications, insurance verification, billing, and collection processes within acceptable time frames
Requires communication skills to clearly and concisely communicate verbally and in writing with peers, management, payers, physicians, ancillary departments, etc
Ability to evaluate own workflows and JHHS processes and appropriately recommends process improvements
Requires continual communication keeping others informed of work flow status updates, trends and/or issues while managing tasks in a timely manner
Requires the ability to work independently while completing billing and continual follow up on routine and challenging accounts with minimal assistance from management and others
Ability to problem solve and analyze high dollars claims/cycles and elevate quickly for resolution
Must have the knowledge and interpersonal skills to be a successful mentor and provide continual constructive feedback to team

Associate Revenue Cycle Coordinator Resume Examples & Samples

The ability to understand, interpret, evaluate, and resolve basic customer service issues, required
Working knowledge of at least one specific payer’s application, billing, and/or collection processes and/or multiple payer’s insurance verification and pre-certification processes
Basic knowledge of accounting principles which directly impact the accounts receivable that may include debit and credit transactions; charge transfers; contractual allowances and adjustments and financial class changes
Basic knowledge of the Maryland and DC Reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues, preferred
Some knowledge of medical terminology, preferred
Requires working knowledge of billing, collection, and telecommunications software, including LANbased claims editing applications
Basic/Beginner knowledge of Microsoft Office
Requires basic organizational skills to complete financial applications, insurance verification, billing, and collection processes within acceptable time frames
Requires communication skills to clearly and concisely communicate verbally and in writing with peers, superiors, payers, physicians, ancillary departments, etc
Proactively keeps others informed of work flow status while managing tasks in a timely manner
Actively seeks assistance for complex account resolution
Ability to effectively work with others in conjunction with the Code of Conduct and Service Excellence Guidelines
Knowledge of accounting, healthcare, and general office procedures, preferred
Knowledge of the Maryland and DC Reimbursement and regulatory environment so as to ensure compliance with State regulations regarding patient and insurance billing issues, preferred
Knowledge of the Johns Hopkins Health System or other Healthcare related policies and procedures, preferred
Understands HCPC and/or CPT coding issues that could impact a claim
Knowledge of the HSCRC, DRG and APC payment reimbursement
Requires knowledge of up to date HIPAA and HITECH rules and regulations
Demonstrates ability to assist in mentoring others in regards to the department’s payers and revenue cycle processes
Ability to work the receivable of multiple facilities with experience, knowledge, and skills that are transferable to other tasks and assignments
Requires analytical skills to compile and prepare reports monthly or as needed utilizing department software applications
Ability to work in multiple billing, insurance verification, and precertification systems simultaneously
Requires minimal assistance for complex account resolution
Requires the ability to adapt to urgent deadlines or rapidly changing priorities and maintain composure in high stress situations at all times
Assists in other staff’s duties in their absences, in addition to routine workload
Ability to adapt to urgent deadlines and/or rapidly changing priorities while maintaining professionalism in high stress situations
Ability to show professionalism when communicating with staff and vendors
1-2 years’ experience in hospital accounts receivable

Epic Revenue Cycle Consultant Resume Examples & Samples

Understands the rural, remote market and smaller community hospital needs
End to End Epic implementation, preferably Hospital Connect
Epic Certifications and experience with version 2015
Work with CFO and able to work with C-Suite, to the end user level
Understands and trouble shoots Claims and Denials
Able to be the translator and intermediary between the Rev Cycle Team and GPH Team
Have experience working in a hospital business setting and patient access
Able to provide a Crosswalk of current state to future state by producing a Start/Stop/Continue Grid for the Training Team
Ability to be the SME to the Trainers and Liaison with the Analyst
Revenue Cycle General Ledger Mapping, ie - Lawson
Experience with Supply Mapping

Revenue Cycle Business Analyst Resume Examples & Samples

Gather and document business requirements
Analyze and interpret data to identify trends, patterns and opportunities for the business and clients
Communicate analysis and interpretation to appropriate audience
2 years of revenue cycle experience
1 year of experience in business / finance including analysis experience with a solid understanding of data storage structures
1 year of experience with project methodology (requirements, design, development, test and implementation)
Intermediate level of proficiency with PC based software programs and automated database management systems (Excel, Access, PowerPoint)
Experience in analysis of hospital accounts receivable, payer trends
Experience gathering requirements from the client / business and documenting
Experience in analysis of business process and workflow and providing an evaluation, benchmark and / or process improvement recommendations
Ability to communicate analysis including trends and opportunities to clients and the business

Revenue Cycle Optimization Consultant Resume Examples & Samples

Improve operational efficiencies throughout the revenue cycle
Optimize patient access collection of both cash and appropriate information to prevent denials of third-party payments
Improve processes to ensure measures are taken to authorize care, bill for care and receive timely payment from all responsible parties
Maximize use of Experian Health solutions to determine sources of reimbursement
Bachelor’s Degree, or Master’s preferred
Six years + experience in a health care setting in revenue cycle management
Experience managing change projects in large enterprises
Experience in analytics and quality management techniques
Prior revenue cycle consulting experience strongly preferred
Excellent documentation and communication skills
Presentation and training experience a must

Revenue Cycle Business Analyst Resume Examples & Samples

Work well independently but able to contribute in a team environment
Excellent communication skills both internally and client facing
Ability to understand authorization requirements and responses
General knowledge of CPT codes
Understanding of HIPPA requirements in relation to PHI
Data modeling and /or SQL queries
Ability to communicate effectively with internal and external customer
Experience working with revenue cycle is a plus
Previous experience with process improvement
Bachelor’s Degree in related field of Business, Health Information Technology or Statistics
Ideal candidate would have experience working with hospital IT department to maintain or implement hospital registration of ADT system(s).Experience implementing revenue cycle solution with any vendor
Experience with more than one hospital system
3+ years in hospital experience in areas such as patient access, outpatient registration, insurance verification and authorizations
Full understanding of hospital revenue cycle and patient access unit workflow
Equivalent combination of education and experience may be considered

Revenue Cycle Senior Director Resume Examples & Samples

When assigned as project lead, responsible for soliciting client/partner feedback on project progress, performance and success, updates client/partner weekly on progress, problems, and accomplishments
Communicates issues, opportunities, risk factors and any other applicable information to the client/partner manager and/or manager on an on-going basis
Experience working in hospital revenue cycle department as a director or supervisor (patient access, patient financial services)
8+ years of healthcare consulting/management experience or leadership experience in provider organization

VP of Revenue Cycle Resume Examples & Samples

Leads the development and implementation of revenue cycle strategies to maximize profitability
Ensures conformity with Compliance requirements throughout revenue cycle
Delivers a full range of services to clinical and business leaders such as project management, interim project staffing, software application optimization, healthcare reform initiatives, and support analysis
Works with clinical and business leaders to define needs or problems, gather data and perform analysis to advise or recommend solutions
Interviews, hires, evaluates, counsels, and recommends the termination of assigned teams
Develops and maintains positive relationships with clinical and business leaders and provides executive support for the BSWH Revenue Cycle organization
Participates in the Information Services Leadership Councils
Bachelor’s degree required, preferably in accounting or equivalent required. Master’s degree in applicable field (CPA and/or MBA) preferred
Experience of 10+ years in hospital patient accounting or Revenue Cycle within a healthcare environment is required; extensive experience with EPIC billing is preferred
Significant experience with hospital, physician practice management, and patient accounting systems
Experience with and ability to manage relationships with up to Executive (C-Suite) level leadership. Specific experience with Clinical Leadership preferred
Knowledgeable of Revenue Cycle Management operations
Proven track record of leadership and strong knowledge in revenue cycle operations and industry best practices. Experience in managing complex, large-scale projects in a matrix organization and demonstrated expertise in developing complex systems and performance-based reporting
In-depth knowledge of Medicare and managed care billing and payment practices, admitting registration requirements, documentation requirements, rate elements, credit and collection practices, and reimbursement techniques. Must be able to analyze payment data through use of multiple financial systems to properly negotiate managed care contract
Extensive knowledge of coding technology tools and experience with coding services within provider settings

Revenue Cycle Improvement Consultant Resume Examples & Samples

Assists revenue cycle departments in the analytical components of workflow redesign
Proactively seeks opportunities to identify revenue cycle inefficiencies,
Research/analyze data, and create solution alternatives
Implement revenue cycle improvement solutions for BHCS revenue cycle departments
Monitor the performance of revenue cycle activities utilizing current monitoring tool sets and performance metrics. Create new performance metrics to address and manage new performance issues
Coordinates revenue cycle department activities including but not limited to charge capture and workflows
Coordinates revenue cycle improvement activities between BHCS Corporate departments and BHCS facilities
Facilitates revenue cycle improvement communications across the revenue cycle
Analyzes and identifies trends in revenue cycle operations. Uses this data to develop and implement process redesign solutions
Assesses the current capabilities of IT revenue cycle systems and creates innovative revenue cycle IT solutions

Member Consultant, Revenue Cycle Solutions Resume Examples & Samples

Effectively triage and manage member production issues post implementation
Communicate directly with members in a professional manner to provide a high level of customer satisfaction and timely response
Identify and assist in implementation of solutions to improve member satisfaction as related to the Product and Support Services
Support the Dedicated Advisor team by proactively identifying trends and potential solutions to member requests
Devise creative solutions to accommodate technical challenges faced by the member
Master the functionality of the Revenue Cycle workflow platforms and develop expertise in product terrain
Maintain an client-facing documentation of all outstanding tickets to be tracked with the member on a bi-weekly basis through recurring update calls
Proactively project manage client to quarterly site updates
Effectively manage multiple and competing priorities
Provide support during implementations as needed
Become a part of a consolidated, highly engaged team
Excellent time management and organizational skills
Intellectual curiosity, persistence and creativity in problem solving
Proven experience managing multiple, competing priorities
Team-oriented but also highly self-sufficient and self-motivated
Experience working in a team environment
Must demonstrate strong attention to detail
Experience in analytic tools (Excel)
Knowledge of revenue cycle management, PFS & hospital systems a plus
Experience with SalesForce.com
Experience in advanced analytic tools (Access, SQL)
1 year in direct customer support

Revenue Cycle Optimization Associate Resume Examples & Samples

Provide evaluation and guidance to clients in the healthcare revenue cycle which includes
5+ years of experience working with large multi-facility healthcare system
5+ years of healthcare revenue cycle management experience as a manager or supervisor
Solid understanding of revenue cycle workflow (registration, scheduling, coding, billing, contracting)

Cerner Revenue Cycle Solution Architect Resume Examples & Samples

Lead client engagements related to the planning, execution, and organizational activities for KPMG’s Transformation Consulting initiatives in the Healthcare industry
Support C-Level growth strategy creation, market development identification and transformation execution for the Healthcare industry
Manage client and KPMG work teams throughout the project lifecycle by leveraging our approaches and frameworks and helping to ensure timely completion of project deliverables and overall project execution
Support the development of value propositions that tie clinical, operational and financial performance metrics and performance improvement opportunities to the C-Suite agenda
Help lead proposal development and other new business development activities by leveraging new and existing relationships with client business leaders
Provide input into engagement decisions including work plan and timeline, project management and resource allocation
Five years of Cerner Millennium Revenue Cycle Solution Architect management consulting experience in the Healthcare industry, focusing on operations/performance improvement and transformation, workflow redesign, clinical performance improvement, and patient throughput/capacity; operations transformation
Bachelor’s degree in finance, engineering, information technology, operations analysis, healthcare administration, nursing, or a related field from an accredited college/university; MBA or other graduate degree, e.g., MD, PHD, MSN, MPH, is a plus,
Demonstrated understanding of healthcare reform and other key industry trends/drivers, such as population health management, demographics, technology, required
Excellent foundational consulting skills: analytical, written and verbal communication, client presence, facilitation and presentation skills
Ability to travel at a significant level

Back End Revenue Cycle Optimization Senior Associate Resume Examples & Samples

Bachelor's Degree in Business, Healthcare or related field; or equivalent experience
3+ years of healthcare revenue cycle management experience as a manager or supervisor
1+ years of experience developing training plans
Master's Degree in Business Administration, or related field
Ability to probe, analyze, and articulate complex subject matter to be easily understood

Analyst Revenue Cycle PMO Resume Examples & Samples

Defines and document revenue cycle data sources of truth and data definitions per project
Populates dashboards, results and benefits realization, track progress, develop, document and ensure adherence to standardized processes and project reporting methodologies
Accesses data bases to provide analytical support and reporting to revenue cycle teams and/or initiative
Organizes and formats data for presentation and to assist with analysis
Validates data provided
Summarizes data and provides direct commentary or insight into data results

Revenue Cycle Optimization Senior Director Resume Examples & Samples

Assumes responsibility for the success of diligence efforts assigned as project lead; contributes to the success of other projects as necessary
Provide written communication with client / partners, team members and management the status of assignments on a weekly basis via project documentation (i.e. status update, scope change, etc.)
Documents all deliverables including; scope definition, status reports, analysis documents, user documentation and other applicable project records as appropriate
Works closely with client / partners and staff to develop client / partner and project risk assessments, implement opportunities, and recommendations regarding business and IT process optimization, profit improvement, internal control and compliance
Conducts studies or surveys for process change or problem resolution to obtain data required for solution
When assigned as project lead, responsible for soliciting client / partner feedback on project progress, performance and success, updates client / partner weekly on progress, problems, and accomplishments
Communicates issues, opportunities, risk factors and any other applicable information to the client / partner manager and / or manager on an on-going basis
Develop reports and presentations based on project specifications for delivery to client / partners
Provide strategic guidance to client / partner on Revenue Cycle process improvement
Lead and focus team efforts in data analysis, data interpretation, process design and formulating conclusions and recommendations
Minimum 8+ years of healthcare consulting / management experience or leadership experience in provider organization
Excellent interpersonal, written and oral communication skills

Revenue Cycle Optimization Consultant Resume Examples & Samples

Revenue cycle assessments for hospitals, health systems, and diagnostic laboratories
Alignment and implementation of client/partner processes and Optum360 technology
Provide revenue cycle management services to client/partners in all areas of revenue cycle which includes
Minimum of 3 years’ experience in acute care and/or laboratory revenue cycle management
Expert in MS Word and Excel and Visio required
Ability to build effective team in order to accomplish goals
Ability to adapt to a flexible schedule
Expert in Outlook and PowerPoint preferred

Revenue Cycle Data Analyst Resume Examples & Samples

Grows expertise in knowledge of KP data systems; actively shares knowledge within and outside the department. Builds queries using one or more tools (e.g. Business Objects, SAS, FOCUS, Crystal, etc.) to extract data from mainframe and server-based data repositories per specifications based on client requests
Performs intermediate to advanced spreadsheet analyses and database solutions using tools such as Excel and MS Access; develops accurate scorecard and other reporting processes; provides detailed statistical measurement and interpretation; creates cost-benefit/profitability analyses; financial forecasts; and other analyses as required
Develops financial outcome measurement techniques and suggests appropriate tools for measuring process improvement
Collects, audits and compiles confidential data, determines statistical significance/variances according to standard criteria
Develops and maintains indicators of department performance
Utilizes critical thinking skills with regard to measurement and data; makes recommendations to management based on interpretation of data
Coordinates data extraction and develops forecast proposals for the annual operating forecast of professional and technical outside expenses, other benefits and hospitalization and tests data validity
Provides training and direction to other revenue cycle staff as necessary
Maintains and supports a culture of compliance, ethics and integrity
Maintains knowledge of policies and procedures and performs in accordance with the Principles of Responsibilities and applicable regulatory requirements, external laws and accreditation standards
Reports appropriately observed fraud or abuse
Minimum three (3) years of experience with Epic software
Minimum four (4) years of experience performing sophisticated data retrieval and analyses
Demonstrated experience in data extracting, manipulation and/or data management, and interpreting and communicating results/recommendations
Experience with Epic's Clarity data model is preferred

Revenue Cycle Interim Manager Resume Examples & Samples

3+ years interim management experience with Revenue Cycle
Experience leading business offices for physicians, hospitals, or both
Diverse background with various vendors such as GE, Epic, and/or Cerner
Excellent interpersonal, organizational, and communication skills
A strong proficiency in common PC software applications

Revenue Cycle Project Manager Resume Examples & Samples

3+ years project management experience with Revenue Cycle
Experience with practice management system replacements
Diverse background with various vendors such as GE, Epic, Allscripts and/or Cerner
3+ years experience working in a Healthcare setting, physician practice, or hospital
Ability to work on multiple, complex projects with high quality results

Revenue Cycle VP Resume Examples & Samples

Assumes responsibility for the success of projects assigned as project lead; contributes to the success of other projects as necessary
Provide written communication with client/partners, team members and management the status of assignments on a weekly basis via project documentation (i.e. status update, scope change, etc.)
Works closely with client/partners and staff to develop client/partner and project risk assessments, implement opportunities, and recommendations regarding business and IT process optimization, profit improvement, internal control, and compliance
Interact with other departments to ensure a high level of client/partner satisfaction through successful execution of projects
Provide strategic guidance to client/partner on Revenue Cycle process improvement
Demonstrates the highest levels of professional conduct and ethical behavior
Works collaboratively with client/partners to exceed expectations; able to overcome major obstacles preventing project success; able to convert a negative client/partner experience to a positive relationship
Demonstrates ability to generate new concepts for innovative products and services; creates business case to move from idea stage to execution and launch; able to market and position products and services to create competitive advantage for Optum360 platform
Able to build, manage and maintain a robust sales pipeline that drives growth
Demonstrates strong ability to lead a consulting practice; creates and executes measurable business, financial and marketing plans to generate profit for the firm; leads efforts to develop value-add resources/materials to support client/partner initiatives
Develops an understanding of external market and industry trends; knows key client/partners of Optum360, can identify key competitors, able to describe major political and economic market forces that influence our business; aware of social, technological, legal and environmental changes that impact our organization
Leads collaboration efforts across organizational boundaries; identifies strategic opportunities to leverage the knowledge of multiple business segments within OptumInsight; builds strong partnerships with peers; optimizes networks to develop and sell projects and ideas across the organization; able to build consensus to drive results
Role model for the mission, vision and values of Optum360 consulting platform
Bachelor's degree from a four-year college or university required
Minimum of 10 years’ experience in related role including extensive knowledge of coding technology tools
Minimum of 10 years’ of healthcare experience
Direct experience working in a hospital environment (such as a former Director, Manager or Supervisor of department) or similar experience in consulting experience (relevant experience includes revenue cycle, compliance/quality, clinical departments/units
Demonstrated performance in strategic/operational analysis and planning, analytical techniques
Demonstrated ability to bring projects/initiatives to completion
Advanced knowledge of at least one practice management system and/or EMR system. Experience with one or several of these vendors is a plus: GEHC, Allscripts, SMS, Cerner, McKesson, Epic, Meditech or other similar system
Advanced knowledge of Microsoft Office (e.g. Word, Project, Excel, PowerPoint, Visio.)
10 years’ experience providing leadership and management direction in a healthcare environment

Revenue Cycle Resume Examples & Samples

Requires an understanding of multiple systems and processes that impact revenue cycle performance and capabilities
Possesses the ability to build trusting relationships with multiple Client Executives at all levels and for numerous unique customers
Possesses analytical ability sufficient to work in a data-heavy environment and to identify trends in the data
Demonstrated experience of the entire acute care hospital revenue cycle processes is required
Three (3) to five (5) years Management in a Revenue Cycle or Acute Health Care

Revenue Cycle Operations Director Resume Examples & Samples

Advanced knowledge of healthcare A/R, collections, insurance, and appeals
Advanced understanding of Compliance Guidelines
Advanced knowledge of the hospital based operations related to the revenue cycle including Health Information Management, Patient Access, Clinical Quality/case Management, Management Information Systems, Accounting and Finance
Intermediate Microsoft Office (Word and Excel)
Ability to provide advanced customer service
Ability to train, mentor and coach staff
4 year college degree in Business Administration, Finance, or Health Administration or equivalent experience
5-7 years experience managing in multi-facility business office

Revenue Cycle Resume Examples & Samples

Organization – proactively prioritizes needs and effectively manages resources
Communication – communicates clearly and concisely, verbally and in writing
Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
Customer Orientation – establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
Tactical Execution – oversees the development, deployment and direction of complex programs and processes
Policies & Procedures – demonstrates knowledge and understanding of organizational policies, procedures and systems
Financial Management – applies tools and processes to successfully manage budget
Minimum 2 years related supervisory experience required
Minimum 3 years of managed care and denials experience

Reg Director of Revenue Cycle Resume Examples & Samples

Routinely performs site visits to each facility and SSC as assigned to provide support, review processes, provide feedback, and identify areas of opportunity
Provides comprehensive site visit reports to Facility, CFO, and SSC
Works collaboratively with the Shared Services Center to understand impact of Patient Access performance on the entire revenue cycle
Serves as on-the-ground support for the Service Center at the facility and hosts onsite leadership meetings as needed to address noted issues
Demonstrated ability to manage the day to day operations of multiple mid-sized – large hospitals providing a more diverse and complex offering of services to the community it serves. (100-500 beds)
Able to work independently to efficiently and effectively manage all functions within the Patient Access and SSC departments
Maintains knowledge of Revenue Cycle ensuring a high productivity and proficiency standards of performance are achieved at all times
Monitors Front End and back end performance and KPI’s on a routine basis, including but not limited to
Accuracy – 98% or greater if software applicable
Alert/Unbilled days - <3 days
Estimate Utilization – 98% or better if applicable
Front end denial rate - < 2%
CIQ/BARTT requests- >3 days
EDUCATION, SKILLS & EXPERIENCE
Administrative Skills

Director Bsmg Revenue Cycle Resume Examples & Samples

Previous management experience in a large, multispecialty billing environment is required. Management experience with business office with a minimum of 35 FTE’s is required
Experience working with enterprise level practice management systems is required
Working knowledge of physician practice operations specifically as it related to patient access and time-of-service (TOS) revenue cycle functions
A Bachelor’s degree is required; Bachelor’s degree in Business or MBA degree is a plus. Equivalent combination of education and experience will be considered

Revenue Cycle Regulations Manager Resume Examples & Samples

The ideal candidate will be detail oriented, highly organized and able to read, comprehend, summarize and manage the implementation of complex Federal and State regulations and regulatory changes
Candidate must have the ability and experience to understand how regulatory changes impact the healthcare revenue cycle at all points, and use good judgment, analytical skills, and experience in decision making related to interpretation and dissemination of regulatory information
Candidate must possess excellent written and verbal communication skills, and be able to produce error-free work product demonstrating a high-level of detailed understanding with minimal or no supervision
Must be able to handle heavy workload requiring the production of time-sensitive work product, and adapt to a high growth, rapidly changing environment
Applicants may be requested to provide writing samples
5-7 years of healthcare revenue cycle experience with focus on payer compliance
2-3 years hospital operations or hospital clinical experience preferred
Demonstrated knowledge and experience in health care industry with specific focus on regulatory/billing procedures and compliance, with particular focus on Medicare and Medicaid
Intermediate to advanced PC skills with Microsoft Office suite (Excel, Access, Word, PowerPoint)
5 or more years of change management experience, which may include program, project, or process experience managing multifaceted projects and teams, including onsite and virtual, through all stages of assessment, identification and communication of impacts and operational changes
Lead experience in managing projects from development to execution, including tracking and reporting of milestones
Proven track record of developing and training staff effectively in a collaborative and cross-functional environment
Well-developed analytical, problem solving and communication skills to include analysis expertise and ability to translate regulatory requirements into operations
Ability to interact and communicate with staff independently at all levels, including management, and the capacity to manage competing priorities in a dynamic environment
Must be able to work in sitting position, use computer for extended periods and answer telephone

VP, Revenue Cycle Optimization Resume Examples & Samples

Prepare final client status reports and create presentations to clients and engagement staff that demonstrate full command of factual material
Manage day-to-day client relationships including primary ownership for client executive team
Develop reports and presentations based on project specifications for delivery to client/partners
Lead and focus team efforts in data analysis, data interpretation, process design, and formulating conclusions and recommendations
Minimum 8+ years of healthcare consulting/management experience or leadership experience in provider organization
Solid understanding of revenue cycle workflow in the hospital and ambulatory environment (registration, scheduling, coding, billing, contracting)
Prior Revenue Cycle hospital based provider consulting experience

Revenue Cycle Management Pre-authorization Clinician Resume Examples & Samples

Possesses excellent customer service skills that include written and verbal communication
Ability to critically think, problem solve and make independent decisions
Ability to prioritize and manage multiple tasks with efficiency
Advanced conflict resolution skills
Ability to conduct research regarding payer pre-authorization guidelines and applicable regulatory processes related to the pre-authorization process
Must possess a valid nursing license (Registered or Practical/Vocational). RN PREFERRED. LPN IS MIN REQUIREMENTS
Minimum of 3-5 years as a pre-authorization or utilization review nurse in a payer or acute care setting; preferably medical-surgical or critical care/ED
Ability to travel approximately 10% of the time; either to client &/or Conifer office sites

Revenue Cycle Representative Resume Examples & Samples

Analyze and verify patient demographic, insurance eligibility and financial information/responsibility for accurate claim submission and reimbursement
Resolve patient billing account concerns in order to obtain appropriate reimbursement and patient satisfaction in partnership with PFS management, UIHC Patient Representatives and UIHC Clinical Teams
Initiate action regarding the management and adjudication of patient account billing and all other customer concerns and inquiries
Document, correct and assure the accurate information is in the patient billing system
Establish payment arrangements, counsel and coordinator available financial assistance with patient as necessary
Verify eligibility of benefits, patient liability and non-covered exceptions; confirm all steps necessary have been taken to adjudicate claims and billing while providing outstanding customer service
Resolves statement edits to ensure correct and timely billing occurs
Contacts appropriate third party payers in order to verify eligibility of benefits, patient liability, non-covered exceptions
Be expected to maintain a high-level of accuracy to meet productivity and quality requirements
Take payments and set up payment plans for patients
Communicate with providers, payers, patients, internal departments, co-workers and Coordinator’s to resolve issues
Maintain extensive knowledge and expertise based around payer regulations/policies, financial classifications and financial assistance programs
Build and maintain solid working relationships with clinical staff, referral sources, insurance companies, medical providers and public
* Please note: Five (5) professional references will be required at a later step during the hiring process
6 months or more of related customer service experience in a professional, financial or health care related environment
Strong attention to detail and proven ability to gather and analyze data and keep accurate records
Proficiency with computer software applications, i.e. Microsoft Office Suite (Excel, Word, Outlook, PowerPoint) or comparable programs and an ability to quickly learn and apply new systems knowledge
Demonstrated ability to handle complex and ambiguous situations with minimal supervision
Effective communication skills (written and verbal), active listening skills and the ability to maintain professionalism while handling difficult situations with callers or customers
Successful history collaborating in a fast-paced team environment
Experience handling difficult callers, customers and patients
Familiarity with medical terminology
Knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
Experience identifying opportunities for improvement and making recommendations and suggestions
Experience with multiple technology platforms such as Epic, Cirius ACD, and/or GE
Ability to drive results and foster accountability throughout the team and organization

Lead Consultant, Revenue Cycle Solutions Resume Examples & Samples

Present research briefings and educational sessions to clients
Review and approve support documentation, work plans, and other deliverables
Participate in new product and service conceptualization and planning -Identify cross sell opportunities and support sales proces
Manage, guide, and coach Project Consultant(s)
Willingness to travel 70-80% (valid Driver’s License)
Experience working at The Advisory Board Company
Master’s degree in business, health care administration or other health care-related field
Proven ability to prioritize across multiple projects and relationships
Possess intellectual curiosity, persistence and creativity in problem solving

Revenue Cycle Optimization Manager Resume Examples & Samples

Develop reports and presentations based on project specifications for delivery to clients
Perform statistical quality assurance review and program validation for each project
Provide analytical and data support for case studies and business proposals
Interact with other departments to ensure a high level of client satisfaction through successful execution of projects
Leverage skills to support creation of product improvements and new product offerings targeted at the sales and market research community requirements Business
Office Process and Performance Assessments
Business Office Centralization
Business Office Structure and Alignment Optimization
Efficiency and Productivity Improvement programs
Workflow Technology Modification and Optimization
Billing Editor and Billing Tool Modification and Optimization
Billing, Claim Follow Up and Cahs Posting Methodology Implementation and Improvement
Policy, Procedure, Job Description and Staff Training Optimization
Provide direction, coordination and leadership to clients in all areas of the healthcare Back End Revenue Cycle may include
Patient, Government and Commercial Payer Billing
Claim Follow Up and Collections
Cash Posting, Credit Balance and Underpayment Review
Patient / Customer Service
Decision support and analytics
Managed care contracting
Utilize internal Optum360 resources to properly accomplish and deliver measurable results in the Back End Revenue Cycle and Patient Financial Services
Transformation Staff and Analytics Team
Optum360 Consulting
Optum360 Technology implementation teams
Optum360 Project Management Office
Optum360 Human Capital, Compliance and Legal
Evaluate and utilize external vendors where internal Optum360 solutions gaps are present
Identify client accomplishments barriers in achieving operational excellence
Development of options and recommendations for client improvement
Understand and represent Optum technology and services and how they will improve client operations
Assist in Optum360 growth process as requested
Must meet minimum performance standards
Willingness to learn new skills and desire to advance upward in the consulting organization
Provide feedback to management concerning possible problems or areas of improvement
Perform other duties as assigned by management
Minimum 5 years experience in the healthcare revenue cycle
Minimum 2 years healthcare consulting experience
Ability to lead, motivate, influence, probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
Ability to work in an Office environment
Ability to travel 75+% as necessary to accomplish assign tasks and goals

Revenue Cycle Representative Resume Examples & Samples

Respond to patient/visitors/family requests and directs to the appropriate areas in a timely manner
Verify insurance benefits to determine if insurance will reimburse UIHC for services provided and ensure that insurance data entered is accurate and complete
Determine insurance company and financial status classification; enter information accurately and completely into the Billing system and be expected to maintain a high-level of accuracy to meet productivity and quality requirements
Confirm co-pay amount and collect from patient as appropriate for the visit and practice safe cash handling procedures to ensure batches reconcile at end of shift
Determine priority of work and work collaboratively with clinical staff in processing of paperwork, lab requests, patient requests, etc
* Please note: Five (5) professional references will be required at a later step during the hiring
Bachelor’s degree; or equivalent combination of education and experience
Demonstrated ability to follow policies and procedures while escalating issues as needed
Demonstrated ability to maintain or improve established productivity and quality requirements
Experience with multiple technology platforms such as GE, Cirius ACD, and/or Epic
Maintain current awareness of industry trends and continually strive for improvement with both technical and professional skills

Revenue Cycle VP-telecommute Resume Examples & Samples

Assists business development teams, sales and client/partner managers on proposals and calls when necessary as requested by management
Designs and delivers effective presentations to peers and client/partners. Designs and facilitates effective project team and/or client/partner meetings leading to desired outcomes
Delivers effective presentations to client/partner executive (C-suite) level; facilitates complex, high-risk group dynamics, conflicts and concerns to promote win-win client/partner outcomes; able to deliver compelling, complex and/or difficult messages effectively
Displays understanding and effectively applies problem solving and decision making skills; able to diagnose problems accurately; skilled at data analysis leading to meaningful insights
Adept at growing and maintaining strategic client/partner relationships; accurately identifies client/partner needs, gains client/partner consensus on proposed solutions; provides meaningful, value-add client/partner advice and guidance; able to move client/partners to action; used as a trusted advisor by client/partners
Demonstrates emotional resilience in stressful situations; maintains a positive attitude when dealing with resistance or setbacks; actively supports organizational change agendas
Works collaboratively with others; constructively manages conflict; maintains open channels of communication
Bachelor's degree from a four-year college or university
Minimum of 10 years of experience in related role including extensive knowledge of coding technology tools
Minimum of 10 years of healthcare experience
Presentation skills, including development and delivery of PowerPoint presentations to audiences of various sizes
Demonstrated complex problem solving skills that have led to actionable recommendations or outcomes
Demonstrated management, teamwork, and interpersonal skills against difficult due dates and timelines
Advanced knowledge of at least one practice management system and/or EMR system; experience with one or several of these vendors is a plus: GEHC, Allscripts, SMS, Cerner, McKesson, Epic, Meditech or other similar system
Advanced knowledge of Microsoft Office (e.g. Word, Project, Excel, PowerPoint, Visio)
Revenue Cycle Management operational knowledge
Master’s degree

Revenue Cycle Representative Resume Examples & Samples

Basic Experience is defined as uses basic understanding of the field to perform job duties; may need some guidance on job duties; applies learning to recommend options to address unusual situations
Working Experience is defined as successfully completes diverse tasks of the job; applies and enhances knowledge and skill in both usual and unusual issues; needs minimal guidance in addressing unusual situations
1-3 years relevant experience in a medical/dental business office with financial counseling, cash collection, knowledge of insurance claim processing requirements/adjudication experience and strong customer service skills including the following skillsets
Experience with electronic health record/patient accounting system
Experience in a dental practice

Supervisor Msrdp Revenue Cycle Resume Examples & Samples

Reviews and analyzes information, identifies problems, recommends solutions and/or writes reports for management or other personnel
Ensure timely revenue cycle work queue metrics are achieved by their direct reports; assigns workload to meet production requirements; compiles, analyzes and reports status and issues involving all aspects of assigned area; makes recommendations to management to reflect changes by reviewing management reports and other data, identifies conflicts and writes resolutions
Monitor charge entry and charge capture quality control thru routine staff and process auditing; ensure charge reconciliation monitoring occurs by Team Leaders
Maintains performance standards by counseling employees, performing appraisals and providing required training; assists with quality control testing and reporting
Ensures departmental policies and procedures are properly followed; develops and revises policies and procedures as needed; maintains written procedures for workflow by writing or updating procedures as needed; communicates and educates all applicable information to appropriate personnel and affiliated facilities as required
Completes special projects and participates in project groups and tasks force teams
Other Duties: Performs other duties as assigned

Revenue Cycle Senior Director Resume Examples & Samples

Direct experience working in hospital or provider setting, including: claims/billing, registration/scheduling, case management, health information management, IT, clinical units/departments, quality, compliance, etc
Workflow redesign and/or performance improvement projects specific to revenue cycle and/or clinical units
Experience with Change Management planning and execution
Minimum of 8 years of healthcare experience
Prior Consulting or Revenue Cycle Management Experience Required
Experience and proficiency in business writing, and highest level of proficiency in presentation skills
Bachelor's degree from a four-year College or university; or one to four years related experience and/or training; or equivalent combination of education and experience

Revenue Cycle Senior Consultant Resume Examples & Samples

Assess the customer Denial Management data and workflow
Complete a root cause analysis and identify potential performance improvement opportunities or best practices and make recommendations to clients on how to integrate new process/best practice into current workflow
Denial Management turn around / redesign
Interim Management
Provide consulting services to clients in all areas of the healthcare revenue cycle with a focus on Denial Management and Prevention
5+ years’ experience with charge master principles and the relationship to coding, billing, compliance in a hospital setting
Knowledge of Denial Management and Prevention best practices
Ability to complete a root-cause analysis for both technical and clinical denials
Requires work experience involving an understanding of Denial Management practices
Master's Degree in Business Administration of related field

Revenue Cycle Consultant Resume Examples & Samples

Ability to complete a root cause analysis for both technical and clinical denials
Evaluate and analyze client data to understand trends
Collaborate with client revenue cycle team and other departments in order to facilitate resolution of process issues and implement world-class solutions
Provide informed feedback to Optum and client executives including assessments of processes, standards, suggestions and improvements
Assist in the sales process as requested
Provide interim staffing services as required
Ability to probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
Excellent interpersonal, written, and oral communication skills
Previous consulting experience

Revenue Cycle Senior Consultant Resume Examples & Samples

Interim management/staffing
Knowledge of CPT/HCPCS coding
Requires work experience involving an understanding of hospital charging practices and governmental coding requirements
Medical record coding or patient accounting experience

Revenue Cycle Optimization Senior Analyst Resume Examples & Samples

Revenue cycle process improvement
Revenue cycle improvement / redesign
Provide revenue cycle services to client/partners in all areas of revenue cycle which includes
Experience and comfort working at all levels of a health care organization. Ability to probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
Knowledge of hospital based IT systems
Ability to travel 80% of the time
Experience with laboratory revenue cycle systems

Assistant VP / Revenue Cycle Resume Examples & Samples

Responsible for coordination of gross charge capture monitoring for multiple hospital patient accounting system planned conversions including collaboration with multidisciplinary teams to identify and mitigate conversion risk related to gross revenue
Oversees the preparation and assembly of monitoring reports for compliance of project implementation
Completes project management and leads optimization efforts across the Revenue Integrity Department long-term
Collaboration with all aspects of Revenue Cycle stakeholder groups including coding, registration, billing, case management, denial management, and charge capture specialists to enhance and optimize existing revenue cycle practices
Assist Revenue Integrity team in validating procedures, items and/or services are documented, captured, billed, and paid according to the terms of regulators and payers
Identify, correct and optimize the processes and systems that lead to lost revenue opportunities and put in place a process to validate accuracy of existing net revenues
Provides revenue and statistical data analyses and works with staff to optimize facility revenue and reimbursement
Provides regular and structured organizational awareness and education to key stakeholders
Performs reviews, research and other duties independently or as requested by the Vice President or Senior Vice President

Revenue Cycle Appellate Resume Examples & Samples

Serves as a resource to non-clinical personnel
Provides CRC leadership with sound solutions related to process improvement
Assist in development of policy and procedures as business needs dictate
Assists Law Department with any medical necessity reviews as capacity allows up to and including attending mediation hearings, other litigation forums, etc
Demonstrates proficiency in the application of medical necessity criteria, currently InterQual®
Possesses excellent written, verbal and professional letter writing skills
Critical thinker, able to make decisions regarding medical necessity independently
Demonstrates knowledge of managed care contracts including reimbursement matrixes and terms
Ability to conduct research regarding State/Federal appellate guidelines and applicable regulatory processes related to the appellate process
Ability to conduct research regarding off-label use of medications
Must possess a valid nursing license (Registered or Practical/Vocational)
Minimum of 5 years recent acute care experience with the last 2 years in a facility environment
Medical-surgical/critical care experience preferred
Minimum of 2 years UR/Case Management experience within the last 2 years
Managed care payor experience a plus either in Utilization Review, Case Management or Appeals
Patient Accounting experience a plus
Previous classroom led instruction on InterQual® products (Acute Adult, Peds, Outpatient and Behavioral Health) preferred
Ability to lift 15-20lbs
Ability to travel approximately 10% of the time; either to facility sites, National Insurance Center (NIC) sites, Headquarters or other designated sites
Ability to sit and work at a computer for a prolonged period of time conducting medical necessity reviews
Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc

Revenue Cycle Coordinator Resume Examples & Samples

Outstanding attention to detail and proven ability to gather and analyze data and make recommendations
Proficient in the use of Microsoft Office Suite with strong Excel skills or comparable programs and the ability to learn and apply new software knowledge quickly
Experience (typically one year or more) in a high-volume customer service environment that demonstrates an ability to manage difficult conversations and resolve conflicts; ability to influence (without authority), and experience with escalation techniques
Demonstrated skills in time management and managing multiple priorities
1+ year experience in medical claims processing, healthcare revenue cycle or medical coding
Advanced knowledge of medical terminology and health care billing
Demonstrated ability to prioritize and coordinate inquiries and concerns of customers: patients, staff, administration and public
Experience as a team leader or supervisor
Experience identifying opportunities for improvements in processes, procedures and reporting

Uwmc Hb Revenue Cycle Program Operations Analyst Resume Examples & Samples

Analyze hospital / professional revenue cycle processes and procedures with a focus on optimizing the use of Epic functionality to ensure the highest level of revenue is recognized through compliant practices and guidelines
Participate in determining the priority, usage and implementation plan for new features and functionality during new version upgrades
Proactively review and evaluate system updates and participate in the upgrade implementation; including analysis, design, testing, communication and implementation of these updates
Partner with HIM / Coding, Peer Systems, Charge Capture and Clinics / Departments to ensure timely billing resulting in clean claims and reduced late charges and denials
Define and document customer requirements
Proactively monitor and maintain systems
Perform problem resolution
Develop and maintain QA documentation
Identify error patterns and recommend training or revised workflows
Provide regular status reporting
Work with all required (intradepartmental & interdepartmental) personnel to define and manage changes to system and/or functional workflows
Perform analysis and troubleshooting for application issues
Provide regular status to management, customers, and stakeholders
Maintain issue tracking tools to manage operational issues to feed regular status reports

Senior Revenue Cycle Data Analyst Resume Examples & Samples

Be a valuable contributor to the project team
Provide analytical support to the consulting team
Interpret data, analyze results using statistical techniques and provide ongoing reports
Develop and implement databases, data collection systems, data analytics and other strategies that optimize statistical efficiency and quality
Maintain communication with team and key stakeholders
Is a critical thinker
Has proven analytical skills
Is able to communicate effectively across roles and levels within the organization
Demonstrates painstaking attention to detail
Is innovate and effective at visual communication
Has experience working in the revenue cycle area
4 year degree or equivalent experience
Proven working experience as a data analyst or business data analyst
Minimum of 2-3 years of experience in a business office setting
Strong knowledge of and experience with reporting packages (Business Objects etc) and databases (SQL etc)
Knowledge of statistics and experience using statistical packages for analyzing datasets (Excel, SPSS, SAS etc)
Ability to work independently when appropriate
Interested in continually learning and growing
Innovative and creative
Flexible and versatile
Prior experience identifying data trends and issues
Knowledge of MS Project

Revenue Cycle Assistant Manager Resume Examples & Samples

Ensure team follows documented policies and procedures, including SOX narratives, and conduct SOX control activities, as appropriate
Make recommendations to Manager on changes to existing tools, policies and procedures to facilitate achievement of department goals
Review daily, weekly, and monthly key metrics to identify trends or areas of focus; work with Manager to develop, document, and implement action plans to address issues
Maintain current and thorough understanding of dialysis reimbursement and industry norms; monitor trends, escalate issues, concerns, and changes
Monitor work of Registration Representatives to ensure patient records are established timely and accurately and maintained properly
Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun
Provide support for department initiatives as needed
Provide support to Finance, ROPs, and Clinical partners
Other duties

VP-revenue Cycle Resume Examples & Samples

10+ years of progressive management experience
5+ years of healthcare industry experience
Experience with Medicare, Medicaid and Managed Care regulatory, billing, compliance, contracting and reimbursement issues
Government and Third Party payer billing and compliance audits experience
2 years of EMR experience

Director of Revenue Cycle Management Resume Examples & Samples

Provide direction to the Claim Scrubber/Submission Team, Acquisition Integration Team, System Set-Up and Maintenance Team, and Payor Specialist Team
Bachelor’s degree in related area required; Master’s degree preferred
Minimum of seven (7) years’ experience in managing complex operational and support functions required; experience in Healthcare, Consulting, Information Technology, or Insurance industries preferred
Minimum of four (4) years’ management consulting experience in healthcare revenue cycle preferred
Commitment to and role model of DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions

Business Analyst, Healthcare Revenue Cycle Resume Examples & Samples

At least 5 years prior business analyst, implementation, or client/payer-side (payer or hospital/health system) experience in healthcare revenue cycle management software and technology
Healthcare revenue cycle experience
Understanding of HL7 and X12 message/file formats and transactions
Effective communication and relationship building skills
Self-motivated, autonomous

Revenue Cycle Coordinator Resume Examples & Samples

Licensure/Certification/Registration: None
Education:Bachelors preferred; may substitute experience
Experience: 3-5 years in a computerized office setting, healthcare billing experience required
Special qualifications: Must be able to successfully complete established competencies for the position within designated probationary period. Must have good communication skills, computer skills (Microsoft Office suite), project management skills,. Must have the ability to organize, prioritize, and coordinate multiple projects simultaneously; presentation and training skills

Middle Revenue Cycle Optimization Associate Director Resume Examples & Samples

Assess the impact of new technologies on specific workflow and identify the associated education needs, system remediation needs and workflow redesign
Identify potential performance improvement opportunities or best practices and make recommendations to clients on how to integrate new process / best practice into current workflow
Bachelor's degree from a four - year College or university; or one to four years related experience and / or training; or equivalent combination of education and experience
1+ years of experience working in hospital revenue cycle department as a director or supervisor (patient access, patient financial services)
In - depth knowledge of the complete healthcare revenue cycle

Revenue Cycle Representative Resume Examples & Samples

Resolve claims from an assigned work-queue to ensure that all claims are worked within the timely filling/appeal guidelines
Determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies, government entities (such as Centers for Medicare and Medicaid Services) to obtain correct payments; and/or appeal claim payments/denials
Perform denial management, research, obtain proper documentation to support resolution of overpayment; resolving credit balances and to resolve outstanding accounts receivable by interacting with third-party entities via websites, telephone, or written inquiries
Identify & report undesirable trends and reimbursement modeling errors or underlying causes of incorrect payment; review allowed variances from third party payers
Identify trends and/or work processes for potential process improvements
Review and analyze report data to provide status updates to leadership
Communicate changes in payor policies and denial trends; escalates claim payment delays as appropriate
Related customer service experience (typically 6 months or more) in a professional, financial, health care or medical related environment
Strong attention to detail with a proven ability to gather and analyze data and keep accurate records
Experience maintaining professionalism while handling difficult situations with callers or customers

Revenue Cycle Representative Resume Examples & Samples

Contact patients and insurance companies by phone to resolve credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries
Contact inpatients within 48 hours of admission and discharge to comply with Centers for Medicare and Medicaid Services requirements for patients to receive, understand and sign receipt of Medicare Discharge Rights letter
Work with court system to provide time sensitive documents and ensure that deadline dates are met and that UIHC is in compliance
Maintain extensive working knowledge and expertise based around payer regulations/policies, financial classifications and financial assistance programs
6 months of customer service experience in a professional, financial, health care or medical related environment

Senior Revenue Cycle System Analyst Resume Examples & Samples

Ensure that the solution is designed leveraging Cerner recommendations
Maintain knowledge of Cerner Patient Accounting, staying current on and utilizing the latest functionality and content on projects
Conduct recurring and ad-hoc meetings with stakeholders from Patient Financial Services
Review escalated requests
Review, prioritize and work open application issues
Manage relationship with Cerner Application Management Services (AMS) and act as liaison for AMS with end users
Drive meaningful initiatives to improve KPIs
Create ad hoc queries/reports
Strong interpersonal communication and client presentation skills
Ability to build and maintain relationships with partners and vendors
Strong Healthcare industry experience
1 years of Experience with Cerner Patient Accounting or other revenue cycle solutions
Must live in or be willing to relocate to San Diego, CA and, if not previously experienced in Cerner Patient Accounting, to travel to Kansas City, MO for 12 weeks for certification courses

Revenue Cycle Consultant Resume Examples & Samples

Ensures business needs are understood and Cerner’s information technology strategies are enhancing client objectives
Follows Cerner policies, upholds professional standards, and performs all work in a manner respectful of others
Strong presentation and facilitation skills
Ability to work off-hours when required Willingness to learn autonomously when needed
Agile
5+ years of healthcare experience in Cerner RevCycle design and build, or workflow (ex: RevCycle, Case Management, HIM, hospital business office, healthcare administration)
Ability to travel nationwide (80% +) required
Reside in or ability to relocate to the Kansas City area

Revenue Cycle Consulting Architect Resume Examples & Samples

Understand and consult on departmental and service line workflows, including associated Revenue Cycle roles and operational/process metrics
Ensure the solutions are designed leveraging Cerner recommendations
Provide expert knowledge, implementation strategy, and workflow design within scope
Successfully use analytics to drive end-user adoption
Understand client value metrics for the project
Maintain knowledge of the solution, staying current on IP development and utilizes latest functionality and content on projects
Work with client leadership team to create consistent communication across revenue cycle projects
Work with engagement management for project planning / phasing, scoping and timeline projection
Ensure Change Management processes are in place for success implementation
Build relationship with Client and Project team leaders
Able to manage multiple projects and deadlines
Basic computer skills, including Microsoft Office suite
Bachelor’s degree or equivalent in experience
1+ year of experience in project management
3+ year of experience leading a full Revenue Cycle solution implementation across all venues (Cerner preferred)
Ability to travel up to 80%
Does not require relocation as long as you live in a major US city
3+ years of experience in healthcare consulting
Previous experience working with Cerner Revenue Cycle Solutions

Revenue Cycle Consulting Executive Resume Examples & Samples

Resource Management experience required
Ability to build relationships at the CXO level
Experience managing a small team of people with disparate focuses
Confident presenter and communicator
10+ years’ healthcare project management and/or related healthcare consulting
3-5 years' experience in healthcare information technology (HCIT)
Experience in Healthcare Revenue Cycle/Financial Management
Ability to travel up to 80% nationwide
Must reside near a major international airport or be willing to relocate to Kansas City, MO
PMP and/or Six Sigma certification
Cerner and healthcare IT industry knowledge

Revenue Cycle Senior Business Analyst Resume Examples & Samples

Work under the direction of the Manager to provide application solutions for assigned business areas
Possess functional knowledge of assigned application technology
Interact with business users to understand new business requirements and enhancement requests
Serve liaison role between application technology vendors, internal IS groups, and business users
Translate business requirements into product-specific designs and configuration, detailed requirement specifications and use cases
Deliver functional specifications, design documents, business process workflow and related documentation for new development projects and/or enhancement and modification requests to be used by Systems Analyst
Interact with Systems Analysts during the software build and/or configuration process and testing process
Perform functional application configuration and configure /run reports at user request
Design and execute functional, integration, and regression test plans for new application functionality, product releases and enhancement and regulatory modifications using business scenarios and use cases
Ensure programs meet business specifications
Demonstrate new functionality to business users seeking inputs on future direction
Review vendor provided documentation and user manuals needed to support the product
Directly interface with business users by responding to support calls escalated by the Service Desk
Participate in user focus groups and requirements workshops, vendor training and demonstrations
Assist in supporting activations and rollouts
Consistent efforts to deliver quality solutions as per agreed scope
Customer focus and close alignment with the customers’ business objectives
Ensure efforts to continually improve domain knowledge
Ensure the quality of the deliverables as per the defined defects standards
Document issues with resolutions and share with team members to improve team productivity
Provide data to generate team performance metrics
Knowledge transfer with other team members to improve overall team education level
Take complete ownership for the assigned task and timely inform the progress of the project / task to all stakeholders
Adherence to the defined standards
Take initiative and drives to bring to logical conclusion; proactive approach
Provide accurate and timely information and escalates when there are issues
Actively participate in meetings and make valuable contribution
BA or BS degree preferred and/or other relevant combination of training and experience
0-2 years Industry experience preferred
2-5 years practical experience in providing technical support and maintenance in assigned product preferred

Engagement Lead Revenue Cycle Solutions Resume Examples & Samples

Developing new Revenue Cycle solutions that drive client value and generate a replicable
Managing client and internal expectations of solution scope and delivery objectives
Communicating all of the requirements and commitments to the client, project team and CST
Minimum of five - seven years’ progressively responsible healthcare experience including a solid
The ability and willingness to travel to customer locations throughout the US approximately up to
60% of the time
Strong Organizational skills
Integration of Clinical Software systems with Revenue Cycle Systems
Five years project management experience
Excellent listening and inquiry skills
Problem resolution and creativity in solution development
Customer political sensitivity and awareness
Self-assessment and development skills and ability to work independently
Microsoft Office (Excel, Word, PowerPoint, Project)
You have the unrestricted legal right work to work in the US
Willing to submit to a drug test
Willing to submit to a background investigation, including for example, verification of your past
Extensive knowledge of multiple Revenue Cycle applications
GE Healthcare Revenue Cycle Solutions applications (IDX Flowcast products and their

Revenue Cycle Associate Resume Examples & Samples

Reconcile Athena postings to deposits in bank
Transfer payments to and from the various Steward vendors
Work manager holds in Athena related to claims
Resolve customer service complaints
Resolve Unpostables in Athena
Upload remits for posting in Athena
Sort and direct correspondence
Work closely with Finance to reconcile receipts
Resolve issues assigned thru Footprints from other departments within SMG
Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations
2-3 years experience with medical billing/collection; physician billing experience preferred
Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus
Experience with patient accounting systems and billing/claim submission software; specific Athena Health experience a plus
Ability to utilize basic Microsoft Office programs - Excel experience a plus
Highly detail oriented and well organized
Ability to read, understand and follow oral and written instructions

Mckesson Revenue Cycle Architect Resume Examples & Samples

McKesson Star – Registration
McKesson Practice Point Plus
Claims Administrator / EC2000
3M APR DRG Grouper
3M Coding Reference Software
Manage process improvements effectively; leveraging existing implemented applications to achieve better performance and outcomes
Review and design workflow for multiple components of domain
Share knowledge and proactively identify issues with client or within teams that need to be addressed
Document all work as part of client deliverables, consistently using a professional documentation approach throughout span of engagement and beyond, resulting in high quality materials for internal and external usage
Monitor industry trends and identifies policies or requirements to ensure applications fit with government and industry directions for technology. Then consult with clients on the requirements and oversee the direction of the architecture
Maintain a deep knowledge of the application(s); stay at the forefront of knowledge around the application(s)
Escalate incidents according to procedures and convert incidents to change requests as needed
Bachelor’s degree in healthcare, information technology, business or related filed strongly preferred
3 years experience in Mckesson RevCycle solution
Experience with physician facing and/or revenue cycle solutions
Previous Integration Architect experience
Must be willing and able to learn the Cerner RevCycle solution
Proven ability to reach across solution and organizational boundaries to deliver result
Experience with McKesson RevCycle solutions such as Registration, PPM Physican Billing and Claims Administrator EC2000, to include Vista/KB query language

VP Revenue Cycle Management Resume Examples & Samples

Bachelor’s Degree in a related field (e.g., management science, operations management, business, etc.), or an equivalent combination of education and experience, required
15 or more years of relevant experience, including experience in call center management, collections, quality control and process improvement
Strong leadership skills, with the ability to influence with and without formal authority
Detail-orientation, comfort juggling dynamic and complex work
Highly analytical, with the ability to operate at both strategic and tactical levels as required

Revenue Cycle Consulting Architect Resume Examples & Samples

Bachelor’s degree or equivalent experience
3+ year of experience leading a full Revenue Cycle solution implementation across all venues
Ability to travel 80-100%

Revenue Cycle Senior Director Resume Examples & Samples

Assists business development teams, sales and client / partner managers on proposals and calls when necessary as requested by management
When assigned as project lead, responsible for soliciting client / partner feedback on project progress, performance and success, updates client/partner weekly on progress, problems, and accomplishments
Interact with other departments to ensure a high level of client / partner satisfaction through successful execution of projects

Revenue Cycle Engagement Leader Resume Examples & Samples

Financial Management experience required
Resource Management experienced required
Has fully participated in all project engagement phases
Proficient in Microsoft Office Application, including MS Project
Ability to build relationships at the CFO level
2+ years of successful project management experience
Ability to travel 80% nationwide
1-2 years of experience leading Revenue Cycle implementation
Previous experience working with Cerner Millennium Revenue Cycle Solutions
Certified Revenue Cycle Representative distinction
Healthcare knowledge/experience
Experience leading Healthcare/IT and/or HCIT projects

Revenue Cycle Resume Examples & Samples

Facilitate communications between ITWorks, AMS and Revenue Cycle departments
Participate in project implementations, system upgrades and quality assurance processes
Actively participates in project activities. Analyzes data requirements for system upgrades
Place a high priority on serving all customers, lead user group meetings to establish client relationship
Interact with AMS, end-users and business unit owners to understand business needs
Work with all team members to achieve goals, identify and resolve issues, overcoming challenges
Assist with system functional and user acceptance testing. Create and/or participate in unit and integrated testing. Obtain approval and signoff from stakeholders
Identify and initiate resolutions to user problems and concerns associated with Revcycle solutions and recommend corrective and preventive action to team lead/manager
Develop training materials to assist the help desk with first tier troubleshooting and issue resolution
Plan and implement upgrade requirements on a timely basis
Participate in the Incident management process. Proactively work to resolve incidents and meet service requests. Document relevant data on requests and resolutions in agreed upon timeframes
Participate in the change management process, with proper work plan, test plan, back out plan and peer review
Bachelor's degree in healthcare, information technology, business or related field strongly preferred
2 years of experience in information systems, healthcare, project management, or business
1 year of experience with Cerner Patient Accounting or other hospital revenue cycle solutions
Experience with Cerner Millennium solutions to include CCL reporting query language, Cerner Patient Accounting and willingness to learn additional revenue-cycle related Cerner solutions such as Registration, Scheduling, and Health Information Management
Must be able to work flexible hours as needed

Revenue Cycle Mgmt Associate Resume Examples & Samples

Process and track Automated Clearing House (ACH) notification, return items, online lockbox decision tools, return checks, field collector payments, return and fee reports
Perform out outbound C&I collections calls on accounts with balances <$5,000 (excluding high risk or managed accounts) and outside collection agency work
Process financial account transactions to ensure accurate account billing, balances, revenue and General Ledger (G/L) accuracy (bankruptcy, disputes, sales tax, debit/credit adjustments, deposit maintenance, suspends, vouchers, G/L activities, final bill disputes, customer directed payments, collection agency manual payments, bank issued, HEAP and cross system payments)
NOTE: Exceptions in RCM are commonly referred to as “WFM”, “Queues”
Sound knowledge of internal customer, financial and operational systems
Ability to create and update excel or system files/reports

Communityworks Revenue Cycle Consultant Resume Examples & Samples

Experience participating in multiple phases of a system implementation
Strong client facing presentation and facilitation skills (may be demonstrated through teaching client or associate classes or presentations)
Ability to work overtime and “off” hours as necessary
Bachelor's degree or equivalent experience in Healthcare, Sciences, or Information Systems
Healthcare IT or Financial industry experience
Experience with financial reporting
Must reside in or be willing to relocate to Kansas City, MO
Technical or healthcare background
One or more years’ experience working with the Millennium suite of solutions

Supervisor of Revenue Cycle Management Resume Examples & Samples

Responsible for managing day-to-day operations of the department including staff supervision and issue resolution, individual productivity, and overall transaction processing
Identifies and responds to staff needs for support and training through side-by-side work review and informal and formal feedback sessions
Provide financial and demographic analysis regarding program participants
Works closely with operational partners to develop strategies for promoting charity care programs

Project Consultant, Revenue Cycle Solutions Resume Examples & Samples

Serve a key role in analyzing client operations and data
Develop presentation and report deliverables, and present recommendations
Facilitate client calls and in person meetings at the client site
Maintain and share business and technical expertise with clients
Assist in providing on-site and off-site assessments and consulting services for a portfolio of clients
Identify potential issues that will impede success and recommend corrective action
1+ Year of Professional Experience
Experiencing analyzing large data sets using Excel advanced functionality
Previous work experience, education, or demonstrated interest in the health care field
Demonstrated ability in client relationship management and project management
Willingness to travel 60-80% domestically
Valid Driver’s License
Experience working with Access and Excel
Proven ability to present effectively to multiple audiences
Ability to manage projects independently
Ability to drill down to the root cause of issues and be creative in problem solving

100

Sunrise Revenue Cycle Management Resume Examples & Samples

On track for a Bachelor's Degree in Business or Healthcare Management or a related discipline
0+ GPA preferred
Microsoft Office experience specially PowerPoint & Excel
Comfortable working with a remote team
Entrepreneurial mind-set wanted
Salesforce & Sharepoint experience preferred, but not required

101

Revenue Cycle Coordinator Resume Examples & Samples

Strong analytical skills with an outstanding attention to detail and proven ability to gather and analyze data, make recommendations or implement changes based on data analysis
Proficient in the use of Microsoft Office Suite with an Extensive level proficiency with Excel or comparable programs and the ability to learn and apply new software knowledge quickly
Demonstrated ability to manage difficult conversations; an ability to influence (without authority), and experience with escalation techniques
Self-motivated with initiative to seek out additional responsibilities, tasks and projects
Knowledge of medical terminology and health care billing
Demonstrated ability to prioritize and coordinate inquiries or concerns from patients, staff, administration and public

102

Revenue Cycle Representative Resume Examples & Samples

Review accounts and initiate pre-certification, pre-authorization, referral forms and other requirements related to managed care; route to appropriate departments as needed
Manages reception area; including greeting patients, check-in for pediatric admissions
Provide financial counseling via phone and/or in-person based on the patient’s liability and ability to pay
Advise patients and/or family members about their healthcare accounts, collect appropriate self-pay balances, establish payment arrangements and link patients to the available funding sources such as: Medicaid, Healthcare Marketplace, Payment Plans and Uncompensated Care
Basic knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
Basic knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
Working experience with multiple technology platforms such as Epic, Cirius ACD, and/or GE

103

Revenue Cycle Project Manager Resume Examples & Samples

Management of medium to large concurrent initiatives which support the strategic goals of the organization. This includes management and follow-up of deliverables as well as open items
Successfully managing projects with interdisciplinary teams to meet project milestones and achieve performance expectations
Demonstrate strong communication skills both written and oral to team members and management
Work with business partners to influence direction and actively align project goals with Conifer strategic objectives
Manage to identified KPI’s and success indicators for the project
Provide guidance and mentorship to other team members
Experience in managing multiple Project Managers and staff
Experience in interacting with the most senior executives of clients in a very clear, cogent, and professional manner
Experience with deploying multiple Revenue Cycle Management (RCM) solutions across an organization that have data-sharing and operational inter-dependencies that must be managed across multiple vendors
Experience in business process improvement methodologies: Lean, Six Sigma, etc
Experience in building scorecards and tracking tools to monitor both project success and operational metric-based performance
Experience in developing and delivering communication plans and vehicles across multiple stakeholder groups (internal and external)
Ability to quickly understand and navigate the internal Conifer business units to align the efforts of key staff to the betterment of the effort
Experience in working within a hospital or physician business environment
4-6 years of experience leading multi-project program level efforts that span client stakeholders, including internal senior leadership, partners/vendors, and external influencers
Solid knowledge of all MS Office Products, including MS Project
Prior working experience with Cerner Millennium revenue cycle EMR system preferred, but not required
Prior working experience with revenue cycle EMR systems (i.e. Epic, GE IDX, Cerner, Athena) required
Ability to multi-task in a fast paced, fluid work environment
Demonstrated high level of written and verbal communication skills working with subordinates, peers, clients and members of senior management
Very organized and detail oriented
Expert knowledge of project management theory and practice. The ideal candidate must be able to select methodologies, standards and tools and make effective use of experts in these areas
Proficient in Microsoft Office tools (Word, Excel Pivot tables, Visio, MS Project, MS Sharepoint and PowerPoint)
Analytical problem solving skills to review, identify and resolve operational issues that would impact the implementation cycle and potentially delay an established go-live date
Ability to identify client policy/procedural issues that must be addressed to ensure a successful implementation Demonstrated ability to think ‘out of the box’ and make adjustments to meet the needs of the client
Nationwide travel varies between 0-60%, depending upon project phase

104

Revenue Cycle Analytics Intern Resume Examples & Samples

Contributing to a designated project or initiative to meet a KP business objective
Report development and analytics
Project management - planning, execution, and measurement
Learning new applications needed to complete assignments or support the execution of business objectives
Job shadowing in other functional areas
Performing additional duties as required
The union and the company are currently investigating the bargaining unit status of this position. If it is determined that this is a bargaining unit position, bargaining unit status (seniority dates, dues payments etc.) will be applied on a retroactive basis based on the employment commencement date
Pursuing a bachelor's degree or have graduated with a Bachelor's degree from an accredited Colorado university within the last year
Desired majors: Computer Science, Math/Statistics, Business Administration or related
Proven ability to build effective working relationships as well as strong interpersonal skills
Ability to learn quickly and experience producing high quality work in short periods of time

105

Cerner Revenue Cycle Consultant Resume Examples & Samples

This position requires 5+ years of Cerner Revenue Cycle Consulting experience
Provide expert Cerner Revenue Cycle services
Cerner Patient Accounting experience preferred
Must have experience with 3 implementations of Cerner Millennium Revenue Cycle
5+ years experience with Cerner Millennium optimization, implementation or support
Applicant must possess excellent understanding of Cerner Revenue Cycle, in the hospital environment
May require long periods of standing
Bachelor's degree preferred or equivalent experience
Project Management/Leadership skills

106

Revenue Cycle Auditor Resume Examples & Samples

Performs duties independently and proactively with a high level of accuracy and timeliness
Excellent oral and written communication and interpersonal skills and demonstrated ability to effectively and collaboratively work with team members and various levels of staff and management
Demonstrated ability to successfully manage multiple priorities concurrently
Maintains high integrity, builds credibility and favorable relationships with customers

107

Senior Soarian Revenue Cycle Consultant Resume Examples & Samples

Applies Cerner's consulting methodology and guides continued client optimization
Understands and consults on entire service line/department workflow, including all associated roles and operational/process metrics
Articulates regulatory impact on service line/department
Establishes trusted relationships with all levels and service lines/department inside the client organization(s) and within Cerner project team
Works in accordance with corporate and organizational security policies and procedures. Understands personal role in safeguarding corporate and client assets
Takes appropriate action to prevent and report any compromises of security within scope of role
10+ years of healthcare experience in Soarian RevCycle design and build, or workflow (ex: RevCycle, Case Management, HIM, hospital business office, healthcare administration)
Ability to travel nationwide 80-100% required
Must reside near a major international airport or be willing to relocate to Malvern, PA area
RHIA, CRCR or other Revenue Cycle credentials
Experience with Microsoft Office products

108

Revenue Cycle Application Consultant Resume Examples & Samples

Demonstrates broad solution knowledge
Develops and maintains solution expertise
Serves as the onsite point of contact for issue resolution and triage for supported applications
Responds to client inquiries via telephone, email or chat sessions
Utilizes effective oral and written communication skills to facilitate discussions and decision making
Articulates the end-user requirements and proposed solutions to clarify and control expectations and achieve user acceptance of the application
Identifies, develops, and utilizes appropriate forums to solicit input and provide feedback to support the design, education, implementation, evaluation, and modification of the application
Participates in design, build and testing for application specific projects as needed
Leverages internal and external resources and tools to deliver problem identification and resolution
Maintains client relationship through direct onsite contact
Complies with standards for change control and work plans. Insures appropriate communication and documentation is completed in order to support application quality programs and application development
Works in accordance with corporate and organizational security policies and procedures
Understands their role in safeguarding corporate and client assets. Takes appropriate action to prevent and report any compromises of security within scope of role
Demonstrated ability to work within a team environment and with diverse groups and difficult clients
Ability to learn and apply new skills and concepts quickly
Ability to sit and view computer monitors or other monitoring devices for a prolonged period of time
Prolonged use of a computer and basic computer skills, including Microsoft Office suite
Ability to work on a flexible schedule and overtime and/or irregular hours when needed
Must be able to travel up to 10%
Must reside in the greater Glens Falls, NY area
Associate’s Degree required or equivalent experience
1+ years of experience in healthcare, sciences, or information systems; with emphasis in information systems
Experience with Cerner Revenue Cycle Solutions (including Scheduling / Registration, HIM, Charge Services and/or Revenue Cycle)
1+ year of experience with database tools, application development, or health information standards

109

Revenue Cycle Management Associate Resume Examples & Samples

Basic account updates, field orders and outbound calls based on account parameters (Service application Management, payment agreements, applications, medical emergency cut-ins, connects/disconnects, protections, account riders, meter reads, leave on for landlord, payments, long term estimates, report lists, contacts, program enrollment, borderline billing, non-qualifying letters and Unable To Complete)
Research, reconcile and resolve customer, agency, internal clients/billing owners/partners, banks inquires including account research, billing and adjustments (customer and billing owner inquiries, payments in suspense, payment investigations, crediting fees, removing cash only status, transferring payment amounts, duplicate bills, prepare documentation statements/correspondence, transferring balances, customer refunds, collection agency reports, discharges, suspends, DSS, government services website, claims backup, DSS agencies, bank, billing, collection vendors, internal billing owners, life support, cross system inquiries and energy suppliers)
Perform and coordinate revenue loss mitigation activities such as pole cuts, field collections, gas safety compliance, consumption on inactive accounts, stopped meter, theft and other loss activities
Communicate with external customers, business partners, vendors and other employees
Advanced use of computer software (Email, MS Office Suite) and office technologies
High School Diploma or Equivalent
AND
Must Pass Prescreening testing (CAT Test)

110

Revenue Cycle Assessment Consultant Resume Examples & Samples

Operations and/or consulting for pre-bill clean claim requirements, billing, collections, payment management
General back office metrics, productivity standards and workflow
Understanding the root cause linkage of back end claim issues and the originating cause of the issue (e.g. payment delays, returned mail and bad debt caused by incorrect information capture and quality checks during registration),
Government (e.g. Medicaid, Medicare), commercial and self-pay payers
Back end experience as described above is required
Identifies opportunity areas and contributes to the development of benefit estimates and financial models for potential clients
Manages timelines and project plans for the completion of the assessment and full due diligence process
Serves as the key data contact for a potential client, including reviewing the data request with the client, fielding questions regarding the request and posing any necessary questions back to the client in order to validate the integrity of the data
Acquires and processes client data necessary for high level assessment and full due diligence efforts. Demonstrates ability to analyze large volumes of data in order to produce useable results to meet evaluation objectives
Collaborates with other functional units (optimization, finance, human capital, technology and compliance) to ensure timely reviews and contributions of final documents
Assists with pre-onsite planning and logistics (e.g. flight, hotel, and rental car logistics)
Contributes to Revenue Cycle Solution Design methodology development and other functional assignments as assigned
Demonstrates creativity to design approach and problem solving skills
Supports innovation execution for strategic organization initiatives
Presents to small / moderate sized groups well and has the ability to adjust message to audience (CFO, CEO or VP of Revenue Cycle)
Ability to condense large amounts of data into succinct, executive level Presentations
General Revenue Cycle knowledge across Patient Access, Health Information Management / Revenue Integrity / Coding / Clinical Documentation Improvement
Industry or consulting experience

111

Revenue Cycle Coordinator Resume Examples & Samples

Supervise work of Adult, Psychiatry and Children’s Hospital Admissions teams and serve as a payor expert and technical resource. Develop new and current staff through training to improve revenue cycle knowledge; work with staff to suggest additional options to resolve patient account inquiries
Oversee and review employee’s work to determine if appropriate actions have been taken with regard to receipt of correct reimbursement
Supports patient care by resolving hospital pre-certification and pre-authorization issues with physicians, radiologists, radiology technologists, and ancillary staff; improving and maintaining quality assurance program for department functions
Perform trend analysis of self-pay accounts and financially unsecured accounts, to identify additional collection opportunities
Manage and monitor timeliness and accuracy of self-pay accounts receivable functions, in adherence to UI Health Care and governmental policies
Investigate transactions to clear up confusion regarding improper medical billing in order to maximize reimbursement and minimize inappropriate self-pay billings
Audit and monitor routine follow up activities of unpaid self-pay accounts and financially unsecured accounts. Set performance measurements/standards to enhance collections and take leadership in resolving problematic accounts
Partner with clinical leaders, admitting departments and physicians related to securing payment on hospital accounts from third party resources and/or patients
Implement new processes developed by management to ensure processes are operating effectively and efficiently; make recommendations based on analysis of data
Develop and monitor employee performance goals to enure compliance. Perform an array of QA checks and productivity audits; identify and resolve undesirable trends and reimbursement errors; prepare reports to assure quality and productivity requirements are being met
Communicates with clinic management and staff regarding insurance carrier contractual and regulatory requirements
Keep current on industry knowledge, skills and certifications to serve as a resource to employees and to conduct job duties
1-3 years’ experience in a high-volume customer service environment that demonstrates an ability to manage difficult conversations with patients or family members, an ability to influence (without authority), and experience with escalation techniques
Proficiency with Microsoft Office Suite with strong Excel skills or comparable programs and the ability to learn and apply new software knowledge quickly
Prioritization, time management and organizational skills; experienced in the management of multiple priorities that enable the ability to coordinate inquiries and concerns of customers: patients, staff, administration and public
Experience training and/or mentoring new employees or team members
Demonstrated ability to appropriately maintain confidentiality
Knowledge of insurance authorizations, referrals and eligibility processes

112

M HIS Revenue Cycle Solution Sales Executive Resume Examples & Samples

Bachelor's degree or higher from an accredited institution
Minimum of three (3) years of combined experience selling and/or delivering/implementing complex technology solutions, across multiple hospital departments
Minimum of three (3) years of experience with one or all of the following: CDI workflow, HIM Operations, IP & OP Revenue Cycle, and the regulatory environments
Masters in Healthcare Administration or Masters in Business Administration from an accredited university
Proven ability to identify and communicate with “C level” decision makers
Excellent organization, presentation, and communication skills
Working knowledge of 3M HIS products
Coding and/or CDI certification(s)

113

Revenue Cycle Management Operations Analyst Resume Examples & Samples

Analyzes data and statistics, including physician productivity and compensation, to identify trends and variances
Provides analysis and data to support the PSA’s strategic planning, growth, and development efforts
Prepares accurate financial and/or statistical reports for internal and external use by governmental agencies, financial institutions, or third-party agencies
Renders assistance to department Directors, Managers, and Service Line Administrators in preparing and reviewing data and systems
Supports clinical practices with the preparation of revenue cycle performance reports
Assists with the development of operational strategic analysis in support of clinical and business operations. Reviews and prioritize requests for financial analysis or reports
Participates on teams, committees, and special projects both internal and external to the organization. Supports senior management and performs other assignments
Coordinates with the PSA’s Physician Practices, Patient Accounting and Finance on business related issues and best practices
Provides crucial insight into business operations through analyses of practice operations, review of performance benchmarking, and assisting in business forecasting
Assists with the preparation of the annual budget related to the revenue, payments and adjustments for the PSA and prepares schedules and analyzes data for comparison and changes
Responsible for maintaining systems for trending specialty and provider performance within the revenue cycle and audits key data fields to ensure accurate data and reports
Physician enterprise operational reports design, preparation and maintenance preferred
Knowledge of physician group practice financials, reports, and tools
Strong customer service and analytical skills
Knowledge of Revenue Cycle processes
Ability to collaborate with operational teams and understand the business of the service lines
Aptitude for conflict resolution, and problem-solving
Interpersonal skills necessary to establish and maintain effective working relationships with physicians and all levels of personnel, both internal and external to the PSA
Skill in the use of complex mathematical and statistical techniques to assess financial and statistical scenarios
Demonstrates competency in design, preparation of spreadsheets, and other reporting tools
Ability to utilize discretion and independent judgment to support the financial goals of the organization
Able to communicate information in a clear, concise, and easy to understand manner for use by internal and external groups
Ability to balance multiple tasks with changing priorities; organization skills

114

Revenue Cycle Mgt Analyst Resume Examples & Samples

Maintain SOX controls for tie outs, including documentation to be provided to auditors as requested
Cash Reconciliation & Specialist Projects
Assist CBOs with complex projects regarding payer issues
Attend committees to maintain company Control Group Numbers for cash reconciliation purposes in Accounting
Create new reports for the RCM Auditing Dept, Contract Revenue Dept, Billing Dept and Business Systems Dept; train said departments on running reports and troubleshoot future issues or modifications
Create and distribute assigned weekly, monthly, and quarterly Management reports for RCM, CLS, Business Systems and Billing Departments
Provide Auditing with documentation as requested
Ad-hoc reporting and analysis for management team as requested
Analyze A/R, collection, reimbursement trends and RCM performance. Provide feedback to RCM leadership as assigned, which may include but is not limited to
Reporting at CBO monthly operations meetings
Identification of root causes obtained through analysis and communicate findings as appropriate
Support and Training, by providing ongoing support to the CBO RCM Revenue Cycle Analysts
Monitor and respond on a timely basis to report requests and other inquiries directed to the Corporate PA Reporting icon
Assist Analyst, RCM III (Sr. RCM Analysts) with training of CBO RCM Revenue Cycle Analysts
Assist and attend Monthly/Annual CBO RCM Revenue Cycle Analyst meeting
Assist with Disaster Recovery procedures, including cutover testing annually
Responsible for submitting and testing service request changes to I.S. as requested by the CBOs
Perform testing on changes as directed by Information Systems
Act as Corporate RCM liaison to Information Systems
Performs other job-related duties within the job scope as requested by Vice President of Revenue Cycle Management
Reads and complies with established policies and procedures
Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations
RCM experience
Advanced knowledge and/or familiarity in Word, Excel, Access, Power Point, Brio, Crystal, GPMS, Medsuite, Monarch, Cognos and Master Database

115

Revenue Cycle Management Analyst Resume Examples & Samples

Responsible for balancing tie outs from billing and patient accounting systems (GPMS, NextGen,
Medsuite, OBR, Availity) to Financial Database and/or Cognos on a weekly and monthly basis
Work closely with Finance and IS FDB/Cognos Team to maintain controls and the schedules for tie outs and resolve any conflicting data in a timely manner
Monitor daily cash report provided by team and provide back-up for issues with banks
Monitor and trend miscellaneous payments posted throughout the company and assist CBOs with reconciliation
Monthly Reporting, Analysis, and Trending
Create monthly OBR, Availity, GPMS, Medsuite and/or NextGen reports for coding educators
Assist with completing CBO Report Cards
Provide back-up coverage for the Analysts and assist Analyst, RCM III (Sr. RCM Analysts) with projects and assigned reports as needed
Create new reports to be used in the CBOs and provide training
Create, maintain and distribute monthly staffing matrices to RCM leadership to determine necessary staffing to support operations
Contribute on committees as needed
Maintain strict confidentiality in accordance with HIPAA regulations and Company policy
Any patient private health information (PHI) must not be divulged on any account except for payers that need the information in order to process the claim for payment
Maintains constant awareness of potential safety hazards insuring necessary safety precautions
Associate's degree (A. A.) or equivalent from two-year College or technical school (Bachelor’s preferred); or three or more years related experience and/or training; or equivalent combination of education and experience
Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables

116

Revenue Cycle Precertification Clinician Resume Examples & Samples

Ability to work independently and self-regulate in compliance with deadlines
Proficiency in the application of applicable nationally and payer authorization criteria
Minimum Intermediate Microsoft Office (Excel and Word) skill
Ability to interact intelligently and professionally with other clinical and non-clinical partners
Ability to communicate effectively at all levels
Ability to sit and work at a computer for a prolonged period of time conducting pre-service medical necessity reviews
Characteristic of typical Call Center environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc

117

Revenue Cycle Coordinator Resume Examples & Samples

Responsible for improving and maintaining an efficient revenue for the department
Maintain accurate and up-to-date knowledge of managed care programs, government and indigent payers
Responsible for coordinating the work related to the department's accounts receivable work files
Ensure appeals are made within filing deadline
Communicate with representatives from managed care companies, government and indigent programs to resolve and prevent denials
Work with coding staff to resolve coding related denials
Track and communicates trends in claim denials
Actively improve collections from hospital patients deemed as self-pay
Work with clinic staff to ensure accurate financial information is obtained
Provide training as needed to improve revenue cycle operations
Special project coordination and management
Proactively assists others as needed
Extensive experience working with insurance companies
Experience with GE Centricity, Enterprise Task Manager (ETM), and Cerner EMR
Demonstrated strong problem solving & decision making skills
Demonstrated ability to manage and motivate change

118

Revenue Cycle Sys Analyst Resume Examples & Samples

Assists users and IT personnel with training and development of user documentation
Evaluates, designs, builds, tests, and implements custom or vendor supplied software and develops system-wide reports to support information management needs
Maintains production systems to ensure reliable performance
Prepares complete unit, system, and integrated test plans and test methodologies
Implements and follows internal Information Technology break/fix and change management processes
Master’s degree in Business Administration, Computer Science, or Project Management with experience implementing and maintaining complex systems in a healthcare environment is desirable
Ability to communicate effectively, both verbally and in writing
Working knowledge of one or more programming languages/reporting systems, including RPG, COBOL, Java, XML, SQL, Crystal Reports, Hyperion, SAS, Cerner CCL
Knowledge of SQL databases and general knowledge of data structures

119

Supervisor of Revenue Cycle Management Resume Examples & Samples

Supervises and leads the day-to-day activities of assigned group of AR Representatives and Payment Posters
Ensures production and quality control standards are met by reviewing management reports
Assigns workload to meet production requirements by evaluating production reports
Maintains performance standards by counseling employees, performing appraisals and providing required training
Ensures departmental policies and procedures are followed. Additionally, develops and revises policies and procedures as needed
High school diploma or equivalent and five (5) years of healthcare supervisory experience such as, but not limited to clinic supervision, accounts receivables and payables or revenue cycle business operations
Two (2) plus years of experience in Payment Applications
Certified Professional Coder (CPC) a plus
Intermediate Microsoft Office
Work requires computer skills
Ability to apply arithmetic, mathematical reasoning and analyze data and/or report information
Proven success in a fast paced, changing environment
Effective oral, written and interpersonal communication skills

120

Senior Revenue Cycle Consultant Resume Examples & Samples

Work with clients to understand business and back office requirements
Define service scope (statement of work) and corresponding labor estimates to complete assignments
Demonstrates ability to estimate and manage work assignments to budget
Provide lead technical support in business development opportunities
Assist in research of new technologies and trends that might impact our clients and make appropriate recommendations
Team leadership, direction, and engagement supervision of Consultants. Assist client with compliance areas associated with back office service
Manage assigned client service engagements
Execute assigned tasks relating to the client’s back office services or as assigned by the Consulting Manager
Communicate advice and answer questions of client staff relating to client’s back office services
Provide training or assistance to client staff relating to client’s back office services
Perform emergency on-site or remote support as needed as requested by client or other consultants when urgent issues arise
Pursue advancement in technical back office service capabilities as well as advancement in “soft skill” competencies
Mentor other consultants and assist them with client management
Revenue Cycle operations experience (Hospital/SNF/Behavioral Health) (include knowledge in pre-authorization, pre-admission processes, denials management, claims adjudication, etc.)
Revenue cycle business process optimization experience (includes knowledge of edits, denials, holds, reimbursement, etc.)
Revenue Cycle Data Analysis Knowledge of key performance indicators for Revenue Cycle and national benchmarks
Deep knowledge of facility coding and billing processes
Revenue cycle information systems knowledge
Provider education experience

121

VP, Revenue Cycle Resume Examples & Samples

Provide leadership and administrative direction to Patient Financial Services, Patient Access, and supporting staff. An inherent element of this responsibility is the mentoring, development and encouragement of these individuals in alignment with the organizations Core Values
Responsible for day to day oversight of the revenue cycle services agreement and periodic reconciliation of the net benefit
Responsible for establishing open communication lines to ensure all relevant information is received from or passed to the appropriate staff members in a timely manner
Ensure employees are hired, trained and evaluated according to the standards set forth by Human Resources and sound management principles
Incorporate the values and standards of Beaumont Health System into all business staff development practices and all departmentally directed activities
Maintains direct oversight of all aspects of third party vendors as it relates to A/R operations and technology Quality / Cost
Maintain appropriate internal control safeguards over A/R records and collection of cash. Maintain compliance standards for providing accurate information on all facility of health system billings
Plan, coordinate, and prepare year-end audits with public accounting firms and third party auditors as they relate to A/R operations
Ensure compliance with relevant regulations, standards and directives from regulatory agencies and third-party payors
Responsible for overseeing and enhancing the development of data collection analysis and reporting processes for the executive management of the revenue cycle at all system facilities, including information integrity validation and interpretation
Oversee the financial interface between and performance analysis of the patient financial services functions and fiscal services functions
Bachelor's Degree in Management Accounting, Finance, Management Engineering
MBA or other appropriate advanced degree strongly preferred
Evidence of continuing additional education and coursework
Broad knowledge of revenue cycle aspects including patient scheduling, pre-registration, central registration, financial counseling, , billing, credit and collections
Broad and deep knowledge of accounts receivables management (tracking receivable levels, days of cash, cash management, days in A/R and aging)
Broad knowledge of financial forecasting, cost center salary and direct expense analysis, month end financial reporting
Understanding of a central business office function
Strong understanding and comprehension of process management
Human relations skills including one-one leadership, team leadership, and leadership within the larger organization with multiple departments and constituencies
Approximately 10 years of progressive experience is desirable with 5 years at the supervisory/management level
Experience in a major systems conversion, preferred
Experience with responsibility for large groups (at least 250+) of employees
Hands on experience in various areas of patient access, registration, billing, credit and collection, cash management
Multi hospital experience strongly preferred
High energy level, proactive and responsive
Energizes self and others
Works collaboratively with others
Enjoys leading a team and playing a role as a team member
Manages by the use of facts and measurable analysis
Ability to maintain ambiguity and confidentiality
Comfortable with large and complex organizations and various cultures and bureaucracies

122

Revenue Cycle Associate Resume Examples & Samples

Prepares and submits clean claims to insurance companies either electronically or by paper in an accurate, timely and compliant manner
Collects and verifies all documentation necessary for timely billing of patient accounts, including requesting and collecting medical records and other documents ensuring the acceptance of the claim
Works all reports related to billing, such as work-lists, hold reports, and rejection reports to ensure claims are submitted timely and accurately, per billing guidelines
Processes claims for secondary insurance carriers, attaching all required documentation to ensure claims are filed to appropriate payers
Understands all payer guidelines related to claim submission; is knowledgeable and proficient with payer websites and other useful resources pertaining to the billing function
Focuses daily on complying with policies, processes and department guidelines for billing and claim edit resolution
2-3 years experience with medical billing/collection; hospital billing experience preferred
Experience with patient accounting systems and billing/claim submission software; specific XClaim and/or Meditech experience a plus
Medical billing and coding certification a plus

123

Revenue Cycle Associate Athenahealth Professional Team Resume Examples & Samples

Various aspects of medical billing; claim creation, claim submission, payment posting for insurance and patient balances in the athenaNet system
Obtain supporting documentation (medical records, EOB's, remits, authorizations, referrals), from the multiple systems
Monitor insurance denials by running reports and contacting insurance companies to resolve and recover denied claims
Monitor aging reports for timely follow-up on unpaid claims
Retroactive review of registration data to aid in the assurance of clean claim submittal
Accurately document actions taken within patient account
Serve as resource for problem solving issues related to registration, demographic and insurance errors
Work payer correspondence including support tickets, emails, and phone message from internal and external contacts
Work collaboratively with Coding, Provider Enrollment, and Cash Posting as well as coworkers, Team Leads, Managers and practice staff to resolve claim and account issues
Adhere to HIPAA guidelines regarding confidentiality relating to the release of financial and medical information
Follow state, federal, insurance and organization guidelines
1-3 years experience with medical billing/collection; professional billing experience preferred
Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices
Experience with athenaNet patient accounting systems and billing/claim submission software
Knowledge of revenue cycle and/or business office procedures
Knowledge of third party payer guidelines and procedures
Experience with insurance claim follow-up, denial & appeal processes
Experience with eligibility, registration and authorizations
Ability to utilize basic Microsoft Office programs
Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward
Attention to detail & possess strong verbal and written communication skills

124

Revenue Cycle Project & Data Analytics Manager Resume Examples & Samples

Managing a team of analysts and associates that are focused on meeting project goals and milestones
Crafting and delivering upon ROI-based goals that meet athena’s needs and contribute to the development of your team
Establishing, monitoring and improving quality and effectiveness metrics
Continually evaluating and optimizing team structure to streamline process and ensure engagement including hiring, feedback and appraisal processes
Implementing and improving processes, policies and procedures to ensure the efficiency and effectiveness of the operational process and the product ‘s posting functionality
SQL proficiency
Understanding of the needs of our clients and how attainment of our goals will meet those needs
Focus on quality of service as our driving principle
Understanding the business need to set and attain ever more challenging goals
Understanding of, and dedication to, continuous improvement of our processes and ourselves to support athena’s mission
Eagerness to participate in change-oriented endeavors geared toward expanding our capabilities
Willingness to vary job responsibilities as required to meet the needs of our clients
Desire to learn as much as possible about our core systems
Monitoring and managing metrics, ensuring that performance is trending in accordance with monthly goals and analyzing variances to identify improvements in quality and efficiency
Supporting and automating existing operational processes, add streamlined controls and reporting to facilitate expansion of team capacity, scope and influence
Managing internal and external stakeholder relationships through clear communication, reporting, and setting clear expectations
Analyzing trends and resolve root-cause issues by working externally with vendors, payers, as well as coordinating with key leaders internally at athenahealth
Mastery of all Microsoft Office applications, including Outlook, Word, Excel and Powerpoint
Proficiency with Visio
Dedication to the corporate mission to become the most trusted and effective business service to health care providers in the world
Commitment to athenahealth’s social mission to improve the quality of healthcare for all
Commitment to athenahealth’s Corporate Compliance Code, including escalation of all compliance issues through the chain of command and to the company’s Compliance Officer and/or General Counsel
Unconditional support of athenahealth’s cultural mission to be a community of teachers, learners and winners
Belief in the primacy of the group over the individual – that “super-performers” are those who most help the performance of those around them rather than those who produce the most themselves
Creating a virtuous circle of learning and innovation through fostering his/her innate curiosity and desire to: 1) master his/her job, 2) innovate in his/her area of responsibility, whatever its scope and 3) teach other athenistas about what s/he has learned
Demonstrate unconditional positive regard for the personal worth (distinct from a particular individual’s actions) of all other athenistas, and act accordingly
Fueled by the passionate desire to make his/her role and athenahealth a terrific success, every athenahealth employee will do what it takes to get the job done, including sometimes working unpredictable, long hours to perform a diverse array of tasks
High level understanding of the three major services lines and of the organization’s responsibility for delivering on them
Understanding of the Balanced Scorecard and each department’s responsibilities under it
Excellent communication skills (particularly listening and speaking); highly articulate; makes arguments in a compelling manner, explain complex processes and data flow in a way that’s understandable by non-technical stakeholders
Maniacal attention to detail
Willing/excited to work in a fast-paced, but sometimes intense, rapidly expanding company
Strong computer literacy and/or the comfort, ability and desire to advance technically
Data driven decision making experience and/or experience with SQL
The comfort, ability and desire to advance technically
Coaches and empowers team to deliver results and gain internal and external stakeholder buy-in
Experience working in agile project
Understands project requirements, coordinates with resources and directs projects in the right direction and in a timely manner
Passion to teach
General understanding of how systems function and how system logic operates

125

Healthcare Revenue Cycle Resume Examples & Samples

Be the “face of IT support” to our Service Operations team
Act as a liaison between Operations System Admin and Optum360 E2E Support team
Obtain, interpret and analyze operation issues/problems/requirements
Be able to perform application walk-throughs from service operation perspective for Optum360 functional teams
Identify and initiate resolutions to user problems and concerns associated with application
Submit and manage requests to Partner IT when information/changes are needed
Bachelor's degree in related field Or equivalent experience
MS Office (Including Word, Excel - to include pivot tables, VLookups, Formulas etc., PowerPoint)
SQL experience (basic queries)
Willingness and ability to travel 25% of the time regionally as well as between multiple offices in the Long Island, NY area
Knowledge of Optum360 Revenue Cycle tools and solutions
Knowledge of Optum360 Revenue Cycle tools and solutions such as: Electronic Financial Records (eFR – workflow/follow-up tool similar to Artiva), Claims Administrator (CA – commercial claim scrubber tool similar to SSI), Medicare Real Time (MRT – claim scrubber tool for Medicare claims)
Able to work in a dynamic environment
Able to self-prioritize tasks
Able to work independently and as part of a large team
837 and 835 formats experience
HL7 preferable
Knowledge of Citrix or Terminal Services configurations and troubleshooting
Familiarity with system / application monitoring tools
Reporting Tools experience
Network Topologies experience
Desktop utilities experience
Excellent verbal and written communication skills are required to represent UHG in a positive fashion to our clients

126

VP, Revenue Cycle Services Resume Examples & Samples

Provides executive oversight for delivery teams engaged with members, in both inpatient and outpatient/professional environments, to drive successful outcomes and positive member results
Acts as a “senior Advisory Board voice and presence” for member senior executive team, providing executive level reports and updates
Coordinates with Revenue Cycle Partner for cohesive delivery and sales initiatives
Identifies upsell opportunities within current consulting engagements; drives opportunities to close through necessary analysis, coordination and communication
Provides direction for project teams working on engagements, including but not limited to, setting engagement strategy, assigning tasks to be completed, reviewing material and providing constructive feedback to consulting teams to drive to successful engagements
Promotes and enhances staff development at all levels through coaching and in-service education creation and delivery
Ability to function as part of the consulting team, driving progress through, but not limited to, leading discussions, white boarding sessions, storyboarding sessions and organizational interviews
Drive cohesive, thorough and accurate recommendations for member organizations through thoughtful analysis of data
Lead consultative meetings with member organizations
Ensure accurate and timely collection of at-risk fees through the management of successful completion and delivery of results for member organizations
Ensure accurate and appropriate adherence to contractual terms; communicate effectively with Revenue Cycle Consulting and Marketing leadership around instances of inappropriate scoping and/or scope creep
Positively represent Revenue Cycle Consulting, and the Advisory Board, through industry meetings and conferences
Maintains and enhances positive communication between departments within the Advisory Board
Performs other related duties incidental to the work described herein
Masters degree in health administration, or other related field is preferred
Six to ten years’ experience, at a senior level, either managing physician practices or, preferably, healthcare system physician group practices with a sizeable employed physician base
Six to ten years’ experience, leading an in-patient hospital finance division, preferably at the VP Revenue Cycle or Chief Financial Officer level; Academic Medical center experience is a plus
Proven to have successfully grown and developed an employed physician model within a health system
Experience working in a physician-led, integrated healthcare delivery organization a plus
Proven experience developing and implementing operating plans, analyzing financial and quality data; experience in developing and/or operating management service organizations is beneficial
Knowledge of various physician compensation plans, incentives and contracting arrangements
Strong knowledge of ICD9, ICD10, CPT and HCPCS
Strong knowledge of payer requirements, including Medicare and Medicaid
Strong PC and Office software skills

127

Revenue Cycle Associate / Senior Analyst Resume Examples & Samples

Interim management (as applicable)
2+ years of experience in revenue cycle management
Knowledge of the complete healthcare revenue cycle

128

Soarian Revenue Cycle Consultant Resume Examples & Samples

Articulates the impact of Cerner solutions on future state workflow, role and service line/department
Performs other responsibilities as needed
Facilitates current state, future state and gap analysis
Ability to work off-hours when required
Willingness to learn autonomously when needed
3-5 years of healthcare experience in Soarian RevCycle design and build, or workflow (ex: RevCycle, Case Management, HIM, hospital business office, healthcare administration)
Must reside near a major international airport or be willing to relocate to Malvern, PA

129

Senior Revenue Cycle Application Consultant Resume Examples & Samples

Understand and consult on Cerner Patient Accounting and overall revenue cycle workflow, including all associated roles and operational/process metrics
Provide expert domain knowledge, implementation approach, and workflow design within scope
Articulate regulatory impacts
Understand client key revenue cycle metrics
Discuss status of Open/Pending projects
Must live or be willing to relocate to the San Diego, CA area
Bachelor's degree or equivalent experience in health care related revenue cycle positions
Minimum of one year of experience with Cerner Patient Accounting
Revenue Cycle build experience
Experience with revenue cycle applications in a healthcare environment

130

MS Revenue Cycle Consultant Resume Examples & Samples

Healthcare/hospital environment experience is preferred
Project Management experience is preferred
Maintain regular communication with client, vendor, team members and team leaders regarding project issues, risks, and needs
Required to use computer for long periods of time

131

Revenue Cycle Optimization Associate Resume Examples & Samples

Knowledge of HL7 standards
Familiarity with Electronic Medical Record systems
Ability to travel 50-60%
1+ years in laboratory revenue cycle management

132

Revenue Cycle System Analyst Resume Examples & Samples

Supports and maintains existing applications and performs system analysis and troubleshooting to resolve end-user issues and technical problems
Performs root cause analysis of data and workflow issues and participates in cross-application solution design (system and/or workflow based)
Researches, configures, tests and implements new functionality and applications to support revenue cycle processes and accurate, complete and efficient data flow
Creates thorough system design and build documentation
Grows expertise in KPHealthConnect (Epic) end to end data flow and Kaiser Permanente revenue cycle processes
Collaborates with Revenue Cycle management, KP HealthConnect clinicals support team, Medical Group, Vendors, National and Regional teams, KPIT and other internal KP departments
Performs analysis of reports relating to financial data completeness and accuracy
May participate in multiple projects at once
Minimum two (2) years of relevant work experience, in areas such as (but not limited to) project management, system analysis, data analysis, health care administration, science, engineering, education, information technology, business or finance
Experience with Epic Systems software a plus
Demonstrated working knowledge of medical terminology

133

Manager, Healthcare Revenue Cycle Management Resume Examples & Samples

Bachelors degree in business related field, or equivalent work experience
8+ years experience in related field
5% travel
Manages department operations and supervises professional employees, frontline supervisors and/or business support staff
Participates in the development of policies and procedures to achieve specific goals
Decisions have a short term impact on work processes, outcomes, and customers
Interacts with subordinates, peer customers and suppliers at various management levels may interact with senior management
Interactions normally involves resolution of issues related to operations and/or projects
Gains consensus from various parties involved
Role is responsible for the shipped unbilled revenue and ensuring timely billing of healthcare claims, patient collections teams and 3rd party vendor relationships related to patient liability
Role will lead a team of about 20 people with 6 direct reports
Role works collaboratively with order entry and order processing teams to improve quality, speed of payment and collecting on aging AR for unbilled and patient responsibilities

134

Hospital Revenue Cycle Admin Assistant Resume Examples & Samples

Ability to fully support 6 – 10 leaders’ priorities to completion
Strong organizational and multi-tasking skills
Proactive problem solving
Display professionalism and flexibility in a fast paced, ever-changing environment
Ability to interact effectively with all levels of staff and management is essential
Ability to maintain strict confidentiality is required
Intermediate MS Office required (Outlook, Excel, Word, PowerPoint, Visio, SharePoint)
3 – 5 years corporate office experience

135

Revenue Cycle Optimization Resume Examples & Samples

Revenue cycle assessments for hospitals, health systems and diagnostic laboratories
Alignment of client / partner processes and Optum360 technology
Provide revenue cycle management services to client / partners in all areas of revenue cycle which includes
Minimum of 3 years of experience in acute care and/or laboratory revenue cycle management
Basic knowledge of at least one practice management system and/or EMR system. Experience with one or several of these vendors is a plus: Siemens, GEHC, Allscripts, SMS, Cerner, McKesson, Epic, Meditech or other similar HIS/LIS/EMR systems
Working knowledge of laboratory and hospital based IT systems
Ability to maintain the highest level of confidentiality
Expert in MS Word and Excel and Visio required, expert in Outlook and PowerPoint
Familiarity with payer to provider or patient to provider transaction sets (such as 270/271, 837/835, 276/277)

136

Senior Director of Revenue Cycle Operations Resume Examples & Samples

The Senior Director is responsible for achievement of client service level agreement targets including Cash, A/R, Denial, and Bad Debt targets
Development and oversight of operational plans
Collaborates with the client as appropriate to improve operational performance for RCM services
Provides leadership and input into the architecture, detail design and development of the business office organization
Oversees the deployment of company operating model (TOPs) and philosophy
Provides input on the refinement of service level agreements with customer leaders and representatives; responsible for market and area satisfaction with overall performance
Contributes to the development and implementation of strategic direction for the Revenue Cycle process for supported facilities
Performs staff reviews and prepares performance documents for direct reports
Promotes employee engagement and satisfaction
Assist Optum360 with designing Best in Class RCM Operating Model
College education or equivalent experience managing large scale operation
Experience leading large organizations (must be 8 or more sites)
At least 10+ years of revenue cycle management experience with five or more years of leadership; healthcare provider service background preferred
Must have broad experience with RCM operations, people leadership, and transition / change management
Industry knowledge is required
Must be proficient in packaging PowerPoint presentations summarizing outcomes
PC skills - skilled in Microsoft Office applications and others as required
Experience with MS4, SSI or Cerne
Ability to communicate long term goals and lead leadership team in development and implementation of performance improvement initiatives
Strong and engaging leadership qualities
Project management - administers using tools and processes to identify and communicate project goals, schedules, responsibilities, progress and performance
Experience in healthcare billing and collection or similar service environments preferred
Managed Care financial and operational experience a plus
Experience with organizational start-ups, mergers, acquisitions, operational consolidation and shared services a plus
Consulting experience in areas of business transformation, finance reengineering, shared services, change management and project management a plus
Health Plan Operations is a plus

137

Revenue Cycle Representative Resume Examples & Samples

Verify eligibility of insurance benefits, patient liability, non-covered exceptions: confirm all steps necessary have been taken to adjudicate claims and billing to maximize reimbursement
Analyze and resolve system generated and user defined work queues to ensure clean and timely claim submission and reduce claim denials
Maintain extensive working knowledge and expertise based around payor regulations/policies, financial classifications and financial assistance programs
*Please note: Five (5) professional references will be required at a later step during the hiring process
Minimum 6 months revenue cycle, health Insurance or related customer/patient focused service experience
Experience maintaining professionalism while handling difficult situations
Knowledge of healthcare billing (healthcare revenue cycle) and/or insurance, and/or federal and state assistance programs

138

Revenue Cycle Representative Resume Examples & Samples

Assist in monitoring utilization services to assure cost effective use of medical resources through processing prior authorizations
Initiate authorization requests for outpatient and inpatient services services in accordance with prior authorization requirements. Route to appropriate staff when needed
Communicate with patients and/or referring physicians on non-covered benefits or exam coverage issues
Contact patients, insurance companies, credit/collections for payment acquisition, pre-authorization and to resolve patient account inquiries
Provide financial counseling to patients and families; and/or determine if appropriate payment has been made by various entities; and/or work with patients and insurance companies to obtain correct payments; and/or appeal claim payments and/or denials

139

Revenue Cycle & Analytics Senior Consultant Resume Examples & Samples

Participate in setting engagement objectives and scope
Develop work plans for components of an engagement
Coordinate activities between work streams
Provide guidance to junior practitioners as they manage large, confidential and complex data sets
Facilitate client interviews and client meetings
Develop process flows depicting pain points in the business process
Conduct detailed analyses to draw conclusions, and develop pertinent and insightful recommendations
Design deliverable content to reflect the engagement contract
Present findings and recommendations to client leadership
Mentor junior staff
Bachelor’s degree from accredited university
Minimum of 5 years of professional experience in revenue cycle operations in a health care provider, consulting, or technology vendor environment
Demonstrates consistent career progression with increasing levels of responsibility
Performed above expectations in previous professional roles
Excellent knowledge of Big Data Analytics, Enterprise Healthcare Revenue Cycle and billing operations, patient financial processes
Deep knowledge of data analytics platform integration for electronic healthcare medical record databases such as Epic and Cerner
Working knowledge of SEO, HTML, CSS, SQL, PuTTY, Salesforce, JIRA and Clarizen
Competent in Microsoft suite of Business Software, specifically Excel and PowerPoint
Possess strong Data & Analytic skills
Willingness and ability to travel 100%
Must live within commuting distance to one of Deloitte’s consulting offices

140

Business Analyst of Revenue Cycle Resume Examples & Samples

Demonstrates the ability to effectively prioritize tasks with limited direction
Performs qualitative and quantitative data analyses, and builds presentations to communicate the results of analysis to leadership and partners
Exhibits the ability to gather business problems, identify the root causes through claim-level deep dives and data analytics, help to define potential solutions, design experiments to test potential solutions, conduct the ROI assessment, and implement the solutions if justified
Exercises good judgment within department and company defined procedures and practices to determine appropriate action
Collaborates with PRT and stakeholders, and drives the adoption of new process changes
Ensures that new processes are documented and that changes are communicated to all affected parties
Generates innovative solutions by approaching problems with curiosity and open mindedness, using existing information to its fullest potential
Assists on various projects, meets deadlines, and handles multiple priorities in a fast-paced, ever changing and evolving business environment with shifting time frames
Attends team meetings, phone conferences, and training as scheduled or needed
Provides guidance and training to other PRT Teammates
Assists in the development and maintenance of best demonstrated practices
Travel required: up to 25%
Bachelor’s degree from accredited university (or minimum of 3 years of related experience)
Certification and/or experience in process improvement and/or project management
Prior health care reimbursement / revenue cycle experience
Proficiency with MS Word, Excel, PowerPoint, and Outlook (MS Access highly desired)

141

Revenue Cycle Coordinator Resume Examples & Samples

Participates in revenue cycle/billing, denial management/follow-up, Patient Access Services, HIM, lab, authorization/referral processing, and other hospital-based work teams
Works with management, clinical and other hospital departments, and the patient accounting staff to improve processes, increase accuracy, create efficiencies, resolve related issues, and achieve the overall goals of the department
Performs XClaim and Revenue Recover training in Revenue Cycle Systems for new users and monitors departmental clean-up of worklists
Reviews and ensures departments are reconciling charges on a daily basis
In partnership with CBO, follow-up on claim status and appeals including interaction with the payors
Develops and maintains efficient working relationships
Recognizes the importance of team efforts and partners with others to achieve positive outcomes
Is responsible for ongoing development of his/her work skills through the use of available resources (i.e.: in-services, formal educational programs, other work groups and on-the-job training)
Demonstrates an understanding of relative Hospital and all-departmental policies and procedures including safety issues
Possesses awareness of programs/services provided by Hospital and where they are located
Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
Maintains a professional appearance and demeanor
Strives to prevent/resolve customer concerns to the customer's satisfaction
Preferred: Minimum 5 years supervisory experience in a healthcare setting
Strong interpersonal/public relations skills and the ability to work effectively with a wide range of customers in a diverse environment
Knowledge of CPT, HCPCS, and ICD-9-CM coding
Ability to establish priorities effectively

142

Director of Revenue Cycle Shared Services Resume Examples & Samples

Manage the day - to - day operations of the charge department
Manage the day - to - day operations of the payment department
Manage the day - to - day operations of the cash management department
Manage the day - to - day operations of the patient call center
Research new technologies that can improve the overall efficiency of each area as well as eliminate risk to the department
Develops functional, strategy, plans, and production priorities
Identifies and resolves technical, operational and organizational problems outside own team across the department
Ensure that each functional area is meeting all SLAs and client expectations
Track and eliminate all backlog for each functional area
Plan, hire, and train staff to ensure success of each area
Ensures key performance metrics for all clients are at or better than industry standards
Ensures that each functional team understands new and existing client delivery expectations and metrics
Reviews all key client processes that have been documented for the Service Delivery Team and ensures understanding across all functional areas
Working knowledge of best practices for each functional area in the Shared Services Department
Working knowledge of improving workflow and operations through the use of technology
Working knowledge of Revenue Cycle Management processes and key performance metrics
Proven track record in following standard policies and procedures with a constant focus on improving processes
Proven track record of re - engineering processes / workflows to ensure operating efficiencies are maximized
Proven track record to utilize tools and technology effectively
Strong organizational skills and an ability to meet assigned deadlines without supervision
Understanding of business reporting packages such as crystal reports and cognos
Strong presentation skills for multi - level audiences
3 - 5 years of experience in managing and leading people and teams in a Professional Revenue Cycle Management Setting
5 - 10 years of experience in revenue cycle services in charges, payments, cash management and /or patient call center
BS / BA in Business Administration or Healthcare Administration

143

Healthcare Revenue Cycle Management Consulting Senior Manager Resume Examples & Samples

Develop management plans to migrate out clients into a leading practice environment
Strong financial acumen; ability to develop budges, forecast revenue, develop early warning signs and adapt the organization to achieve financial targets
Solid financial acumen and financial analysis and diagnosis skills
Strong executive level relationship building skills
Ability to create and deliver high-impact communications to senior audiences (written and oral) and facilitate complex discussions

144

Revenue Cycle Representative Resume Examples & Samples

Contact insurance companies for credit/collections and/or investigation on payments to resolve patient accounts
Manually post payments/denials/contracted discount to patient account and research when the Explanation of Benefits (EOB) provides or does not provide all necessary information
Work to identify correct facility (UIHC, UI Dental School, etc) of account to apply payment to the unapplied clearing account in a timely manner
Research and resolve overpayments and ensure that proper documentation is forwarded to the Credit Team for final resolution
Assist with Remittance edits; research and identify each payment on the edit and determine appropriate placement in the Epic Patient Accounting System
Be expected to complete deadlines in support of week-end, month-end and year-end accounting activities
Communicate with internal departments, co-workers and Coordinator’s to resolve issues
Experience using EPIC

145

Meditech Revenue Cycle Consultant Resume Examples & Samples

MEDITECH Revenue Cycle experience is required
Candidate must have strong knowledge of Claims Builder
Classify problems as system, training, or process and recommend appropriate corrections
Assistance with other tasks as necessary
On occasion, may be required to lift and/or carry up to 25 lbs

146

Director Information Technology Revenue Cycle Management Applications Resume Examples & Samples

Develops strategic and technical business plans
Develops budgets, resource utilization plans, allocations and contingency availability plans
Manages resource utilization and expenditures. Identifies best practices and makes recommendations
Directs systems functions and technical support
Monitors, reviews and adjusts work plans to meet requirements
Secures and allocates resources
Manages staff; provides guidance, evaluates performance and recommends training
Manages vendor relationships; evaluates performance, provides feedback and resolves conflicts
Develops and administers systems area policies and procedures
Provides quality information systems customer service to user community
Acts as advisor and consultant to project sponsors and executives
Provides project status updates and resolves issues to meet project deliverables and deadlines
Produces management reports and conducts executive presentations
A minimum of 7 years of functionally related experience, including at least 4 years of progressive management experience
Strong communication, leadership, team building and project management skills required
Additional experience managing large complex enterprise projects preferred
Experience leading and aligning enterprise hospital, professional, and specialty revenue cycle billing functions and projects that ensures the health systems efficient and effective use of the Epic portfolio (e.g. billing, collections, claims, and remittance), statements, legacy, and related third-party applications
Demonstrated understanding of healthcare revenue cycle operating drivers, metrics, business concepts and industry strategies
Experienced in building collaborative models of consulting with operational leaders, revenue producing areas, and revenue cycle operations
Experience in developing successful operational service models, work production standards, and Service Level Agreements (SLA)
Relevant Epic certifications, information technology or professional certifications highly desirable

147

Strategist Revenue Cycle Resume Examples & Samples

Acts as the subject matter expert for specific healthcare revenue cycle roles, venues, markets and/or segments
Understand and articulate the current competitive landscape
Recommends development priorities, leveraging quantitative and qualitative analysis
Performs analysis of solution needs and defines scope of capabilities
Communicates existing and emerging solution functionality to Client
Ensures alignment of client goals and strategies with current IP capabilities and roadmap
Collaborates across solution groups on similar functionality to ensure common process and seamless integration
Protects innovation through the patent process
Support Cerner Implementation and Consulting processes
Obtains feedback on quality of solutions
Demonstrated excellence in written and verbal communication: including speaking at conferences as well as with C-suite executives
Bachelor's Degree (or the equivalent) with emphasis in related field; or equivalent experience
Experience in healthcare revenue cycle
Related industry certifications (CHFP, CRCR, CRCE, CRCP, PMP, etc.)
5-7 years of experience managing a revenue cycle practice in a provider organization, or related consulting or IT solution provider experience

148

Revenue Cycle System Analyst Resume Examples & Samples

Develops system design, including functional specifications, and implements strategies based upon the analysis of specific operational needs
Provides day-to-day operations support to customers as required
Coordinates efforts between stakeholders from multiple areas in order to gather requirements, develop technical specifications, and test enhancements and other changes to these systems
Identifies data integrity issues and analyzes data and process flows for process improvement opportunities
Performs data analysis in order to extract requirements, identify data inaccuracies, and ensure accurate processing and reporting
Identifies policies and requirements that drive a specific solution
Works effectively on project teams and meets deadlines in accordance to project manager's expectations
Works with stakeholders to build, test and maintain integration points with revenue cycle and clinical solutions
Provides ongoing 24x7 application support and troubleshoot problems when they arise
Work with all stakeholders to evaluate, approve and deliver requested system changes
Follows MCHS policy and procedures regarding confidentiality and privacy of all related work activity, and in compliance with IT standards and regulatory practice (i.e., HIPAA)
3+ years of Cerner Millenium experience desired
Prior experience with patient financial services, patient access, and/or health information systems preferred
Ability to manage large scale projects and software deliveries
Ability to work effectively on team projects
Strong analytical, interpersonal, customer service, communication, and problem solving skills
General knowledge of HL7 ADT Transactions
Solid skills working with PC and multiple software applications including Microsoft Word, Excel, Access and Visio

149

Senior Director of Revenue Cycle Operations Resume Examples & Samples

Experience leading large organizations (must be 5 or more sites)
Experience in healthcare billing and collection or similar service environments
Experience with organizational start-ups, mergers, acquisitions, operational consolidation and shared services

150

Epic Revenue Cycle Application Manager Resume Examples & Samples

Maintain the scope, schedule and quality of the project in the Revenue Cycle area
Work closely with the service lines and other project managers to coordinate activities and workflow
Ensure that the Revenue Cycle business community is engaged in the success of the project
Assist the application Analysts in their respective areas
Review the progress of the project on an on-going basis with the service lines and the PMO
Help review revenue cycle optimization opportunities prior to, during, and after go-lives

151

Revenue Cycle Coordinator Resume Examples & Samples

Supervise work of Pre-Authorization team and serve as a payor expert and technical resource. Develop new and current staff through training to improve revenue cycle knowledge; work with staff to suggest additional options to resolve patient account inquiries
Manage and monitor timeliness and accuracy of radiology and procedure preauthorization functions, in adherence to UI Health Care and governmental policies
Provides administrative support to licensed health professionals to gather and enter pertinent information, supporting Medical Management functions for physician peer review
Supports patient care by resolving pre-authorization issues with physicians, radiologists, radiology technologists, and ancillary staff; improving and maintaining quality assurance program for department functions
Develop and monitor employee performance goals to enure compliance. Perform QA checks and productivity audits; identify and resolve undesirable trends and reimbursement errors; prepare reports to assure quality and productivity requirements are being met
Experience in a medical setting and/or emergency room setting

152

Director of Revenue Cycle Management Resume Examples & Samples

Direct all of our efforts surrounding outstanding and aged accounts receivable, reimbursement and refund posting, lockbox correspondence and reconciliation with 3rd party vendors and collection agencies
Manage Inbound Call Center to provide world-class service within prescribed department KPI’s
Manage Outbound Call Center for all initiatives and collection targets within prescribed department KPI’s
Manage vendors utilized for billing claims to insurances outside of the United States
Act as liason between USACS and external collection agencies performing work on USACS accounts
Prepare older USACS debt for sale to external agencies
Work closely with Athena healthcare to drive occupational efficiencies to optimize net revenue while reducing expenses
Optimize and analyze all RCM reporting for each entity on a monthly basis
Ensure compliance throughout entire RCM Operation
Work closely with Director of Continuous Improvement to constantly improve the efficiency and effectiveness of the organization
Communicates with other departmental managers to ensure smooth transition of inventory between departments
Develops & maintains key performance indicators for departments and uses them to measure & improve departmental results
Monitors, analyzes, and recommends improvements to the workflow systems and procedures
Analyzes financial reports for clients, identifying trends and communicating such to USACS leaders and clients
Manages and coordinates personnel including delegating tasks and ensuring a uniform workflow
Ensures that employees are adhering to company and departmental policies & procedures
Accounts for and administers human resource matters including: recruiting, hiring, terminating, wage and salary administration, career development, corrective action counseling, performance evaluations and time records
Implements business and department strategies set forth by senior management
Participates on committees and takes ownership of Continuous Improvement efforts as needed
Gains familiarity of the day-to-day operations of the team, department, and company
Performs and assists with other duties as needed
At least 8 - 10 years of progressive management experience in healthcare revenue cycle services, especially accounts receivable, payment application and reimbursement
Demonstrated experience with all major payors within healthcare revenue cycle, including Medicare, Medicaid, Commercial, Blues, Workers Comp and Self Pay
Demonstrated experience in overseeing a 60+ employee team of revenue cycle associates
Familiarity with several revenue cycle software solutions
Operational knowledge of both Inbound and Outbound Call Centers, with some working knowledge of 1st party and 3rd party debt collection laws and practices
Familiarity with call campaign development, utilization of debt scoring and the capabilities of automated dialing equipment
BI Reporting and Information Technology experience in a high-volume processing environment a plus
Thorough knowledge and ability to gain new knowledge of business principles, practices and procedures required to effectively administer, analyze, draw conclusions and make recommendations regarding department operations
Knowledge of and skill in using personal computers in a Windows environment with an emphasis on spread- sheet applications and graphs, word processing, and basic presentation software applications
Knowledge and understanding of a broad scope of functions within the medical insurance industry
Ability to effectively manage staff to ensure productivity that accomplishes the needs of the department and, at the same time, fosters employee growth and involvement in the required day-to-day operations of the department
Ability to effectively communicate with coworkers to coordinate department operations with other departments to ensure that business requirements are satisfied
Ability to perform mathematical calculations in order to accurately analyze and complete reports and budgets
Ability to use sound judgment and problem solving skills to identify and analyze employee and departmental problems and to recommend the proper course of action
Ability to organize and prioritize job tasks and requirements
Ability to pay close attention to detail
Ability to effectively perform in a multi-task work environment
Knowledge and understanding of the performance impactors horizontally throughout departments
Ability to exhibit leadership by demonstrating a commitment to teamwork, supporting alignment with company and department goals and objectives, assisting others to develop their knowledge of the company and department, adapting to change in a positive manner that exemplifies commitment, and working proactively with minimal supervision

153

VP of Revenue Cycle Management Resume Examples & Samples

Organize, design and develop the appropriate organization structure for the
Extensive knowledge in HIPAA privacy and security regulations
Thorough knowledge of Medicare, Medicaid, Commercial and 3rd Party Payor billing practices
Strategic decision making on best collection practices
Strong managerial acumen in setting corporate directions and aligning strategic goals around business plans
Familiarity with medical contracts and contract review
Strong background in financial management and knowledgeable of federal and state laws and requirements relating to healthcare management
Skilled at managing multiple projects and grasping new concepts
Knowledge of healthcare industry and medical terminology
Excellent internal and external customer service skills
Effective communicator at all levels in the organization, with strong oral, written and persuasive skills
Advanced proficiency in Microsoft Office with Excel skills
Bachelor’s degree in health care administration, business or other related field, OR equivalent required
Extensive experience working in a multi-location healthcare environment
Minimum of 10 years experience in health care management such as but not limited to clinic management, patient management, accounts receivables and payables, and marketing and public relations
Strong managerial competencies in the areas of leadership and Team development, managerial coaching and mentoring and situational assessment skills and with proven track record in building and developing high performing Teams
A change agent capable of guiding the Team in initiating / implementing management initiatives with the view of leading and guiding the organization towards the future
Strong ethics and a high level of personal and professional integrity

154

Director of Revenue Cycle Resume Examples & Samples

Oversee revenue cycle operations of an assigned geography to ensure the successful management of receivables and effective and efficient function of the revenue cycle
Provide strategic leadership of short- and long-term goals through the use of thoughtful techniques in the communication of the company’s mission and core values as a means to implement positive change and/or create organizational structure within the assigned business unit(s)
Direct and control the broad activities of the business unit(s) through the interpretation, application and implementation of company-wide policies and processes appropriate to the functional area(s)
Ensure that budgets and schedules are within company requirements with significant organizational responsibility for the overall control of planning, staffing, budgeting, expense priority management, and recommendation and implementation changes of current methods
Maintain current knowledge of all applicable laws and regulations; ensuring operations of the assigned functional area(s) maintain necessary compliance
Review current policies and procedures within the assigned functional area(s); providing recommendations for improvement as necessary
Provide appropriate training for the team(s) to ensure the maximum efficacy and efficiency of operations within the assigned functional area(s)
Assist with various projects as assigned

155

Auditor, Revenue Cycle Audit Resume Examples & Samples

Assist the Revenue Cycle Health Service Division and other UPMC areas in responding to billing inquiries/complaints which require a coding, charge description master or billing compliance understanding
Assume ownership responsibility for non-clinical billing holds assigned to Audit Team, ensuring that all claim holds are worked accurately and timely. Identify trends and opportunities for improvement for non-clinical claim holds
Complete Insufficient Documentation and CHP PFG Diagnosis Verification Request Queue(s)
Ensure timely resolution regarding completed Diagnosis Verification Requests as outlined in the Revenue Cycle policies and procedures. Identify trends and opportunities for improvement in the diagnosis code review process
Identifies potential or actual risk areas related to billing in response to audit findings regarding internal and external audits. Assists with corrective action plans and communicates pertinent findings to appropriate UPMC areas
Lead Revenue Cycle Audit Team Coding Reviews focusing on modifier, CPT and diagnosis coding issues captured on the Clinical Billng Log. As applicable, work with HIM and Hospital Departments to resolve
Lead and/or support Revenue Cycle self-audits to ensure compliance of all revenue cycle protocols, which may include auditing the following: acounts receivable, registration, referrals, scheduling, cash collections, denials and productivity
Lead investigation efforts associated with cases received via the HIPAA reporting tool and/or assigned from management, maintaining documentation of each case file, determining if breach notification is required and initiating any required notices
Maintain Non Audit Plus Service Account. Enter Non Centralized Audits into the department databases. Review and distribute Centralized Audits when necessary. Verify Third Party Audit Payer Responsibility has been met per Third Party Chart Audit Process. Complete necessary documentation, post collection status code, prepare audit bill, UPMC Confidentiality Agreement and UPMC Insurance Audit Settlement Review Sheets
Maintain Third Party Auditor Calendar and Contact List making sure all information is current including Medical Record view access
Maintain the Identity Theft Log. Review inquiries, identify root cause i.e., charge posting error, registration error, EMPI error. Work with departments to correct accounts and charges. Complete OCPC Investigation Form when necessary for management review. Provide trending of Identify Theft volumes and outcomes by location
Provide training and support to coworkers on appropriate tools and techniques related to Audits, Billing Holds, Identity Thefts, DVR's and External Back-End Billing Office HIPAA related issues
Support and contribute to UPMC core values and guiding principles and abide by all UPMC departmental policies, procedures and goals in the process of performing all job responsibilities. Incorporates acts of dignity and respect in daily interactions
High School or equivalent and four years of healthcare revenue cycle experience including two years previous billing audit experience, or six years of related experience required
Analytical problem solving skills and the ability to coordinate the work of others and communicate effectively with all levels of management required
Knowledge of medical terminology, ICD-10 and CPT coding
Knowledge of HMO, POS, PPO, Medicare, SNP, CHP and Medicaid plans
Detail oriented with excellent organizational, interpersonal and communication skills
Must be able to establish priorities, effectively problem solve, and communicate in a positive professional manner at all times
Knowledge of MS Office products
Ability to maintain designated quality and production standards

156

Supervisor, Revenue Cycle Operations Resume Examples & Samples

Can supervise the operations and processes of any given function within the Revenue Operations department (insurance collection team, cash posters, inbound/outbound collection, credit/returns) to maximize productivity, effectiveness, and quality
Provide operational support for department; address and resolve escalated questions and issues
Segregation of duties
Safeguarding of data
Regulatory compliance (HIPAA, EMTALA, PHI, Stark, Sarbanes‐Oxley)
Governmental reporting ( e.g., cost reporting, IRS reporting, Medicare/Medicaid,CHAMPUS)
Ratio analysis (e.g. days in accounts receivable, days in accounts payable
Manage all teammate employment activity such as hiring, promoting, job performance, evaluations, and disciplinary actions with appropriate approvals as required
O Address teammate relations issues appropriately and escalate as necessary
Associate's degree in related area strongly preferred; Bachelor's degree in Business, Accounting, or other related area preferred

157

Revenue Cycle Mgmt-internship Resume Examples & Samples

Conduct research related to ESI and its clients
Collaborate with other functional areas on various projects as needed
Knowledge of the PBM or healthcare industry preferred
Dates of Internship are May 15th-Aug 4th, 2017

158

MGR Revenue Cycle Resume Examples & Samples

Develops and leads the business strategy and processes for billing and collections
Develops and leads customer communication strategy and policy for billing and collections
Establishes and maintains policies and procedures to ensure compliance with the order to collections cycle
Develops key performance indicators (KPIs) to monitor performance and assess revenue leakage; ensures research, analysis and reporting to facilitate revenue capture
Facilitates business process reviews to improve quality, efficiency and effectiveness of revenue cycle operations; tests, implements and evaluates enhancements
Analyzes invoicing and statement costs and develops cost reduction initiatives
Manages the collection functions and performance as executed by internal resources and/or external vendors
Manages billing and collections operations and accounting teams
Partners with sales tax department and business in the management of sales tax process, including process improvement
Partners with customer relationship teams to ensure the billing and payment customer communications meet/exceed customer expectations
Completes other projects/tasks as assigned by manager
Master’s degree strongly preferred
5-7 years of billing, collections, accounting, or related experience required
Supervisory and project management experience required
Data mining experience with business intelligence or database applications (e.g., Access, Cognos) required
Certified Public Accountant (CPA), or actuarial professional designation preferred
Knowledge of internal audit and accounting principles and practices
Critical thinking, problem solving and decision making skills
Qualitative and quantitative analytical skills
Good computer skills with Microsoft Office Applications (Word, Excel, Outlook, PowerPoint)
Knowledge of database applications, management and querying tools (e.g., Access, Cognos, JD Edwards)
Project management and process improvement knowledge and skills
Supervisory and performance management knowledge and skills
Excellent verbal and written communication skills, including public speaking and presentation
Ability to effectively present information and respond to questions
Knowledge of database management, project management, call center operation, accounts receivable and customer service management
Ability to collect data, establish facts, and draw valid conclusions
Ability to read and interpret general business procedures
Ability to deliver and create high level reporting and analyze data for management
Close visual acuity to perform detail oriented activities at distances close to the eyes, as well as visual acuity to perform activities at or within arm’s reach with skill, control, and accuracy, such as preparing and analyzing data, viewing computer screen and expansive reading

159

Mgr Revenue Cycle IV / FC Resume Examples & Samples

Manages front-end registration and insurance verification operations
Bachelor’s Degree in Finance or Accounting, required
Minimum of five (5) years experience in healthcare finance administration, two of which are in an admitting or business office function, including one (1) year supervisory experience
Advanced knowledge of related hardware/software and hospital registration/ billing systems, required
Strong interpersonal and communication skills

160

VP, Revenue Cycle Resume Examples & Samples

Includes being visible, communicating, holding other executives and groups accountable and celebrating successes. Develop a strong vision for the future of healthcare revenue cycle infrastructure and processes while driving consensus among stakeholders
Deliver on established imperatives, communicating issues in a timely way, brainstorming and creatively identifying alternative methods
Proficient with all healthcare payer models including private pay, government and contracted programs. Direct knowledge of all processes related to registration, admissions, coding, billing and collections. Has led groups whose efforts resulted in increases of clean claim rates, accelerated cash collections and reductions in cost-to-collection ratios
Analyze and report on large data sets. Understand the contractual structure and terms of the partnership. Interfaces and collaborates with Cerner finance and HR regarding deal mix, budgets and penalties
Understands information technology architecture, usability, processing and reporting capabilities. Deep expertise of government program guidelines, HCPCS, ICD, CPT, Revenue Codes, DRG, payment methodologies, managed care operations for both hospital and physicians billing
Demonstrated ability to compile and analyze data, strong decision making capabilities that support the organizations objectives
Demonstrated ability to work on multiple initiatives at a time performing cost/benefit analysis, evaluating solutions, and driving consensus among stakeholders
Knowledge of patient accounting information systems applications, customer call center applications, data interfaces and system integration required to effectively support day to day billing and collection processes
Operationally demonstrating success leading large, complex revenue cycle organizations, including oversight of CDI and case management
Lead large organizations during periods of significant, positive change championing continuous improvement
When necessary be involved in managing and improving fundamental operations and processes
Motivating and influencing disparate teams to embrace new practices that enhance operations
Confidently interacting, collaborating and presenting at all levels of a health care delivery organization to corporate officers
Develop and implement revenue cycle policies and procedures
Implement continuous process improvements utilizing quality assessment and education of staff to monitor the accuracy, efficiency and productivity of revenue cycle staff
Partner with the Adventist Health compliance office to ensure adherence of all Medicare/Medicaid and governmental rules and regulations
Responsible for overseeing the appeal process of all third-party denials for hospital services to include, but not limited to medical necessity and administrative denials for purpose of obtaining payment and eliminating denials
Maintain and update all managed care contracts in Contract Management system and oversees maintenance of all contract files
Responsible and oversees all coding, documentation, health information management and release of information, and clinical documentation specialist activities and operations
Must currently reside or be willing to relocate to the greater Sacramento, California area
Bachelor’s degree or equivalent industry experience
10+ years of experience in Revenue Cycle/Financial Management in an executive level role (i.e. VP, CFO etc.) for a healthcare system or organization
Prior health care operations executive, consulting, project management, and/or installed client relationship experience
Experience in Revenue Cycle health care information technology (HCIT)
Certification in related field (ex: CRCR – Certified Revenue Cycle Representative)
Cerner Revenue Cycle Solution experience

161

Fvc-revenue Cycle Supervisor Resume Examples & Samples

Oversee diverse revenue cycle activities to maximize the efficacy and efficiency of operations within the assigned function(s)
Serve as an SME to cross-divisional teams in the resolution of diverse issues; ensuring applicable knowledge and comprehension of processes within the assigned function(s)
Provide direct supervision of the assigned team(s) through ongoing leadership and guidance; partnering with Human Resources on employee matters
May support new site implementation, enrollment and evaluation of various systems as assigned
Assist with various projects as assigned by a direct supervisor
Strong computer skills with demonstrated proficiency in word processing, spreadsheet and email applications

162

Revenue Cycle Consultant Resume Examples & Samples

Demonstrated ability to work within a team environment
Demonstrated ability to work with diverse groups and difficult clients
Good communication skills; written and verbal
Ability to work irregular hours and weekends when needed
Ability to work on multiple projects simultaneously
Must live in or be willing to relocate to Springfield, MO area
Associate's Degree or equivalent work experience
Background in healthcare revenue cycle or revenue cycle information systems
Experience with database tools, application development, and health information standards preferred
Soarian Financials experience; including Provider Accounting and CRDT
Cerner Millennium experience; including Cerner Practice Management/Revenue Cycle

163

Revenue Cycle Data Analyst Resume Examples & Samples

Conducts analysis of revenue cycle data trends to determine issues and root causes
Coordinates with Billing and Follow-up Managers to develop action plans to address identified issues
Prepares reports to reflect trends in revenue cycle data and prepares presentation for managers and executive level reviews
Performs in depth analysis on accounts appearing on our issues log to determine cause of variance. Maintains a tracking process for payor issues as well as assists with the resolutions
Assist with tracking the success of appeals
Responsible to review, validate and update our payor issues logs prior to our next meeting with a specific payor
Assists in the development of productivity standards and tracking to provide management with real time information on the job performance of staff

164

Revenue Cycle Integrity Coordinator Resume Examples & Samples

Interview users, stakeholders, and sponsors to assess departmental needs to create Business, functional and technical requirements documents
Develop documentation of test plans, technical documentation, release notes, end-user guides, training programs and/or other materials as necessary
Analyze and document client's business requirements and processes; communicate requirements to technical personnel by constructing basic conceptual data and process models, including process

165

AVP, Revenue Cycle Operations Resume Examples & Samples

Monitoring and tracking accounts receivable performance, daily, weekly and monthly in the areas of cash collections, aging trends, monthly bad debt write-off, contractual and other adjustment's, departmental productivity and customer satisfaction
Measurement of key performance indicators and metrics which parallel industry standards and achieving improvement in high impact areas such as cash flow, net revenue and reduction of bad debt expense
Monitors and ensures that vendor performance stays within the boundaries of the statement of work, performance does not deteriorate and quality measurements within acceptable levels
Assists with establishing goals and objectives that support strategic plans of Ardent Health Services
Monitors the annual department operating and capital budgets
Manages Daily operations of assigned departments
Manages performance of staff
Supports the mission statement, policies and procedures of Ardent Health Services
Achieves ongoing compliance with all regulatory agencies
Communicates effectively with all levels in the organization as well as external customers
Selects personnel for hire and promotion at the managerial level as well as teaching and managing up or out staff unable to achieve desired outcomes
Responds proactively to employee needs and concerns
Facilitates consensus among divergent groups
Minimizes staff turnover
Recognizes and rewards employee's accomplishments
Assists in development of competency plans and provides opportunities for learning
Provides continuous feedback on Business Office performance and related corrections to processes, people and technology
Keeps current with emerging industry issues and provides timely guidance to management staff
Utilizes resources efficiently and effectively
Participates in performance improvement activities

166

Revenue Cycle Consultant Resume Examples & Samples

Responsible for the preparation of recurring standard and special ad hoc reports to summarize Revenue Cycle results and facilitate data analysis of Radiology Revenue Cycle functions, including Scheduling, Precertification, Preregistration, Patient Registration, Billing Functions and payor denials, as well as departmental and staff productivity metrics for each area
Responsible for the daily/weekly/monthly charge reconciliation between systems
Develops and maintains excellent working relationships with members of the Department of Radiology and Penn Medicine Administration. Handles the coordination of revenue cycle projects and activities at the direction or by request of Revenue Cycle Director
Assists in the development of training programs to increase knowledge of relationship between scheduling, reception, charge behavior, billing flow, and reimbursement
Provides technical and analytical guidance and expertise. Recommends through analysis solutions of revenue cycle problems
Follow-up with Revenue Cycle teams to ensure adherence to policies and their affect on metrics
Work closely with Penn Financial Analysts to develop and maintain meaningful report sets and collaborate together to strategize and implement best practices within the department
Assist and troubleshoot issues identified when related to revenue cycle. Analyzes and reports variances for a variety of Revenue Cycle functions
Must stay current with industry standards, rules and regulations affecting reimbursement and revenue cycle
Monitor front end/back end performance against established industries standards, monitor benchmark compliance for all revenue cycle functions
Query writing using SQL and Access. Expert knowledge of excel data functionality
Report development in SQL Server, Business Objects, Clarity, Access
Bachelor’s degree in Healthcare, Finance, Engineering, Computer Science or related field required
5years of relevant work experience required in reporting/database structure and revenue cycle
Knowledge of electronic systems for front end and back end functions and the willingness to learn new systems, applications and programs
Experience in data extractions (DBMS & Data Warehouse Tools) and analysis role
Experience working on SQL Server/Oracle or other relational database platform required
Expert knowledge of excel data functionality, with excellent analytical and problem solving skills
Proficiency in health insurance billing, collections and eligibility as it pertains to commercial, managed care, government and self pay reimbursement concepts and overall operational impact
Ability to work independently and follow through and handle multiple tasks/special projects simultaneously
Ability to communicate effectively in both oral and written form. This position requires the ability to interact positively and constructively with employees and leadership at all levels
Must be a motivated individual with a positive and exceptional work ethic
Ability to educate and train at all levels of professional staff

167

Supervisor Revenue Cycle Management Resume Examples & Samples

Acts as liaison with Patient Access Services, Medical Records, Care Coordination / Utilization Management, Patient Financial Services, Financial Counselors, Information Systems and Third Party Collection Agencies regarding issues affecting the proper and timely billing and payment of accounts
Proactively reviews payer aging reports and establishes achievable goals for AR reduction and/or cash acceleration. Notifies Senior Leadership of potential systemic issues and high risk / high exposure situations. Recommends solutions for resolving aging receivables
Recommends changes to departmental procedures, i.e., job aides, training resources, and work flow, to promote process improvement
Strong customer service expertise

168

Revenue Cycle Representative Resume Examples & Samples

Previous experience in customer service
Experience and proficiency with computer software applications (i.e. Microsoft Office Suite – Word, Excel, Outlook, PowerPoint) or comparable programs
Self-motivated with initiative to seek out additional responsibilities and tasks along with generating suggestions for improving workflow
Effective verbal and written communication skills, active listening skills and the ability to maintain professionalism while handling difficult situations
Demonstrate effective problem solving abilities and meets challenges with resourcefulness
Experience working in a complex hospital system is desirable
Experience working in a collaborative team environment is desirable
Pharmacy experience is desirable
Knowledge of healthcare billing, experience working with insurance and/or federal and state assistance programs is desirable
Experience working with multiple technology platforms (i.e. Epic, GE) is desirable
Knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA) is desirable

169

Director, Middle Revenue Cycle Resume Examples & Samples

Directs Health Information Management Operations, Hospital Billing Coding, Professional Billing Coding, Clinical Documentation Improvement Program, and Documentation Integrity
Leads and is accountable for organization projects affecting areas of responsibility
Provides direction for Release of Information, Transcription, and other external service agreements
Provides direction for Revenue Integrity (charge master, fee schedules, charge reconciliation and training, pricing)
Develops and implements, policies and procedures that guide or support service, assesses and improves department performance, and ensures orientation and continuing education of department staff
Develops specific objectives, budgets, and performance standards for each area of responsibility
Actively seeks ways to control costs without compromising patient safety, quality of care of services delivered
Actively participate in advising HCMC leadership on methods to optimize HCMC’s use of Epic
Responsible for compliance with all applicable regulations including Hospital Attorney General Agreement, State of Minnesota Department of Revenue-Revenue Recapture, and HCMC Admissions and Treatment Policy
Improve Revenue Cycle performance, efficiencies, transparency, and employee engagement through Lean Management methods including Visual Management Systems and incorporate metrics driven outcomes through revenue cycle
Work with Public Relations, Patient Experience, and other HCMC departments to maintain and enhance community and patient communication related to HCMC charity care, billing and collection procedures, and methods for patients to access revenue cycle resources
Collaborate with the Assistant Medical Director of Documentation Quality and Associate Medical Director of Clinical Documentation Improvement to improve and optimize the organization’s documentation quality standards and practices
Bachelor s degree in Health Information Administration/Medical Record Administration
7-10 years of progressive management experience in a healthcare operations environment
5-7 years experience managing Health Information Management and Coding
Certification as a Registered Health Information Administrator (RHIA)
Extensive and demonstrated expertise in CPT-4, HCPCS, and ICD-10-CM coding
Thorough knowledge of medical terminology, anatomy and physiology and ability to interpret physician’s medical documentation
Working knowledge of HIPAA regulations, Joint Commission standards, and clinical information systems
In-depth understanding of third party reimbursement and coverage policies
Proven, successful, progressively responsible leadership, management and execution experience
Ability to develop and implement process improvements, preferably using Lean or Six Sigma methodologies
Exceptional strategic planning, problem solving and critical thinking when addressing organizational issues
Excellent interpersonal skills and the ability to communicate and negotiate with people at all levels
Epic Revenue Cycle Management Systems experience

170

Business Applications Analyst, Revenue Cycle Resume Examples & Samples

Design, build, validation, implementation, and maintenance of Revenue Cycle application software using Cerner build tools
Provides ongoing analysis, training and functional support for Revenue Cycle applications
Creates and maintains detailed test plans and scripts. Participates in testing efforts and ensure issues are identified, tracked, reported and resolved in a timely manner
Understands report qualifications and provides guidance with report development
Identifies and implements system solutions that support improved workflows, reduces manual intervention, eliminates rework and increases efficiencies related to Revenue Cycle
Manages incidents and requests that have been assigned through the IT Service Management System which includes the change management process
Develops and maintains clear, understandable documentation to describe design decisions, build requirements and troubleshooting steps
Updates system and support documentation as necessary to reflect changes to application design and functionality
Minimum 5 years healthcare experience as an Analyst, or in an equivalent role, required
Experience in one or more of the following revenue cycle functions required: Patient Accounting, Patient Access, Charge Capture or Patient Financial Services
Prior experience configuring revenue cycle vendor-supplied software required
Experience with CDM structure for professional and technical charges and methodology that supports charge capture within Cerner applications required
Experience with Cerner Millennium Fundamentals preferred
Experience with Cerner Millennium: Building & Maintaining Patient Accounting preferred
Experience with Cerner Millennium: Building & Maintaining Charge Services preferred
Bachelor’s degree, or equivalent professional experience, required
Knowledge of Patient Accounting integration with Lawson, 3M, MedeAnalytics and MedAssets
Demonstrated knowledge of automated Revenue Cycle functions in a multi-facility healthcare delivery system that includes Hospitals and Ambulatory Surgery Centers
Knowledge of Electronic Data Interchange (EDI) formats
Proven abilities in workflow improvement, issue resolution and root cause analysis
Effective communication skills when developing project specifications, identifying issues and communicating resolution
Ability to translate technical requirements and procedures into well-implemented application solutions
Hands on experience gathering and documenting user requirements, performing design/build, writing/executing test scripts and performing ongoing maintenance and support
Proficient in the use of Microsoft Office Suite and Cerner application build tools

171

Revenue Cycle Coordinator Resume Examples & Samples

Analytical skills; Problem solving skills; Action oriented
Experience with A/R process flow
Knowledge of CPT4 and HCPCS coding
Ability to research and collect data
Knowledge of the Charge Master Process
Knowledge of Government compliance regulations

172

Revenue Cycle Representative Resume Examples & Samples

This job requires proficiency with the computer systems that are used in the practice including Practice Management System, Internet products that relate to office functions and Microsoft office systems available to the office
Knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Thorough knowledge of Medicare Fraud and Abuse regulations
Ability to counsel patients financially regarding outstanding charges and effectively resolve problems via the highest customer service skills and etiquette
Possess full knowledge of HIPAA regulations

173

Revenue Cycle Consultant, Project Manager Resume Examples & Samples

Management, delivery, and completion of projects across various functional areas
Provides subject matter expertise in areas including project scope definition, risk identification, project methodology, resource allocation, facilitation, budget management, and other areas of expertise based on established project management techniques
Establishes timelines based on project scope of services
Ensures projects are completed on time and in scope
Monitors and tracks project status using established tools and techniques such as MS Project or other established tools
Responsible for project financial performance including creating/establishes project budgets based on statement of work (SOW) requirements, updates project tasks to trigger billing and invoices, approves invoices generated from ERP, reconciles budgets to ensure on track based on SOW
Maintains ongoing communication with client with routine status reports, team calls, etc
Makes presentations to management on project updates, project cycle, and expected results
Provides explanations and interpretations within area of expertise
Provides consulting services to clients in areas of the healthcare revenue cycle, i.e., patient access, patient financial services, revenue integrity, decision support and analytics, health information management, clinical documentation improvement, managed care contracting, among others
Development of recommendations and action plans for client improvement
Learn and understand Optum technology and services and how they will improve client operations
Accountable for all decisions, actions, and directives with respect to job responsibilities
Escalates potential risks and issues identified as appropriate
Other duties as assigned by leadership
Proficient or above in Microsoft Excel, Word, PowerPoint, Visio, Project as well as SharePoint
Experience managing at least 3-5 projects concurrently
Strong analytical Skills
Process Improvement focused
Professional services/consulting or healthcare background
Has revenue cycle experience in core area(s) including: Patient Access, Revenue Integrity, Patient Financial Services, Billing, Vendor Management, etc
Has project management / coordination experience in a healthcare setting

174

Administrator, Revenue Cycle Resume Examples & Samples

Collaborates with Physicians, various practice department management, and US Oncology management to identify areas of exposure and design processes to increase knowledge and improve outcomes in service, quality and accuracy including patient accounting, revenue compliance, health information, and centralized scheduling. Demonstrates ability to effectively facilitate parties toward a "win win" agreement; identifies key players; defines objectives, significant issues, and shared interests; determines motivational drivers and potential obstacles for all parties; communicates effectively; gains results without either party losing face
Assess revenue cycle performance in accordance with set goals and objectives. Identifies gaps. Creates and implements action plans to close gaps and achieve business metrics. Provides focus and direction to process improvement in revenue cycle management. Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty
Establishes standards and processes to ensure continuous improvement in the revenue cycle. Identifies revenue cycle external benchmarks and best practices
Monitors effectiveness of software, vendors, payers. Provides feedback and recommendations to Managed Care Contracting
Manages Practice-wide projects including any legal requests. Responsible for building affective working relationships with US Oncology counter parts to facilitate problem resolution
Establishes vision and identities goals and priorities for management staff. Identifies and eliminates obstacles as well as identifies and obtains resources to accomplish business goals. Develops and implements high standards for long and short term goals that align with the company*s vision and business goals. Cascades goals down to staffs annual objectives
Attracts high caliber people, accurately assesses strengths and development needs of employees; gives timely, specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Responsible for interviewing, recommending hires, assessing performance, recommending salary changes, and progressive discipline. Enforces adherence to the Practice*s and US Oncology*s policies

175

Revenue Cycle Project Manager Resume Examples & Samples

3-5 years experience is preferred
Comfort with reviewing financial information
Excellent interpersonal/communications skills
Exceptional organizational skills and the flexibility to handle multiple tasks and deadline pressures
At least 3+ years of project management experience within revenue cycle
Certification(s) in project management a plus

176

Financial Analyst Revenue Cycle Management Resume Examples & Samples

Generate financial and statistical reporting by obtaining data from disparate sources ensuring the applicability and accuracy of the information
Evaluate payer reimbursement trends and system modifications to drive increased cash collections and reduce denials and bad debt
Develop analytical tools to evaluate revenue cycle performance and financial results
Conducts reviews and variance analysis
Assist management team in evaluating strategic plan metrics
Assist management team by assembling and presenting any requested information necessary for the preparation of reporting packages and presentations
Preparation of schedules and financial reports for internal and external audits
Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems
Healthcare revenue cycle (provider side) experience and knowledge preferred
2 – 4 years analytics experience in a multi-company, multi-location environment helpful
Data manipulation, forecasting, financial reporting, account analysis and account reconciliation experience required
Tableau or dashboarding experience is preferred
Extensive knowledge of Excel
Comfortability with SQL, MS Access or any type of data retrieval tools is preferred
Must have effective oral, written and interpersonal communication skills. Must be a self-starter and have the ability to develop analysis of accounts and financial statements with limited supervision
Demonstrated Experience in analytical problem solving (including statement of problem, identification and collection of pertinent data, analysis, recommendation, and re-evaluation) strongly preferred
Must be available for limited travel as needed

177

Meditech Revenue Cycle Lead Consultant Resume Examples & Samples

MEDITECH Patient Accounting/Revenue Cycle 6.1 experience is required
Must have MEDITECH 6.1 implementaiton experience
Candidate must have strong knowledge of MEDITECH 6.1 Patient Accounting/Revenue Cycle, including build and implementation experience, experience working as a Lead is preferred
Candidate must have prior 6.1 experience implementing in a hospital environment, a multi-facility environment is preferred
Required to sit for long periods of time

178

Revenue Cycle Project Manager Resume Examples & Samples

Candidate must have very strong Revenue Cycle Project Manager experience
The client is implementing several modules of Relay Health to work in coordination with their Soarian Financials product. We are in need of a Project Manager who can oversee the IS technical team tasks for the build and integration with Soarian, the user build effort and work side-by-side with the Relay Health vendor Project Manager
Candidate needs to be able to coordinate internal staff, resources and tasks
General Project Management skills required
Candidates may live anywhere in the contiguous US and travel 75-100%, as needed by project
Maintains at least 85% billable utilization rate

179

Technology Sales, Revenue Cycle Resume Examples & Samples

Prospect and build new business within an assigned territory; acquire new clients successfully and negotiate to expand memberships for existing clients
Serve as a subject matter expert across the Revenue Cycle practice area, with deep expertise in multiple products including Payment Integrity Compass, Revenue Optimization Compass, Business Office Suite, and Price Transparency Compass
Responsible for knowledge of the Revenue Cycle practice area (both technology and consulting)
Collaborate with a Practice Partner who oversees the Revenue Cycle practice area and helps clear the path for you to drive Technology and packaged Consulting sales within your territory
Build relationships by meeting with senior executives (CEO, CFO, CMO, etc.) to discuss their strategic and operational challenges, present best practice solutions and effectively sell the vision of their capabilities
Actively contribute to and drive forward product offering roadmap, helping to perfect and refine current offerings and test new offerings in the market
Conduct onsite presentations, including a technical demonstration, to educate prospective members on our services
Meet quarterly and annual revenue goals through management of a sales pipeline with pursuits in various stages of the evaluation process
Maintain up-to-date knowledge of competitors
Provide insights from marketing visits to inform future research initiatives and new product development inquiries
Manage team member to goals, provide formal feedback, and guidance on professional development
Must possess a minimum of four years post-undergrad experience in at least two of the following
Relevant healthcare industry experience
Technology experience (SAAS)
Must possess a minimum of three years of commercial experience – track record of successful sales/ownership over a personal revenue target
Strong presentation and facilitation skills; the ability to manage executive meetings and member interactions to desired outcomes
Proven negotiation and persuasion skills
Desire to succeed in a sales environment and sell prospects on the current and future proposition of a product
Experience selling SAAS products, preferably in the health care industry
Resilience and comfort with ambiguity – ability to be flexible and adaptable in a changing environment
Ability to manage a Sales Associate to goal, coach and provide constructive formal and informal feedback
Receptive to feedback, coaching and constructive criticism; ability to learn from mistakes

180

Senior Consultant, Revenue Cycle Solutions Resume Examples & Samples

Monitor engagement progress; answer questions and devise solutions to client problems
Participate in new product and service conceptualization and planning
Identify cross sell opportunities and support sales process
Bachelor’s Degree
Experience working in the health care industry
Electronic Medical Records experience (i.e. Athena, Epic, Cerner)
Possess 4+ years of professional experience and at least two of the following
Consulting experience
Experience presenting to senior executive level audience or facilitating training sessions
Experience working at The Advisory Board Company highly preferred
Background in health care consulting with specific expertise in one or more of the following areas of hospital operations: revenue cycle management, supply chain, clinical utilization, throughput and efficiency, cost
Knowledge and previous experience in health care revenue cycle
Experience performing root cause analysis
Team-oriented but also highly self -sufficient and self-motivated

181

Cerner Revenue Cycle Consultant With Expertise Resume Examples & Samples

3+ years, current, in Cerner Revenue Cycle
The ideal professional is well versed in the detailed aspects of design and build of Cerner Patient Accounting
Experienced in implemented and/or maintaining a Cerner Patient Accounting system
Ideal professional will have an analytical background in Patient Accounting and not a Biller/Coder with Patient Accounting
Must be experiences in the Revenue Cycle workflow to improve financials
Ability to travel up to 100% as required by client engagement and the ability to work remotely when not onsite with client
Must have strong written and verbal communication skills to a technical and non-technical audience

182

Revenue Cycle, Executive Consultant Resume Examples & Samples

Executive Consultation and Leadershp: Acts as an advisor or thought partner by structuring undefined issues for resolution, researching issues, summarizing information and working with relevant stakeholders to provide the executive with the information needed to make sound decisions
Provides leadership, consultation and analysis regarding state-wide, cross-entity or cross-functional performance and strategic opportunities
Identifies and recommends approaches to issues and identifies the most effective means of solving the issues
Facilitates committees and task forces of diverse membership
Ensures the delivery of high quality results on time
Acts as a communication liaison between the office and direct reports by providing advice and speaking for the executive
Routinely represents the executive's point of view and proactively makes decisions on behalf (within established parameters)
Assists and advises direct reports to ensure their recommendations and reports to senior executives are coordinated across the organization and thoroughly crafted
Partners with a variety of individuals from other entities, other regions, national program, and labor on behalf of the executive on projects or on issues that require resolution
Prepares formal presentations for the executive as well as papers and public statements
Develops, leads and monitors the office budget
Develops and leads forums for executive consultants to coordinate efforts and cross-entity or department silos to help this set of individuals to continuously improve and build their skills and effectiveness in support of their executives and the organization
Functional Area Management
Drives internal planning processes associated with the development of a functional area goals and priorities
Directs the development and execution of the functional area's operating and capital budgeting process, as well as ensures the development of accurate monthly forecasts
Supports the planning, management and execution of key business processes associated with management of the applicable functional area, including but not limited to performance management, strategic planning, communications, and tactical initiatives. Applies process improvement methods and tools to improve and/or redesign organizational business processes
Leads and/or participates on high priority projects for the executive
Minimum ten (10) years of experience in consulting, operations or project management

183

Revenue Cycle Collections Director Resume Examples & Samples

Technical Expertise – Some understanding of healthcare including knowledge of healthcare terms and accounts receivable processes
Tactical Execution - oversees the development, deployment and direction of complex programs and processes
Financial Management - applies tools and processes to successfully manage to budget
Project Management - assesses work activities and allocates resources appropriately
Interpersonal Skills - able to work effectively with other employees, patients and external parties
PC Skills - demonstrates proficiency in Microsoft Office applications and others as required
Basic Skills – demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes, have ability to work quickly and accurately in a fast-paced environment while managing multiple demands, ability to work both independently and collaboratively as a team player, adaptability, analytical and problem solving ability and attention to detail and able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly. Spell correctly and transcribe accuratel
Minimum 5 years healthcare management experience with three of these years in the related area for the position. Relevant education may substitute experience requirement with SSC Executive approval

184

Associate of Revenue Cycle Management Consulting Resume Examples & Samples

Perform data collection and analysis, identify issues and utilize models and analyses to support project deliverable content
Develop understanding of KPMG methodologies, tools and techniques and apply them on assigned projects
Communicate problems, barriers and issues within the appropriate context and identifies and present solutions to client performance issues
Conduct research for, and make presentations, to clients and KPMG project team
Handle routine client and project team interactions
Identify and present solutions to client performance issues
Bachelor’s degree in Health Care Administration, Business, Management Information Systems, Economics, Industrial Engineering, or Accounting from an accredited college/university
Strong computer skills (Excel, Word, Windows, PowerPoint, Microsoft Office) and analytical skills (problem solving, quantitative, work flow process, etc.)
Ability to demonstrate proficiency and comprehension of KPMG tools
Capable of working with project management teams, drafting status reports, tracing issues, monitoring resources, workflow analysis and design
Proficiency with foundational skills such as analytical, written, and verbal communication, client presence along with facilitation and presentation skills

185

National Director of Finance for Revenue Cycle Management Resume Examples & Samples

Develop and monitor reporting tools to track key performance indicators (KPIs), (e.g., A/R, DSO, Cash Collections)
Provide regular analysis of cost and performance of outsourcing vendors (e.g., billing and collections agencies, off-site storage suppliers, real estate property and equipment leasing companies)
Analyze current and past trends in Key Performance Indicators, including: billing, payment sources, cash collections, productivity, A/R and DSO. Suggest initiatives to improve key metrics
Develop in-depth intimacy with RCM functions and operations, including the flow of cash (by day/week of month, typical problems and issues)
Respond to queries from Envision Physician Services Operations and Finance/Accounting with appropriate analysis and executive-level communications, regarding specific performance indicators, payer mix, cash collections, and other issues
Develop and continuously refine cost accounting methodology and system, identify and capture all related costs and apportion them appropriately. Make adjustments for changes in systems or work flow which impact productivity and costs
Communicate overall cash goals and priorities for the management team. Monitor changes in priorities and the resulting maximization of revenue. Ensure appropriate follow-through
Set goals jointly with subordinates; clearly communicate goals and objectives; monitor them regularly through counsel and documentation
Monitor and manage labor costs, inventory levels and production planning for designated departments. Optimize productivity while avoiding unnecessary costs such as excess overtime
Oversee preparation of necessary materials for various audits and work with outside auditors and regulatory representatives
Assure compliance with all local taxing, licensing and regulatory authorities. Provide support on state and federal tax issues
Forecast and anticipate other operating expense needs (e.g., travel, training, and consulting). Make recommendations to SVP regarding operating and capital budgets
Lead initiatives to develop new approaches to streamline existing processes, reorganize work, implement new technologies, and improve resource utilization, with a focus on best cost methods
Develop and sustain excellent working relationships with Envision Physician Services professionals (e.g., Operations, Business Development, IT and Finance), as well as with the Company’s clients, payors, consultants, banks and financial intermediaries and government agencies
Present image to subordinates, superiors, and client-users as: knowledgeable, creative, energetic, and assertive
Manage and inspire staff with an “inspirational”, positive leadership style. Promote the advancement of the best performers
Promote by personal example, a positive “esprit de corps”. Proactively identify negative attitudes and behaviors and bring a professional attitude to extinguish any negative influences and foster a positive, productive environment
Healthcare billing, collections and other support functions including: audit, patient complaint, grievance processing, bid preparation, regulatory compliance
Hospital processes, including functions and processes of Emergency Rooms and Admissions offices
HIPAA, Sarbanes-Oxley and other critical governmental regulations
Regulatory compliance and auditing practices
Management principles
Envision Physician Services business models
Develop and document policies/procedures, SOPs, and reports

186

Revenue Cycle Supervisor Resume Examples & Samples

Responsible for primary oversight of billing and patient accounts functions such as processing, denials and follow up on accounts
Oversees write-offs, work orders, insurance processing and verification, patient chart maintenance, accuracy of billing, payment processing
Researches incomplete, incorrect, or outstanding claims and submits claims with knowledge of all insurance plans and contractual arrangements affecting payments
Investigates and resolves claims submission problems with insurance payers and reviews new and existing insurance claims processing information
Works to resolve billing/insurance issues and ensure compliance with departmental financial policies
Provides information and facilitates communication with and between interdisciplinary healthcare providers, employer groups, and patients
Develops and implements overall cost effective staffing plans, schedules staff and confirms time records
Interviews, orients, trains, counsels, mentors, disciplines and evaluates staff
Provides leadership and direction in resolving operational issues
Monitors and evaluates key processes in order to identify opportunities for improvement
Addresses customer complaints and ensures that follow-up action is taken and documented
The information above is for summary purposes, and is not intended to be a comprehensive list of essential functions
High School diploma or equivalent, required
BS degree or High School Diploma or equivalent with minimum of 5 years of supervisory experience in a health services group or physician office, required
Minimum of three years’ experience with billing, insurance claims processing, and ICD-9 coding, required
Ability to communicate effectively and diplomatically within a multi-functional team, required
Strong organizational skills and attention to detail, required
Ability to successfully function in a fast paced, service oriented environment, requireed
Experience in understanding and usage of computers, including the Microsoft Office Suite and preferably knowledge of billing/collections software, as well as the ability to learn applications relevant to the position, required

187

VP Revenue Cycle / Integrity Management Resume Examples & Samples

Provides leadership in development, implementation, and oversight of system-wide/regional standards, programs, and/or systems in order to achieve desired and integrated strategic business initiatives, objectives, and outcomes including, but not limited to, growth, accountability and patient care
Directs, supervises, and evaluates the work of staff. Holds management staff accountable for achieving plans and performance targets. Works with them to identify and resolve the most complex issues and problems impacting initiatives and operations. Develops staff to ensure continued professional growth and to provide the competencies the company needs to support its growth and long-term success. Articulates and demonstrates an expectation for continuous quality improvement utilizing processes that include consideration of all stakeholders. Fosters an environment that focuses on processes and outcomes
Builds and supports effective collegial relationships with applicable internal and external stakeholders and organizations, ensuring and fostering a high level of collaboration in order to develop partnerships, coordinate activities, review work, exchange information, and/or resolve problems. Promotes and models positive relationships among various entities
Oversees the development, implementation, and consistent application of effective organizational policies and practices. Participates in maintaining an effective internal control environment to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, proper compliance with existing laws and regulations achieved, and operations comply with the legal and regulatory parameters in which it operates
Develops, reviews, and monitors financial and performance outcomes to assure attainment of organizational objectives established by corporate leadership and the Board of Directors. Maintains an effective budgeting and capital planning discipline in conjunction with operational management to ensure planned revenues, expenses, and/or profit goals are met
Directs the development and integration of new and innovative operations and/or services by providing leadership that maximizes management staffs contributions and assures timely decision-making reflective of the mission, vision, and values of the system
Reviews, prepares, analyzes, and presents reports and recommendations to senior management regarding operations and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making
May serve as a staff resource to the organizations Governing Board and/or applicable committees. Develops, implements, and reports to the Board on strategic initiatives, outcomes, and measurements

188

Supervisor, Revenue Cycle Management Resume Examples & Samples

4+ years experience in related field
Administers and executes policies and procedures
Ensures employees operate within guidelines
Interactions normally involve information exchange and basic problem resolution
Role will be focused on supporting government payors and ensuring compliance with CMS guidelines
Role will also be responsible for the returns and refunds team

189

Revenue Cycle Representative Resume Examples & Samples

Act as a liaison between UI Health Care and assigned payors via telephone/websites in regard to insurance claims follow-up and revenue collection from an escalated perspective
Perform extensive research on reimbursement methodologies, maintain industry knowledge related to changes regarding reimbursement, and apply knowledge to claims processing
Have a direct impact on cash collections due to continuous reimbursement analysis and findings of over- and underpayments, based upon our contracted commercial and governmental payors. Work closely with the Revenue Integrity Coordinator to identify payment trends; escalate and address claims processing errors at the payor level
Participate in the training of new Revenue Integrity staff, create training/reference materials specific to payors, and test changes in GE, Epic, and other systems
Attend appropriate conferences and training sessions provided by various payors, vendors, and fiscal intermediaries as it relates to reimbursement
Strong attention to detail with a proven ability to gather and analyze data, identify trends through data analysis and keep accurate records
Self-motivated with initiative to seek out additional responsibilities, tasks and projects and demonstrated ability to maintain or improve established productivity and quality requirements
Revenue Cycle experience (typically 6 months or more) in a healthcare environment
Working knowledge of Health Insurance Portability and Accountability Act (HIPAA) laws
Advanced knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs
Experience with Experian Contract Management software

190

Epic Revenue Cycle Director Resume Examples & Samples

Guides the project team through the design, build and implementation phases of the Revenue project
Serves as the central point of communication for the Revenue Program to ensure a common vision, plan and goal are maintained across all areas of the project. Communicate regularly with Revenue business leaders
Provides regular status reporting and issues escalation/resolution to the Access and Revenue Application Director and Program Director
Promotes the new systems and represent it positively to the user community
Builds the Revenue team. Directs, guides and mentors the Revenue Team and Leads
Manages assigned staff. Hires, terminates, assesses performance, recommends salaries and rates, recommends assignments, promotions, and demotions, provide counsel and feedback. Develops staff. Schedules and assigns work
Conducts regular status meetings with the Revenue team, and represent the Revenue team through participation in regular status meetings with the Program Leadership Team
Champions Lahey Health project management guidelines and policies
Maintains strict adherence to the Lahey Clinic Confidentiality policy
Champions LH project management guidelines and policies
Maintains courteous and effective interactions with colleagues and patients
Demonstrates an understanding of job description, performance expectations, and competency assessment
Demonstrates a commitment toward meeting and exceeding the needs of our donors, prospective donors, patients and other stakeholders and consistently adheres to our Office of Philanthropy and system-wide service protocols and standards
Participates in departmental and/or interdepartmental quality improvement activities
Participates in and successfully completes Mandatory Education
Performs other duties in support of the organization as required or directed
1)Must have leadership experience with at least one full life cycle implementation with demonstrated past-success
2)Experience with at least two of the revenue program areas which includes; HIM, Hospital Billing/Claims, Professional Billing/Claims, Home Health Billing/Claims
3)Experience in building the application from the ground up (application is currently not live and no build has occurred)
4)Should have experience leading large teams of individuals and the ability to manage staff effectively

191

Revenue Cycle Supervisor Resume Examples & Samples

Supervises the daily business functions of the patient visit from point of entry to accurate adjudication of the patients* accounts. Scope of responsibilities includes appointment scheduling, insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Resolves escalated and unique revenue cycle issues
Responsible for quality work, meeting deadlines, and adherence to the Practices Standard Operating Procedures (SOPs); regularly audits staffs work to ensure compliance
Monthly, prepares revenue cycle financial analysis, including aged accounts. Monitors and assesses business metrics in order to refine processes and improve efficiencies. Guides individuals and teams toward priorities; clarifies roles and responsibilities of others; coordinates resources to meet objectives. Cascades goals down to staffs annual objectives
Champions new initiatives; acts as a catalyst of change and stimulates others to change; paves the way for needed changes; manages implementation effectively. Steps forward to address difficult issues; puts self on the line to deal with important problems; takes ownership and accountability
Responsible for the overall coordination of front office duties to include scheduling, check-in, and co-pay/co-insurance collection

192

Revenue Cycle Application Architect Resume Examples & Samples

Ensure the design of their domain of application(s) and the associated processes are completed successfully, leveraging best practices
Contribute to team performance by providing key stakeholders with direction and critical domain knowledge to help drive best outcome for overall IT strategy
Effectively communicate to clients about current and future domain functionality
Leverage domain expertise to contribute to optimal application performance and utilization
Responsible for contributing to the development and mentoring of Application Consultants
Complete change tasks and update them with relevant information and status changes
Perform other responsibilities as needed
Bachelor’s degree in healthcare, information technology, business or related field strongly preferred
3 years experience with Patient Access solutions such as Scheduling, Registration
Experience with physician facing and/or scheduling, registration solutions
Must live in or be willing to relocate to Silver Springs, MD area
Strong troubleshooting skills, specifically in performance and stability troubleshooting
Strong client facing presentation and facilitation skills
Experience working with clients recommending changes in software development, business processes, maintenance, and/or system standards

193

Director Physician Revenue Cycle Resume Examples & Samples

In collaboration with Executive Director Revenue and Reimbursement, and VP of Revenue Cycle, establishes processes for an effective revenue cycle, ensures excellent customer service is given to patients, staff, and other users who interact with the department
Plan, coordinate and implement new centralized physician revenue cycle
Plan, lead and coordinate new billing system implementation to ECW
Organizes the billing and collection activities of revenue cycle
Create metrics and reporting tools to monitor and enhance Revenue Cycle performance
Administers corporate and departmental policies and procedures to ensure ethical and sound business practices and procedures are followed
Evaluates, monitors, and communicates identification of the organization's registration, charge entry, and coding problems impeding the revenue cycle process, in relation to billing and AR resolution
Responsible for managing and supervising Revenue Cycle Staff including
Assist, mentors, and promotes the growth of the department's staff in achieving objectives and duties
Measures and reviews staff performance and quality, recommending and assigning training
Responsible for the professional conduct of staff and maintaining a professional work code and environment
Assist with new hire on-boarding (interviewing, training, assessing)
Work collaboratively with other members of management to find solutions, create policy and monitor for successful resolution
Evaluates and monitors daily process controls to meet departmental effectiveness and efficiency standards
Responsible for implementing changes needed to comply with third party/governmental rules and requirements, coordinating the training of staff on these changes
Ensures department areas timely and accurate response to patient and internal inquiries
Independently initiate and manage projects designed to improve team efficiency, productivity, and quality
Perform other work related duties as assigned or requested
Bachelor's degree or equivalent industry experience of 3-5 years
Required 3-5 years experience of physician receivables, third party billing and payment requirements, medical terminology, and ICD9 and CPT4 coding
Ability to evaluate personal performance against established goals
Athena experience required
Demonstrates goal-oriented thinking, leadership ability, and strong interpersonal, operational and organizational skills
Prior experience enforcing, maintaining, and updating department policies and procedures
Excellent communication skills, including listening, writing, and relationship development
Prior experience supervising a group of individuals from both a development and personal issues standpoint

194

Revenue Cycle Director Resume Examples & Samples

Plans and directs registration, patient insurance, billing and collections and data processing to ensure accurate patient billing and efficient account collection
Manages the Business Office within the established budget including annual planning. Develops monthly status reports
Develops, implements and administers annual capital budget; initiates corrective action to significant variances
Plans and prepares monthly revenue reports for review and use by Administrator, senior leadership and faculty
Provides ad-hoc reports on associated revenue metrics (i.e. RVU, Payor Mix, CPT volume, etc) as requested by Chairman, Division Chiefs, Faculty and Administrator
Establishes and maintains a working relationship with all third party vendors assigned to the billing office. Oversees all collection efforts, account management and related patient to vendor relationships
Manages Physician credentialing process with managed care and government payors. Interfaces with the IPA, Medical Staffing and faculty to ensure credentialing is completed in a timely manner
Develops, supervises and maintains daily cash processing workflows and associate reconciliations. Ensure all monies received to general ledgers match the posted receipts in IDX
Reviews current status of patient accounts to identify and resolves billing and processing problems in a timely manner
Directly supervises accounts receivable collection team. Monitors progress of team on a daily basis and re-directs follow up efforts as appropriate
Establishes and implements methodologies for the collection of delinquent accounts ensuring third-party payors are contacted
Establishes and recommends credit and collection policies, and makes recommendations for improvement
Solves difficult payment and associated business office problems. Audits problem accounts
Maintains contacts with medical records and other departments to obtain and analyze additional patient information to document and process billings
Develops and oversees business systems and works with information technology to ensure timely and accurate implementation
Supervises, trains, orients and evaluates performance of assigned personnel. Recommends merit increases, promotions, disciplinary actions
Monitors daily operating activity of department and makes necessary adjustments in work assignments
Initiates and answers pertinent correspondence. Maintains required records and files
Attends administrative meetings and participates in committees as requested. Conducts special projects and studies as directed
Participates in professional development activities and maintains professional affiliations
10 years directly related and progressive health care revenue cycle experience will be considered in lieu of a degree. With degree, minimum 5 years medical business office experience, with 2 years as a department manager in billing, accounting or information systems

195

Revenue Cycle Director Resume Examples & Samples

10 years directly related and progressive health care revenue cycle experience will be considered in lieu of a degree
With degree, minimum 5 years medical business office experience, with 2 years as a department manager in billing, accounting or information systems
Patient billing management software
Knowledge of ICD and CPT guidelines
Ability to shift priorities; superior problem-solving capabilities
Persuasive, encouraging, and able to motivate others
Ability to effectively prioritize and execute tasks in a high-pressure environment

196

Manager, Physician Revenue Cycle Resume Examples & Samples

Responsibility for Revenue Cycle Management for physician revenue cycle service offerings
Management of strategic and critical business initiatives related to revenue cycle management for professional services
Maintain and a command of nephrology and physician practice revenue cycle trends, business performance management, and key performance indicators
Responsible for management and oversight of Physician Revenue Cycle performance to included but not limited to scheduling, insurance verification, billing, denials management and avoidance, collections, cash posting
Lead operational efforts through subordinates to complete the administration of business processes and services to ensure the operations effective achievement of goals within the assigned business unit(s)
Direct and control the broad activities of the business unit(s) through the interpretation, application and implementation of Company-wide policies and processes appropriate to the functional area(s)
Facilitate communication and coordination with cross-divisional teams, customers, vendors and/or third parties to ensure the effective exchange of necessary information
Provide leadership, guidance and coaching for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters
Collaborate with employees in the establishment of clear and concise development plans to ensure succession planning and the advancement of future leaders within the organization
Provide technical guidance
#L1-AF2
6 – 8 years’ related experience
5-7 years in Physician Revenue Cycle, preferably with direct Nephrology experience

197

Heathcare Revenue Cycle Resume Examples & Samples

You will be the “face of IT support” to our Service Operations team
Uphold enterprise policy and guidelines and recommend new/improved guidelines
Facilitate daily standup and weekly incident review meetings with service operations
Understand the solutions being used by operations and their upstream/downstream impact
Provide support to service operations on development of application test approaches/plans
Translate operation needs into system/technical requirements
War Room/Situation Management participation when system down event is occurring
Partner with functional teams and interact with service operation teams as well as vendors to find solutions for application issues and problems
Responsible for various configuration documents and tools that are used to manage the solutions
Bachelor's degree in related field or Equivalent Experience
3+ years healthcare revenue cycle billing experience
3+ years troubleshooting or client IT support experience
MS Office (Including Word, Excel – to include pivot tables, VLookups, Formulas etc., PowerPoint)
The willingness and ability to work in other offices in the Phoenix, AZ area on an infrequent basis
Previous experience in a healthcare environment
837 and 835 formats
Network Topologies
Desktop utilities

198

Revenue Cycle Representative Resume Examples & Samples

Bachelor’s degree, or equivalent combination of education and experience
Experience (typically 1 to 3 years) in medical billing and claims processing; demonstrated at a working level proficiency
Experience (typically 1 to 3 years) working with Electronic Medical Records (EPIC), demonstrated at a working level proficiency
Knowledge of insurance authorizations and eligibility processes; demonstrated at a working level proficiency
Working level proficiency with written and verbal communication skills including individuals with communication disorders
Working level proficiency working within a medical clinic setting including handling confidential records and knowledge of HIPAA compliance
Medical Billing certification
Ability to run reports in EPIC
Knowledge of healthcare billing (healthcare revenue cycle); insurance, and/or federal and state assistance programs; demonstrated at a working level proficiency

199

Revenue Cycle Senior Consultant Resume Examples & Samples

6+ years of healthcare consulting / management experience or leadership experience in provider organization
Project management experience and technical expertise working with EPIC, Cerner, Allscripts and other systems
Proven ability to probe, analyze, synthesize and articulate complex subject matter so it can be easily understood
Ability to travel 70-80%
Bachelor's Degree or Master's Degree in Business Administration or related field

200

Revenue Cycle Director Resume Examples & Samples

Managing a large team of medical billers and medical coders
Ensure HIPPA privacy regulations and keep up to date with CPT and ICD-10 coding protocols and procedures
Analyze reimbursements, bad debt and AR aging along with forecasting of AR sub ledger functions to management
Lead continuous improvement of department and minimize employee turnover

201

Revenue Cycle Auditor Resume Examples & Samples

Internal controls
SOX 404
Sarbanes Oxley
Public accounting

202

Revenue Cycle Improvement Senior Consultant Resume Examples & Samples

Leads revenue cycle departments in the analytical components of workflow redesign. Identifies, creates and implements improvement solutions for BSWH revenue cycle related departments
Monitors the performance of revenue cycle activities utilizing current monitoring tool sets and performance metrics. Creates and implements new performance metrics to address and manage new performance issues
Leads revenue cycle department activities including, but not limited to technology planning, staffing assessments, operational improvement strategies, and workflow optimization
Leads revenue cycle improvement activities between BSWH Corporate departments and BSWH facilities
Leads revenue cycle improvement communications across the revenue cycle
Analyzes and identifies trends in revenue cycle operations. Uses this data to develop conclusions, recommendations, and implement process redesign solutions
Assesses the current capabilities of IT revenue cycle systems and creates and leads implementation of innovative revenue cycle IT solutions
Develops revenue cycle training tools and leads revenue management educational activities for BSWH revenue cycle departments
Builds and manages successful relationships with multiple levels of stakeholders inside and outside of Revenue Cycle
Plans, organizes, and prioritizes Revenue Cycle project activities using work plans and other project management tools
Manages multiple projects and other activities at a time
Assesses current and potential vendors and works to negotiate contracts or amend existing contracts
Location/Facility – Bryan Tower/Dallas

203

Revenue Cycle Performance Analyst Resume Examples & Samples

Compiles, analyzes, interprets and presents data necessary to assess goals
Generates weekly and monthly accuracy reports and distributes to appropriate managers for performance review
Reviews documentation quality as it relates to the revenue cycle and helps develop best practices that are monitored for accountability
Timely resolution of Service Now tickets and WQs owned by Revenue Cycle team
Works in conjunction with Revenue Cycle Managers and Directors to identify process opportunities to improve accuracy and workflows through random audits of patient accounts and site observations
Serves as a subject matter expert and is able to answer questions and provide guidance
Routinely monitors front-line WQs and reports to ensure targets are being met and trends are being identified. This may occasionally require assisting with error resolution
Delivers instruction to individuals and groups in a variety of formats with an emphasis on revenue cycle operations
Assists in developing annual competencies and records results
Monitors and responds to Revenue Cycle communications as needed

204

Regional Director of Revenue Cycle Resume Examples & Samples

Maintain knowledge and skill required to assure accurate and timely reimbursement of Accounts Receivable. Manage staff, projects, and systems that impact the success of achieving successful fiscal integrity related to Accounts Receivable
Develops and implements department budget that demonstrate efficiency and prudent utilization of resources to manage Revenue Cycle teams
Establish strategic goals for each Revenue Cycle Department that align to the Organizational Goals. Collaborate with the Management team to implement and monitor success
Assures all Patients are registered accurately and timely demonstrating respect to meet the needs of all patients. Collaborates with the Management Team to optimize pre-registration, insurance verification, and financial counseling at scheduling, registration, and at discharge
Creates and implements efficient work flow in Coding and Transcription to bill timely and accurately, provide data to departments relying on the accurate assignment of charges, diagnosis, and procedures for revenue and abstraction of data
Assures that Medical Records are maintained accurately, utilizing electronic and paper formats. Assures critical data elements are analyzed to identify and correct deficiencies. Assures compliant release of patient’s records following prescribed policies and procedures to protect the privacy of the patient, and meet Federal and State regulation
Oversee Billing, Follow-up, and Collections performed by the Patient Accounts department and Customer Service relating to Billing inquiries. Assures all assigned staff are trained and meet established performance standards. Oversees the Charge Description Master file and assures that charges reflect the documented services provided to patients in their Medical Record
Monitors cash flow applied to AR to analyze deficiencies and create and apply corrective action to assure accurate and timely receipt of payment from Patients, Government Agencies, and Commercial insurers
Establishes policies and procedures to assist Patients in meeting their financial Responsibility for payment of services received at the Hospital. Strategize with Management and staff to maximize the benefits to all patients in need of assistance
Create an environment that empowers staff to continuously develop performance improvement processes. Solicits input in daily operations and projects to improve all Revenue Cycle functions. Assists staff in developing new skills and applying them to the work place
Assures all staff are treated fairly and consistently in accordance with the organization’s Human Resources policies and procedures
Achieve annual and periodic goals for significant statistical indicators or revenue cycle performance and for the organization’s overall financial performance
Works with utilization management staff in all patient care sites in order to ensure timely and accurate care authorization, response to, and resolution of care denials
Three (3) years’ experience of Healthcare Management in a Financial or Revenue Cycle related role
Two (2) years’ experience of providing leadership
Two (2) years’ experience of medical office experience
Five (5) to Seven (7) years’ experience in a HealthCare Management Role preferred
Ability to read and understand oral and written instructions, and effectively communicate information. Basic computer skills (including opening/reading email, basic internet use). Expert at managing Revenue Cycle workflow to assure optimum results. Ability to manage large and diverse work groups to assure cohesive interactions to maximize achievement at meeting department and Organizational Goals

205

Dir Revenue Cycle Resume Examples & Samples

Create and communicate revenue cycle policies and procedures for scheduling, registration, insurance verification, transcription, coding, medical records, billing and collections
Determine best practices and educate business office staff
Collaborate with executive ASC entity leadership and others to establish new programs and processes to improve revenue cycle performance across ASCs
Prepare and present reports and data regarding revenue cycle performance including, for example, accounts receivable, cash collections and process improvement initiatives
Set key operating metrics and monitor performance against benchmarks
Audit ASCs revenue cycle performance on regular basis, document and report results and improvement plans and monitor progress
Coordinate with ASCs entity accounting to ensure appropriate month-end patient financial system accounts receivable closing and balancing processes to lead to reliable accounts receivable reports
Lead ASCs in annual Charge Master reviews and adjustments
Lead ASCs in understanding their payor contracts, including maintenance of payor tables and loading of payor contracts into patient financial systems
Lead process improvement innovation including evaluating new vendors and/or technology
Lead on-boarding and education of new ASCs and business office staff for implementing revenue cycle processes and technology
Lead relationships with third-party billing and collection firms, where applicable
Lead relationships with patient financial system vendors
Lead standardization of patient financial system tables and reporting
Manage change management process for enterprise-wide patient financial system tables
Manage timely completion of payor applications
Manage timely filing of state data submissions
Support the evaluation of new ASC business office managers or comparable position candidates
Position requires up to 50% travel to ASCs
Bachelor’s degree in accounting, finance or related field required and Master’s degree in in health care management, finance, business administration or related field a plus
Five years minimum multi-site managerial experience as a Director, Assistant Director or Manager in ASC revenue cycle required

206

Revenue Cycle Associate Resume Examples & Samples

Provides reception for Revenue Cycle Administration office, greeting and directing visitors. Assists and responds in a timely manner to internal and external customers, providing direction, support and information to ensure high quality customer service. Assesses all customer needs and independently addresses concerns within the scope of the position
Receives, distributes, and processes US Postal and interoffice mail within the department
Processes and posts credit card payments received for patient accounts. Prints and mails receipts to patients
Performs a variety of administrative tasks including, but not limited to, printing and mailing patient letters, producing documentation for patient refunds, developing check requests, preparing invoices for medical record requests, posting of patient account information to the practice management system and placing and answering telephone calls
Monitors and maintains inventory of office and kitchen supplies, places orders as needed. Receives and puts away orders ensuring accuracy of packing slip/invoices. Coordinates the maintenance and repair of office equipment
Validates accuracy of invoices related to the operation of the Revenue Cycle Department. Enters and processes invoices for payment in the accounting system (Meditech). Maintains appropriate back up and files
Tracks and reports financial and banking information for SHMG practice locations. Compiles a variety of reports for end of month processing. Interacts with bank courier. Orders banking supplies for all SHMG locations
Serves as a liaison, as needed, to building supervisor and building management as it involves maintenance and other issues on a daily basis
Maintains appropriate documents, reports and files in order to comply with all applicable laws and policies
Performs other related duties as assigned or requested in order to maintain a high level of service. Completes required continuous training and education, including department specific requirements. Complies with departmental organizational policies and procedures and adheres to external agency requirements
High school diploma or equivalent with 1-3 years relevant healthcare experience in front office or billing office
High level of competency with computers, the Internet, and computer software such as MS Office or equivalent is required. Experience with Practice Management systems preferred
Ability to organize and prioritize workload to manage multiple tasks and meet deadlines with minimal supervision
Excellent verbal, written, organizational, and interpersonal skills are required. Effectively communicates with internal and external customers positively, confidentially and professionally
Ability to work with individuals at all organizational levels, particularly peers, team members, other departments, patients, and the community is required
Strong problem-solving skills and ability to make timely decisions in a fast-paced environment
Demonstrated ability to work in a continuously changing environment and willingness to assist with a variety of tasks as needed
Willingness to learn and share knowledge with others

207

Operations Analyst, Revenue Cycle Resume Examples & Samples

· Works with management on all Access/Revenue Cycle initiatives such as meaningful use of the EHR, telemedicine projects etc
Manages Project Request for System Enhancements and Changes by working closely with the IT team
Protects the integrity and confidentiality of all data and information through physical and electronic measures
Provide service according to the expectations of policies/procedures and standards developed around the Access/Revenue Cycle for client departments
Evaluates and documents client needs and all aspects of business processes both operational and financial, including current process analysis; and proposed revisions to optimize business processes
Assists with the design and documentation of business/system functional requirements in formats to facilitate the development of deliverables such as Request for Proposals and/or Information, custom development efforts, project based planning documents such as scope documents and client services communication
Works with ISD staff, clients and/or vendors to evaluate technology solutions including both packaged system solutions and custom development application and component development options
Assures quality of information technology solutions through business case and application level testing; validates test results to initial business needs
Provide ongoing troubleshooting, support and maintenance of eRecord production applications
Work with Information Services staff and the integration team to design, test and deploy appropriate hardware solutions, connectivity requirements and interface solutions, as appropriate
Bachelor degree in Information Systems/Computer Science, Nursing, Health Information Management, Business, clinical or financial studies or related field required OR an equivalent combination of education and experience would be considered
A Masters degree in a related field preferred
Four years experience in financial and/or medical analysis or successful completion of the FMR Program with a minimum of three years of health care, business or IT experience required
Good oral and written communication skills are required
Extensive related experience will be considered
Superior computer skills with expert knowledge in Word, Excel and EpicCare/eRecord preferred
Demonstrate a high degree of professionalism, enthusiasm and initiative on a daily basis
Ability to work in a fast-paced environment a must
Ability to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiences
Attention to detail is critical to the success of this position, with demonstrated competency in customer orientation and the ability to deal with ambiguity
Excellent planning, communication, documentation, organizational, analytical, and problem solving abilities
Ability to interpret and summarize results of various analyses in a timely and meaningful way
Ability to effectively approach problem solving
Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy
Possess technical knowledge and expertise in understanding patient access, physician template utilization and must possess an understanding of the complex information system solutions and the implementation/support of those solutions in the client community
Ability to analyze financial & clinical results and to comprehend forecasting models
Well-informed and conversant with general business, economic, and clinical matters
Effective analytical skills are required
Must be able to work within an aggressive deliverables based and/or service quality based environment
The ability to continuously interact effectively with all levels of clients is critical
Available to work overtime if required

208

Consulting Analyst, Revenue Cycle Consulting Resume Examples & Samples

Serve a key role in coordinating logistics of complex engagements
Review and support development of presentation and report deliverables, and present recommendations
Support client calls and in person meetings at the client site
Set and execute against project milestones
Assist in providing on-site and off-site assessments and consulting services for large clients
1+ Year of Professional Work Experience
Willingness to travel 50% domestically and valid Driver’s License
Previous experience working at The Advisory Board Company
Strong track record of attention to detail and service orientation
Ability to manage multiple projects simultaneously and communicate project timelines effectively
Understanding of Advisory Board Company Revenue Cycle Consulting and Management team
Demonstrated analytical reasoning and solution-focus problem solving skills
Demonstrated project management and organizational expertise
Ability to drill down to the root cause of issues and be creative in problem solving

209

VP-revenue Cycle Management Resume Examples & Samples

Plans, directs and supervises revenue cycle systems and operations
Actively works with the Acute Division Hospitals' Leadership Teams and corporate leaders to review revenue cycle performance and pursue ways to improve cash flow
Addresses regulatory reimbursement and managed care issues related to revenue cycle management
Develops and implements policies and procedures to ensure that the clinical revenue cycle is effective and properly utilized
Directs technology related activities to achieve desired goals and maintain compliance with federal, state and local regulations
Develops budgetary goals and initiates corrective action to address variances
Interacts with vendors and various departments that impact the revenue cycle management results, including: Patient Access, Patient Accounting, HIM Case Management, I/S, Finance and hospital patient care areas
Performs other duties as assigned/required

210

VP of Revenue Cycle Resume Examples & Samples

Perform complex data analysis and make independent decisions
Interacts with executives, other directors, and all members of the Revenue Cycle team
Knowledge of state and federal regulations as they pertain to billing processes and procedures
Insurance claim processing and third party reimbursement
Detailed understanding of all negotiated agreements
External contacts may consist of patients and their families, insurance companies, state and federal agencies, auditors, and vendors
Technical or professional accounting
Skill in time management and project management
Advanced proficiency in Microsoft Excel
Apply appropriate supervisory, management and leadership techniques in an operational setting
Deal effectively with constant changes and be a change agent
Ability to set priorities and use good judgment for self and staff
Seven (7) to ten (10) years hospital accounts receivables experience is required
Three (3) years of progressive leadership experience (at a supervisor level and above) in a complex healthcare organization is required

211

Revenue Cycle Supervisor Resume Examples & Samples

Serve as floating supervisor Front End / Patient Access staff of up to 80 team members (25 on the weekends)
Acts as liaison with Patient Accounts, Care Coordination/Utilization Management, Patient Financial Services, Financial Counselors, and Information Systems regarding various issues that arise in the Consolidated Business Office
Proactively reviews work lists, staff activity, productivity and time and attendance. Notifies Senior Leadership of potential systemic issues and high risk/high exposure situations. Recommends solutions for resolving issues
2+ years of experience to ensure familiarity with patient accounting, patient registration, insurance verification and/or patient access
5+ years of experience in a healthcare setting
Must be able to work in variance schedule (requires weekends and holidays)
Knowledge of basic accounting principles, business administration, and computer systems as normally acquired through completion of 2+ years of college, business or technical school

212

Revenue Cycle Supervisor RAD ONC Resume Examples & Samples

Supervises the daily business functions of the patient visit from point of entry to accurate adjudication of the patients* accounts. Scope of responsibilities includes appointment scheduling, insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Resolves escalated and unique revenue cycle issues for RAD ONC
Develops, implements, and maintains the Practices revenue cycle training materials. Conducts training of SOPs, systems, metrics, government regulations, and etc
Excel experience with pivot tables and V look up strongly preferred
Attracts high caliber people, accurately assesses strengths and development needs of employees; provides timely, specific feedback and helpful coaching; provides challenging assignments and opportunities for development. Responsible for interviewing, recommending hires, assessing performance, recommending salary changes, and progressive discipline. Enforces adherence to the Practice*s and US Oncology policies

213

Epic Certified Revenue Cycle Business Analyst Resume Examples & Samples

Analyze and document client's business requirements and processes; communicate requirements to technical personnel by constructing basic conceptual data and process models, including process flowcharts and technical specifications
Presenting concepts in a concise and focused manner, including narrative, process diagrams, role and accountability diagrams and business-focused story boards
Coordinate user groups and project teams, convening conference calls and meetings and maintaining minutes and follow-up logs
Work collaboratively with Systems Analyst to develop designs, mockups and prototypes
Experience with an Epic implementation at a multi-hospital system, and/or a major academic medical center
A Baccalaureate Degree from an accredited college or university in computer science, Information systems, business administration or equivalent experience or education is required
At least 3 years of revenue cycle healthcare systems experience
At least 3 years of experience on commercial core revenue cycle applications
Strong understanding of the core functions and processes of the billing office
Experience documenting system architecture design and revenue cycle system workflow
Excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts
Must be well organized, detail oriented, highly analytical, possess strong problem solving skills and must have a desire to be accountable for project success
Detailed knowledge of general phases of SDLC, project management methods
EPIC - Resolute Hospital Billing Administration, Claims Administration certification required
EPIC – Charge Router, Resolute Hospital Billing Electronic Remittance, Resolute Hospital Billing
Expected Reimbursement Contracts Certification preferred
Experience with Epic integration
Strong technical background, including an understanding of ANSI 837 and 835 formats and the ability to create and customize logical rules to prevent incorrect claims from being submitted
Have a full understanding of the PPS and non-PPS Hospital Billing revenue cycle and the revenue cycle as it pertains to Epic
Hospital Billing experience
Must have General Ledger experience

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Epic Revenue Cycle Business Analyst Resume Examples & Samples

Decompose information gathered into details including sources of data, data types, users, user types, interface components, interface navigation needs, reporting needs, and administrative system needs
Communicate technical design issues to non-technical people
Ability to work independently and as part of a fast moving team
Experience with HL7 communications is a plus
Experienced working in a Project Management Office (PMO) with cross-functional teams is a plus
Completed multiple go-lives, and at least one from (near) inception to completion
At least 3 years of clinical healthcare systems experience
At least 3 years of experience on commercial core clinical applications
Experience documenting system architecture design and clinical system workflow
EPIC - HIM Coding and Abstracting required
EPIC – Identity
EPIC build and integration experience
Strong technical background,
Have a full understanding of HIM processes and procedures, coding, Medical terminology, Hospital Medical Record coding experience

215

Revenue Cycle Management Manager Resume Examples & Samples

Overall responsibility for accounts receivable-related metrics and goals, developed in conjunction with Revenue Cycle Management Director and Home Care leadership
Utilize reporting and metrics to identify strategies, tactics, and to manage the team collectively and as individuals
Engage in audit activity, as needed
Timely and accurate billing; manage unbillable and timely filing risks and denials
Accurate revenue recognition; includes accruals, reserves and bad debts
DSO management/cash collections; maintain and oversee collection process, handle escalations, process refunds, manage relationships with outside collection agencies, review patient financial waivers
Monitor cash application processes and ensure accuracy relevant to appropriate fee schedule application and over or underpayments
Credits and adjustments; assess appropriateness, review and approve credits and adjustments per policy guidelines; recommend exceptions to Revenue Cycle Management Director
Identify needs and coordinate initiatives related to development of payer policy strategy necessary to support timely resolution of accounts receivable
Recommend and monitor Billing and A/R policies and procedures for third party Respiratory Care business
Act as a liaison with sales team regarding open A/R balances and actions taken regarding credits and adjustments
Develop escalation path with Payer Database, Managed Care, and other partner teams to identify and establish process for payer or claims issues
Identify and implement technology, structure, and process enhancements to improve department efficiencies
Special projects include challenging assignments in payer analysis, third party billing process improvement and business project support
Lead development and execution of Revenue Cycle Management initiatives
Apply broad knowledge to solve others’ challenges and lead the solutions to problems
Effectively manage team, including performance, personnel issues, and conflict resolution
Recognize and reward success of team and individuals
Manage execution of initiatives and activities to drive for results
Network and participate in industry or trade organizations, as appropriate
Other duties and projects as needed or assigned
Recruit, train and provide for career development of staff
Monitor and evaluate team effectiveness and individual productivity measured against established performance standards. Apply corrective measures as appropriate to ensure standards are maintained and goals are achieved
BS/BA degree or equivalent experience
8+ years experience in Revenue Cycle Management, preferably with a DME supplier
3+ years leadership/management experience
Strong management skills and proven ability to effectively manage through change
Knowledge of federal, state, and local regulations, guidelines, and standards, including a working knowledge of Compliance and HIPAA rules and regulations
Knowledge of accounts receivable principles, procedures, standards and documentation within a medical billing environment
Strong financial, analytical, and strategic skills
Proficient in Microsoft Office Software
Exceptional written, verbal and interpersonal communication and presentation skills
Detail oriented, organized, and good discretionary judgment
Strong negotiating skills

216

Revenue Cycle Consultant Resume Examples & Samples

Revenue cycle turn around / redesign
Provide consulting services to clients in all areas of the healthcare revenue cycle which includes
3+ years of experience in the Healthcare revenue cycle
Expert in MS Word, Excel and Visio

217

Revenue Cycle Pre-service Coord Resume Examples & Samples

Obtain and revise patient demographic, insurance, and account information as needed to ensure payment
Assures all PCP, Specialty, and Out of Network Referrals are obtained effectively and efficiently
Produce an Estimate of the Patient’s out of pocket liability for both the facility and professional services
Cash Collections/Financial Assessment
Performs other area support activities
Knowledge of medical and insurance terminology, provider billing, access operations, medical insurance plans, or managed care plans

218

Supv-revenue Cycle Resume Examples & Samples

Determines, coordinates and supervises daily staffing assignments and staffing levels
Trains, coaches, and evaluates assigned staff on performance expectations. Applies progressive discipline when appropriate. Participates in hiring and termination procedures
Ensures accurate identification of managed care plans, network eligibility, and/or compliance with contractual and regulatory requirements. May alert provider and/or patient as necessary
Determines the patient financial responsibility and performs revenue collection. May perform daily balancing, coding and charge entry procedures. Refers any patient deemed necessary to the financial counselor. May qualify patients for financial assistance
Minimum three (3) years of experience directly applicable to the primary work required

219

Supv Revenue Cycle Resume Examples & Samples

Three years experience in a hospital setting or related field
A collaborative team player with a high degree of comfort interacting with patients and hospital leadership
Able to effectively communicate in English, both verbally and in writing
Experience as a Lead or Coordinator preferred
One year experience in a Revenue Cycle role preferred
Strong analytical skills and proficiency with Microsoft products to analyze and trend data preferred

220

PNO Supervisor, Professional Revenue Cycle Resume Examples & Samples

Strong leadership competencies in team development, coaching, mentoring and situational skill assessment with proven track record of building, motivating, and developing high performing teams
Five years of increasingly responsible related healthcare management experience required, such as clinical or administrative practice operations, physician or hospital billing revenue cycle, finance, patient access, informatics, information systems, process improvement, consulting, or business intelligence
Two years of experience using healthcare information systems required, i.e. practice management, electronic health record, and/or billing
One year of supervisory experience required
Experience with system implementations, HL-7 interfaces, and/or EDI transactions highly desirable
Provide oversight, strategic direction, and guidance for the Physician Network CBO by defining objectives, goals, tracking progress, and measuring success. Partner with PNO leadership to assume responsibility throughout the physician billing revenue cycle, from front-end processes to account resolution. Responsible for the overall direction, coordination, planning, and assignment of work. Establish deadlines and productivity standards to efficiently minimize accounts receivable and enhance professional fee collections, while maintaining standards through ongoing quality assurance measures
Ensure compliance with and assist in the development, planning, communication, and implementation of department policies and procedures. Provide oversight and guidance for the implementation of new initiatives and processes. Modify and/or create procedures aimed at reducing backlogs, improving financial performance, or cash collections. Serve as a liaison with third parties to ensure billing processes are compliant and within current standards
Develop systems and controls to ensure successful claims processing and payment through pre and post claim editing systems, continuously striving to increase the percentage of electronic transactions. Develop effective internal dunning processes and collection techniques, along with an effective outsourcing strategy to achieve the highest possible self-pay collection results. Develop and maintain a patient friendly bill statement
Monitor, report, and manage discrepancies and/or deficiencies, analyze for trending and root cause, and develop action plans. Monitor key indicators through accounts receivable aging summaries, workfiles, and other ad-hoc reports to recommend improvements. Work with other departments to adjust operations accordingly to meet unit objectives
Participate in continuous quality improvement efforts by proactively identifying improvement opportunities, comparing performance to industry best practices, encouraging hands-on problem solving, and implementing appropriate solutions. Develop systems and controls to ensure that accounts receivable issues are identified, and resolved in a timely, cost effective manner. Generate and implement new ideas for reducing costs while maintaining similar or better service levels
Assist in the development of annual department budget to ensure appropriate allocation of resources to support operations and meet departmental goals, managing costs within budgetary constraints
Maintain high standard of professional conduct, demonstrating a positive, open-minded, can-do attitude, representing the PNO and CBO with a team perspective, willingness, and enthusiasm to collaborate with others. Work closely with Trinity Health, other Regional Health Ministries, and key stakeholders to expedite the resolution of issues, understand, and address key business needs aligned with organizational goals
Serve as technical project manager, billing system subject matter expert, and system training specialist. Assist with technical set up, maintenance, and on-going support of system. Implement new and optimize existing technology to ensure revenue enhancement and efficient operations. Investigate, analyze and diagnose operational, technical and communication issues. Translate billing requirements into solutions that improve processes, increase automation, and decrease expenses. Maintain ongoing priority/issues log for the department
Provide leadership, coaching, supervision, and reporting structure to support superior performance and well-being of colleagues. Provide clear channels of communication, delegation and accountability. Hire and retain qualified staff by providing opportunities of continuing education, professional development, skill training and upward mobility. Conduct regular department meetings for purposes of education, goal monitoring, and feedback
Partner with Human Resources to address employee issues, develop performance improvement plans, discipline and rewards, address complaints, and resolve problems within the department. Conduct regular and timely performance evaluations. Foster positive team environment that encourages productivity, loyalty, job satisfaction and positive reinforcement to achieve patient satisfaction and employee engagement goals
Demonstrates and actively promotes an understanding and commitment to the mission of St. Joseph Mercy Oakland through performing behaviors consistent with the Trinity Health Values
Maintains a working knowledge of applicable Federal, State, and Local laws and regulations, the Trinity Health Organizational Integrity Program, including the Standards of Conduct, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behaviors and maintains confidentiality. Actively engage in professional development to maintain current skills and knowledge of industry trends, best practices and business opportunities

221

IT Revenue Cycle Business Analyst Resume Examples & Samples

Master’s degree in Business Administration, Computer Science or other health care related field is highly desired
Physician Billing experience preferred
Cerner Millennium experience preferred
Cerner CCL experience preferred
Working knowledge of database structures, query tools, and reporting system
Ability to work effectively on team project
Strong analytical, interpersonal, customer service, and problem solving skills
Possess meticulous eye for detail and accuracy
Advanced proficiency with multiple software applications including Microsoft Word, Excel, Access and Visio
Practical experience with project delivery and systems development life cycles

222

Centralized Scheduler Infusion Center Revenue Cycle Kissimmee Resume Examples & Samples

Accuracy and data entry within established time constraints
Knowledge of medical terminology (Preferred)
Knowledge of insurance health plans (Preferred)
College education or coursework in business or healthcare, or related field (Preferred)
Customer service experience (Preferred)
Call center experience (Preferred)
N/A

223

Revenue Cycle Strategist Resume Examples & Samples

Acts as the subject matter expert for the specific market segments. Expertise in one or more is preferred, with the role expanding to encompass all sub-acute venues of care
Communicates existing and emerging solution functionality to our Clients
Defines/ develops or supports solution vision through client interaction, market research, interpretation of regulatory and accrediting agency guidelines
Prioritizes and reviews content development to support area of responsibility
Ensures alignment of client goals and strategies with current solution capabilities and roadmaps
Manages backlog of needed solution capabilities, collaborating in prioritization and definition of the functionality
Support Cerner Sales and Marketing processes
Identify, research and lead selection of possible partner solutions
Bachelor's Degree with emphasis in related field or equivalent experience
3 - 5 years’ experience in managing Revenue Cycle
Experience in behavioral Health, Home Health, Rehab, Skilled Nursing or other sub-acute venues of care
Ability to travel 30% to 50%
Must live in or relocate to the Kansas City metro area
Master’s degree or advanced certificate in business, healthcare, or information technology
Related industry certifications through HFMA, AHAM, MGMA, ACHE or other professional organization (CHFP, CRCR, etc.)
Progressive leadership responsibilities with 5-7 years of experience managing a healthcare revenue cycle, or through consulting or an IT solution provider
Proven and polished communication skills. The Strategist must be able to discuss detailed processes with end users as well as lead presentations and discussions with health system executives
Demonstrated writing ability which must be clear, concise, and professional
Demonstrated subject matter expertise by speaking at conferences and publishing articles

224

Registration Representative Infusion Center Revenue Cycle Altamonte Resume Examples & Samples

Ability to use discretion when discussing employee/patient related issues that are confidential in nature
Ability to respond to ever-changing matrix of hospital needs and act accordingly
Self-motivator, quick thinker
Ability to communicate professionally and effectively in English, both verbally and in writing
High school diploma or GED (Preferred)

225

Analyst, Revenue Cycle Resume Examples & Samples

Participate with management in strategizing for Process Improvement initiatives
Attend and participate in management meetings
Work with management on special organizational projects for CCHC
Assist the supervisor in the performance of the daily operations of the physician revenue cycle department
Reviews, monitors, resolve, and escalate matters related to delays and failure of accurate and time submission of electronic claims/billing statements
Assists in the development and implementation in efficient and effective operational policies, processes and best practices within functions of the revenue cycle which includes claims processing and patient billing management
Aids in the development and implementation of appropriate billing policies and procedures
Identifies, tracks, and reports issues related to unbilled receivables, internal denials, claim edits, special adjustments, and/or write-offs as required and facilitates to staff for resolution
Assists in preparation, and/or maintain requested reports on billing activities
Investigates and delegates matters for resolution of billing complaints and issues
Maintains up-to-date expertise and knowledge of healthcare billing laws, rules, regulations, and developments necessary for the organization to make informed business decisions
Develops and delivers organized, concise yet thorough communications to management, Sr. Leadership, and other departments regarding proposed changes, deficiencies, developments, and opportunities affecting the organization and Physician Revenue Cycle department
Make sound and evaluative judgments; strong organizational, problem solving and analytical skills
Bachelors Degree in business, health care administration or related field preferred
Extensive knowledge with billing concepts, practices, and procedures
Two years work experience in a hospital/physician environment dealing with Revenue Cycle billing operations or software billing organization; experience with government regulatory payers preferred
Excellent interpersonal, problem solving and critical thinking skills are required

226

Front End Revenue Cycle Management Associate Director Resume Examples & Samples

Provide revenue cycle management services to client/partners in all areas of the healthcare revenue cycle which includes
Proficient personal computer skills, including Microsoft Office
Master's Degree in Business Administration or related field
Prior Revenue Cycle hospital based provider consulting or revenue cycle management experience

227

Revenue Cycle Consultant Resume Examples & Samples

A minimum of 5 years of experience in billing and coding for physician offices and/or healthcare facilities
Must possess presentation skills
Proficiency in Microsoft products required
Oral communication skills needed to develop rapport with physicians, office managers, staff and internal & external customers
Written communication skills necessary for written reports, physician communication, and both internal and external customer communications
Presentation skills for classroom settings as well as one-on-one presentations
Demonstrated customer service skills including; conflict resolution, employee relations, and maintaining client satisfaction
Excellent organizational skills and the ability to manage multiple tasks/projects simultaneously
A positive, results oriented approach to problem solving is needed
Ability to travel by automobile or plane as needed

228

Director of Financial Ops / Revenue Cycle Resume Examples & Samples

Developing department capital and operative budget with assistance of the CBO Director of Operations, CFO and staff
Maintains department operations within budgetary guidelines
Monitors employee productivity on an ongoing basis
Accepts supervisory responsibilities inherent in position
Demonstrates ability to initiate planned change in department, due to change in workload, schedule changes, or emergency situations and reallocates staff appropriately
Extends special attention and sensitivity to all patients, visitors, physicians and fellow employees
Assists in maintaining an atmosphere of cooperation with other departments and allied professionals
Actively participates in an encourages actions that promote good public relations with patients, families, visitors and the community
Accepts changes as an opportunity for growth, learning and development; adapts to changing procedures and goals in a cooperative and positive manner
Responsible for daily operations of the Patient Accounting areas and functions. Accepts supervisory responsibilities inherent in position
Demonstrates responsibility in Professional Growth and Development
Supports the attainment of facility goals and the CBO
Assists the CBO Director of Operations in preparing the operating and capital budget utilizing cost effective strategies
Company 401K
Medical, dental, vision insurance
Paid time-off

229

Associate VP of Revenue Cycle Operations Resume Examples & Samples

Responsible for achievement of client service level agreement targets including Cash, A/R, Denial, and Bad Debt targets
Work closely with the VP of Service Center Operations to communicate and report results
Oversees and monitors progress against specific business goals and cost containment efforts
Leads team in day to day operations of specific functional responsibilities
Performs duties and job responsibilities in a manner that supports the mission, vision and values of Optum360
Oversees the monthly results and planning
Ensures that financial analyses, financial forecasts and routine reports are completed accurately and within established schedules for operational areas
Identifies and provides implementation recommendations and administration concerning means for reducing costs and/or increasing revenue based on market trends and industry operating procedures
Participates in the development of short and long term objectives that will assure the continued growth of Optum360 and the provision of healthcare services required by the community
Monitors performance and communicates with Information Technology management to ensure optimal use of installed technology, planned system conversions and identify future needs
Practices and adheres to the Mission and Values of Optum360
May require travel between the various locations, occasional travel out of the area and travel to outside offices
College degree or equivalent experience managing large scale healthcare operation
Experience managing $1B + in billed AR
10 or more years of revenue cycle management experience with five or more years of leadership
Broad experience with RCM operations, people leadership, and transition / change management
Industry knowledge
Proficient in packaging PowerPoint presentations summarizing outcomes
PC skills in Microsoft Office applications and others as required
Project management experience - administering tools and processes to identify and communicate project goals, schedules, responsibilities, progress and performance
Managed Care financial and operational experience
Consulting experience in areas of business transformation, finance re-engineering, shared services, change management and project management
Health Plan Operations
Healthcare provider service background
Ability to execute large scale transition while monitoring ongoing changes for performance impact
Ability to earn respect and trust of facility CFOs and other external customers

230

Intern Revenue Cycle Operations Resume Examples & Samples

Currently has a bachelor degree or in a bachelor degree program
Previous internship or work experience preferred
Passion for solving complex challenges facing the US healthcare industry
Superior oral and written communication skills
Working knowledge of Microsoft Word, Excel, and PowerPoint
Knowledge of Business analytics, SQL or CCL a plus
Ability to travel within Southeastern Wisconsin
Strong Conceptual, qualitative and quantitative skills
Work as a member of a team as well as a self-motivated independent
Regularly uses close visual acuity and operates computer equipment to analyze and transmit data
Generally work in an office environment

231

Revenue Cycle Overpayment Resolution Manager Resume Examples & Samples

Minimum 3 years management experience preferably in a multi-site/multi-state environment
Preferred experience in a healthcare setting
Strong call center operational knowledge
Ability to work simultaneously with multiple systems
Strong team-building skills
Excellent written skills
Excellent verbal skills
Ability to Identify Trends
Ability to build and maintain internal and external relationships
Proven track record of inventory management and account resolution
Proven track record managing staff productivity and quality
Proven track record of successful process improvement in account resolution
* ONLY CANDIDATES WITH SALARY REQUIREMENTS LISTED WILL BE CONSIDERED***

232

Revenue Cycle Billingmanager Resume Examples & Samples

Identify, research, and resolve outstanding billings and collections issues as necessary
Contribute to the development and implementation of policies and procedures within the assigned function(s): ensuring compliance with company policies and procedures, Sarbanes-Oxley Act (SOX), and other regulatory requirements
May support process reviews, business process analyses and internal control monitoring to ensure compliance with the specifications of SOX within assigned function(s)
May support internal and external audits as necessary
Act as an SME by providing support, guidance and expertise on diverse issues within assigned function(s)
Serve as a liaison to cross-divisional teams and management as necessary; managing cross-divisional team communication and ensuring effective dissemination of information
Strong working knowledge Generally Accepted Accounting Principles (GAAP) and SOX

233

Spvr Revenue Cycle IV / FC Resume Examples & Samples

Supervises day-to-day operations as they relate to hospital billing, registration, admitting, and office management, as applicable
Analyzes, recommends, implements and monitors approved work-flow changes
Ensures comprehensive authorizations are obtained for services provided. Collaborates with clinical personnel in obtaining authorizations and contacts insurance companies, as needed
Ensures compliance with Department of Health regulations as they pertain to completion and filing of death certificates and termination certificates
Maintains daily workflow in order to expedite processing while ensuring quality, accuracy and customer service
Monitors the inpatient and outpatient registrations for Quality Assurance
Supervises, hires, trains, disciplines and evaluates staff
High School Diploma or equivalent, required. Knowledge of management, computer systems, and third party reimbursement as normally acquired through completion of a Bachelor’s Degree in Health Care, Business or Public Administration
Proficiency in Excel and Microsoft applications, required
Outstanding written and verbal communication skills. Ability to articulate departmental policies and procedures clearly too all levels of staff

234

Administrator, Revenue Cycle Operations Resume Examples & Samples

636 licensed inpatient beds
Emergency medicine
Surgical services
Ambulatory surgery services
Skilled nursing units
Cardiology services including emergency and elective angioplasty
Oncology services from diagnosis to treatment
Orthopedic services including joint replacements
Bariatric Surgery Center of Excellence
Birthing centers
Outpatient diagnostic imaging
Geriatric assessment
Primary and family care practices
Adult day care
Mental health and chemical dependency programs
Diabetes program
Wound care
Outpatient infusion services
Physical, occupational and speech therapy
Hospitalist services
Rape intervention and support services
Community screenings and support groups
BS/BA in Business Administration, Accounting, Finance or a related field,; MBA preferred
Minimum 7 - 10 years of progressive responsibility in a related healthcare field (hospital and/or provider based)

235

Manager Hospital Revenue Cycle Resume Examples & Samples

Manages, coordinates or participates in a wide variety of operational and personnel functions related to Insurance Verification, Medicaid Application Services, Registration Services, Cash Operations, EC2000 and other related front-end and billing processes
Includes scheduled as well as emergent services for inpatient, outpatient and ambulatory surgical encounters
Plans & directs day-to-day operations
Key player in the development and implementation of revenue cycle improvement processes as well as metrics to measure performance. Participates in quality assessment & continuous quality improvement activities
Performs other responsibilities to ensure an efficient and customer-focused operation
Prior supervisory/management experience is required. A minimum of five (5) years of revenue cycle experience including but not limited to billing, registration/ insurance verification, point of service collection related experience is required
Comprehensive knowledge of a wide range of revenue cycle processes is preferred
Proficient knowledge of Word, Excel, Access Database, Windows, and the Internet. Ability to create, analyze and interpret reports and spread sheets. Must have the ability to independently organize and prioritize responsibilities; problem solve and implement solution based ideas
Ability to effectively work and adapt to a wide variety of different staffs, environments and situations. Ability to interact with leadership, staff, patients and visitors of various social-economic backgrounds
Coach and mentor staff in a positive manner. Must have excellent customer service skills and ability to interact with nurses, physicians, patients, families, agencies, and the Department of Human Services. Comprehensive knowledge of state and government billing standards as it relates to insurances for but not limited to, Motor Vehicle accidents, Workmen Compensation, Medicaid, Group Health Plans, BCBS and Medicare
Must have excellent written & verbal communication skills & strong facilitative interpersonal skills

236

One Revenue Cycle Business Analyst Resume Examples & Samples

Bachelor’s degree -or- equivalent combination of education and experience
2 years of Application Support or Business Analysis experience, with demonstrated problem solving skills
5 years Industry Related Experience with 3 years being in Healthcare Revenue Cycle or other applicable Business experience
Prior Epic experience (certification a plus)

237

Revenue Cycle Rep-business Office CBO Resume Examples & Samples

Advanced knowledge of third-party insurance in regards to plan types: HMO, PPO, POS, and Indemnity
Excellent knowledge of the Medicare Program particularly as it relates to CPT and ICD9 coding CPT. Thorough knowledge of Medicare Fraud and Abuse regulations
Possesses advanced knowledge of the Practice Management System. Possesses the ability to run standard reports in order to answer questions from practice manager and physicians
Possess thorough knowledge of HIPAA regulations

238

Revenue Cycle Supervisor Resume Examples & Samples

Consolidates/communicates problems within the Accounts Receivable (AR) and EDI Teams to the Revenue Cycle Managers and works with the Revenue Cycle Managers to resolve such problems
Assists with changes and/or improvements to AR and EDI internal processes, policies and procedures
Performs AR and EDI Team daily tasks
Reviews AR reports and EDI rejections and develops plan of action and changes in work flow to improve revenue cycle and reduce timeline for claim payment
Sets up patient appointments with Patient Services Department when needed
Works directly with other West Clinic Departments to improve the revenue cycle
Works with payers, EMR company and clearing house to improve revenue cycle
Reviews EOBone for unpaid or incorrectly paid claims
Develops procedures and policies AR and EDI
Works in conjunction with MLH to create charity write-offs for mutual patients
Assists with training/education processes, particularly AR and EDI personnel as needed

239

Revenue Cycle Director Resume Examples & Samples

Bachelor's Degree in healthcare, finance, or related field required
Understanding of CPT, HCPCS, APC, DRGs, and OPPS/IPPS required
Highly motivated team player who demonstrates competency in working in teams and ability to effectively communicate with all levels as well as the ability to prioritize and work multiple projects simultaneously
Demonstrated leadership in creating and implementing new processes
Must possess a high level of interpersonal skills and strong analytical and financial abilities
A minimum of 7 years' of progressive experience in health care management such as but not limited to clinic management, patient management, accounts receivables and payables
A minimum of 2-5 years of experience serving the role of revenue cycle director directly reporting to a system CFO of finance team
Willingness to work flexible hours

240

Healthcare Revenue Cycle Supervisor Resume Examples & Samples

Produce monthly statistical reports for management on billing-related tasks; maintain statistics for quarterly and annual reporting
Knowledge and ability to lead teams in process redesign/change management
Conduct bill revenue and cash analysis to identify areas of opportunity for revenue enhancement
Implement, monitor, and revise annual goals, objectives, and performance standards including team metrics
Monitor, track, and evaluate staff productivity and performance and provide summary report to management
Overseeing department training and individual development
Collaborate with IT to development system enhancements and automation opportunities
Strong organizational skills with the ability to work on multiple, complex projects with high quality results

241

PFS Revenue Cycle Representative Resume Examples & Samples

Review and correct all billable claims in billing software in accordance with payor specific guidelines and billing requirements within one working day
Work with HIM and applicable departments to resolve questions related to modifiers, orphan CPT/HCPCS codes, charge entry errors, ICD-9 and CPT/HCPCS coding errors, and other questionable claim form elements such as discharge disposition
Perform timely and appropriate follow-up to resolve unbillable claims. Using Interpoint, document in account notes all reasons for billing delays and actions taken. Apply the appropriate hold reason code in billing software
Process secondary billing in accordance with department procedures
Every time an account is accessed, review and correct all account discrepancies, update demographics and other field values such as mnemonic, insurance and billing information, etc., to ensure data integrity in Cerner/Meditech as well as in the billing software
Review all high dollar claims for potential stop-loss criteria and direct stop-loss claims to correct payor processing unit
Prepare and submit appropriate billing attachments as required by specific payors
Mail paper claims to appropriate payors
Review daily claim rejection reports, resolve rejection issues, and resubmit corrected claims to ACS within 24 hours of rejection
Collaborate with manager to resolve claim submission delays exceeding five working days
Inform manager of recurring claim errors in order to facilitate system improvements
Review and resolve non-covered charges according to facility procedures
Review late charge report. Submit late charge or adjustment claims, or write off late charges as appropriate per facility procedures
Review assigned Interpoint worklists to ensure appropriate and timely actions are completed
Review and respond to mail, correspondence and reports on a daily basis
Validate that all charges and/or accounts have been combined in accordance with regulations prior to claim submission
Request and submit interim claims on long-term care inpatients every 30 days
Perform timely and appropriate follow-up on unpaid, underpaid, suspended, and denied accounts
Review credit balance accounts and take appropriate action to resolve the credit balance
Review remittance advices to ensure payments are correct for services rendered and resolve payment discrepancies
Submit adjustment request to reduce account balance for “not medically necessary” (failed) services where an ABN was not obtained
Document payment details in patient account notes according to EOB documentation standards
Evaluate EOBs and remittance advices by comparing amount paid against the expected reimbursement amount
Evaluate denials to determine if appeals are warranted
Submit adjustment requests as necessary to ensure that contractual discount amounts are correct according to contract terms
Close carrier on correctly paid accounts when patient owes a share of cost (SOC), update financial class to next carrier and validate that account balance matches total patient responsibility amount as determined by Medi-Cal
Escalate unresolved or unreasonably delayed appeals to Manager for special handling and/or assessment
Utilize all available tools and resources to perform follow-up in the most efficient manner electronic transactions, Internet, phone calls, etc
Submit denial adjustments on denied amounts not likely to be paid on appeal, if not billable to a subsequent payor
Understand and comply with all current Medi-Cal regulations
Work with departmental staff, hospital departments, physicians, physician’s office staff, government agency and insurance company representatives, patients, consultants and co-workers
Maintain confidentiality of all patient information
Ensure all billing documentation required by payers, including but not limited to CPT-4, HCPCS and ICD-9 coding, prior authorization, provider identifications, primary and secondary insurance, patient demographics, insured identification, charges and dates of service are complete and correct
Complete claims submission on a daily basis
Follow-up on 50 accounts per day. Follow-up is defined as activity performed that creates account resolution
Percentage of accounts receivable > 60 days must remain below 36.0% of the total outstanding Medi-Cal balance on a monthly basis
Percentage of accounts receivable > 90 days must remain below 15.0% of the total outstanding Medi-Cal balance on a monthly basis
Percentage of accounts receivable > 120 days must remain below 10.0% of the total outstanding Medi-Cal balance on a monthly basis
Percentage of accounts receivable > 180 days must remain below 6.0% of the total outstanding Medi-Cal balance on a monthly basis
Ability to follow oral and written instructions and interpret institutional and other policies accurately
Knowledge and appropriate use of electronic claims billing system
Ability to work effectively with individuals at all levels of the organization
Knowledge insurance and medical terminology
Knowledge of accounts receivable system like SMS, IDX, or Meditech
Knowledge of computer systems and software used in functional area
Knowledge of one or more of the following: Medicare, Medi-Cal, Worker's Comp or Managed Care (HMO,PPO,POS, etc)

242

VP, Revenue Cycle Resume Examples & Samples

Responsible for all aspects associated with planning and delivering of the highest quality customer focused Revenue Cycle (over $1b net patient revenue) through a combination of direct and indirect oversight of the various revenue cycle departments
Directly supervises day-to-day activities of the City of Hope National Medical Center revenue cycle staff and 3rd Party revenue cycle service providers, as well as provide oversight of the revenue cycle across the wider network to ensure that processes are coordinated and end-to-end performance is optimized
Functions as a change agent; leads the enterprise-wide development and implementation of revenue cycle strategies that are optimal and consistent with best practice processes
Provides support and information to the medical staff with regards to health information with the goals of optimizing revenue and promoting billing compliance
Assesses and responds to current and future internal and external healthcare trends in order to establish and ensure the necessary direction for the revenue cycle activities
Ensures Revenue cycle goals including Medical Center A/R days, cash and bad debt are delivered
Responsible for coordinating and enhancing the development of data collection, analysis and reporting processes for senior management of the revenue cycle, including information integrity validation and interpretation
Oversee the financial interface between and performance analysis of the patient financial services functions and other fiscal services functions
Maintain a collaborative supporting relationship with other management staff across the network and encourage direct reports to do likewise to ensure integration of patient processes that will achieve optimal patient and financial outcomes
Directly participate in completion of various financial forecasts, including cost center salary and direct expenses, month-end financial reporting, receivables, cost center productivity, and strategic plans for the department
Lead Monthly Revenue Cycle Steering Committee Meetings, Participate in revenue cycle, denial management, charge master, and access management meetings
Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
Bachelor’s Degree in Finance, Accounting, Economics or related field required
Must have a minimum of ten (10) years of experience in a financial leadership role and demonstrated experience in a leadership role in hospital revenue cycle management
Must be proficient in MS Office Suite, PeopleSoft and EPIC
Thinks strategically; develops and operationalizes plans in accordance with the organization’s mission
Demonstrated understanding of healthcare financing, strategy, community benefit, and charity care
Exhibits strong executive presence, outstanding written and verbal communications skills, and public speaking skills
Displays a passion for healthcare and for making a difference. Expresses commitment to City of Hope’s mission, personally identifies with its vision
High ethics and strong set of values. Unwavering integrity. Demonstrated courage
Exhibits flexibility while influencing others and is open-minded on alternative means of getting needed business results; excellent negotiation capabilities
Anticipates needs, responds quickly, provides guidance and support, monitors and follows up as required
Approaches change by accomplishing milestones and works with and through others to drive change
Able to handle stressful situations yet remain calm in crisis
Master’s Degree in Business, Finance, Accounting, Economics or related field

243

Senior Revenue Cycle System Analyst Resume Examples & Samples

Acts a liaison among stakeholders to identify opportunities and support efforts to develop and maintain all assigned applications to better meet the needs of the end user
Maintains a working knowledge of all assigned application structures, and operating practices. Understands each application’s purpose and how it supports the end user’s needs
Performs the daily maintenance operations necessary for the effective and efficient use of the application
Initiates all additions and modifications to the application’s table structure after completion of appropriate testing and receipt of necessary approval
Investigates business system issues, identifies opportunities for improvement and in conjunction with Information Systems develops and implements a plan to resolve or address
Performs integration and acceptance testing, supports the development of training and implementation materials and accepts and addresses customer feedback about the provided service utilizing quality measures
Performs data analysis and reporting by extracting data, preparing reports, graphics and analysis as needed to ensure operating processes are conducted and completed in an accurate and efficient manner. Works with management on process improvement efforts which are based on data results that are impacting financial outcomes, including the need for staff retraining and/or process flow modifications
Identifies, troubleshoots and oversees the resolution of application functionality issues
Responsible for leading projects related to the management and coordination of complete and accurate system data collection, claims analysis, and issue resolution
Identifies opportunities for process improvement changes and makes recommendations to Director Revenue Cycle
2+ years of experience in writing business and / or system requirements and business / finance analysis
2+ years of experience with documenting processes and practices in an revenue cycle operational setting
2+ years of MS4 Experience or similar programs such as Meditech or Epic or others
2+ years of Revenue cycle experience from an Acute Care Setting
Bachelor's degree in Business, Finance, Health Administration or related field or equivalent work experience
2+ years of Cerner Experience
Previous experience with SQL
Previous Healthcare Industry experience
Previous Team Lead or Project Lead experience

244

Supervisor, Revenue Cycle Resume Examples & Samples

Full time Supervisor for weekend and holiday staff of 27 - 30
Serve as floating supervisor during the week for a staff of up to 92 team members
Supervise and manage the Registration and Insurance Verifications as well as Patient Accounting
2 or more years of experience in patient accounting, patient registration, insurance verification and/or patient access
5 or more years of experience in a healthcare setting
Proficiency in Excel, Word , PowerPoint and Outlook
Must be able to work weekends and holidays
BA Degree
Union Experience
Hospital experience

245

G-revenue Cycle Management Associate Resume Examples & Samples

Open, deliver, route, scan, log and process incoming correspondence (faxes, mail, emails, return mail/email)
Investigate and process billing, service order, collections, payment and audit/control related systems exceptions for timely and accurate revenue recognition
Excellent communication skills with external customers, vendors and other employees
Solid math skills
Ability to investigate, review and reconcile financial transactions
High School Diploma (Associate’s Degree preferred)
1-3 years of Customer Service or Financial Business Experience in an office setting
Demonstrated experience of common business applications such as Microsoft Office (MS Word, MS Excel, MS Outlook)
Must possess excellent interpersonal verbal and written communication skills
Satisfactory completion of validated skills testing, as determined by the Company

246

VP, Revenue Cycle Resume Examples & Samples

Builds a world-class outsourcing office through strategic hires, mentorship, and establishing a culture of accountability
Promotes a service-oriented culture within the Winston-Salem office and assures client satisfaction with the quality of the AR services performed and feedback provided
Meets regularly with all clients to review project results, identify improvement opportunities and communicate financial impact
Assures satisfaction among customer groups with the quality and amount of support provided by monitoring and responding appropriately to outcomes and feedback
Responsible for reporting any detected trends in payments or denials, as well as procedural problems, to the client
Makes recommendations regarding the correction of these trends and/or problems
Manages and balances future business opportunities with required resources to maintain excellent service delivery
Continually seeks ways and means for improving the delivery and support of AR services performed in Winston-Salem
Establishes and tracks key metrics for project success such as: imports, bills, touches, untouched accounts, productivity, quality, collections, etc
Establish productivity monitoring for billing and collection follow-up staff to maximize resources and results
Set processes and tools in place to consistently achieve monthly cash and margin goals
Maintain a current working knowledge of all patient financial and healthcare related issues and regulations
BA/BS in business or related concentration
7 years’ experience in the healthcare industry including 4 years’ experience leading a large Accounts Receivable team
Hands-on experience and oversight for the billing, follow-up, cash application, and customer service areas, including the ability to represent the revenue cycle at all levels of the organization
Experience in client facing at C Suite level
Solid understanding of the revenue cycle industry
Thorough knowledge of AR services drivers in a healthcare system / IDN setting
Execution-oriented and able to thrive within a fast paced environment
Strong financial acumen; ability to develop budgets, forecast revenue, develop early warning signs and adapt the organization to achieve financial targets
Superior analytic and problem solving skills
Solid knowledge of all MS Office Products
Demonstrated leadership and organizational skills with the ability to facilitate and influence decisions by motivating others to achieve excellence in both the quality of work and their approach to team work
Graduate degree, preferred

247

Cerner Revenue Cycle Resume Examples & Samples

Has 3 years minimum experience in managing Cerner Millennium Charge Services as it relates to Clinical Charge Capture
Expert Knowledge in Cerner Millennium Alpha Billing within PowerChart
Functional Knowledge of the cspricingtool and cstiermaint
Functional Knowledge of how to monitor and resolve Suspended Charges in Cerner Millennium
Functional Knowledge of how charges get dropped or created in Cerner Millennium and then interfaced into a foreign system

248

Revenue Cycle Denial Analyst Resume Examples & Samples

Responsible for prioritizing and managing to resolution denied claims with third party payers. Research, develop and maintain a solid understanding of payer requirements, including filing limit, claim processing logic, coordination of benefits requirements, patient responsibility and authorization requirements
Ability to triage denied claims to identify those that should be appealed. Responsible for writing timely, comprehensive and compelling appeals to third party payers in order to get denial overturned. Responsible for timely follow up on filed appeals via telephone, writing, or the payer website
Organizes, maintains and updates the access payer database to house the issues that need to be addressed with third party insurers, as well as maintaining an expert knowledge of the history of prior disputes and problems to prevent them from recurrence. Applies findings to internal systems and workflows such as pre-billing edits and system automation
Performs ongoing analysis to determine the root cause of denials and makes well thought out recommendations for workflow, operations or systemic changes. Maintains action plans for improvements
Compiles, maintains and distributes reports to management on success of appeals and root cause analysis. Serves as department resource related to denials and payer requirements
High School diploma or GED required. Bachelor's degree preferred
1-3 years related work experience required
Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases
3 -5 years Healthcare related experience
Problem Solving:Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues
Independence of Action:Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager
Written Communications:Ability to communicate clearly and effectively in written English with internal and external customers
Oral Communications:Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers
Team Work:Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments
Customer Service:Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations

249

Revenue Cycle Epic Applications Manager Resume Examples & Samples

Partners with subject matter experts and other Electronic Health Record (EHR) AMs to ensure build consistency and successful end to end patient centric workflow
Identifies and plans appropriate training for team members and leads the team in attaining a high level of application knowledge
Responsible for implementing, administering, and supporting assigned systems under the minimal guidance of senior members of the team
Minimum of 3 years of management/supervisory experience with demonstrated experience in information system development and advanced management practices
Experience with implementing and supporting a major system in a clinical or system analyst capacity
Epic implementation experience
Understanding of Epic modules, ancillary systems, and health system operations

250

Revenue Cycle Financial Analyst Resume Examples & Samples

Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products, processes and technologies
Bachelors degree in Business, Finance, Health Administration, related field or equivalent work experience
2+ years of healthcare experience
1 +year of experience in business / finance including analysis experience with a solid understanding of data storage structures
1+ year of experience with project methodology (requirements, design, development, test and implementation)
2+ years of revenue cycle experience

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