dsmith4548
New
HIGHLIGHTS OF QUALIFICATIONS
I. Manage, maintain and grow client accounts; developing relationships to enhance and maintain satisfaction
II. Support customer retention and contract renewal by providing on-site visits; focusing on compliance concerns, process improvement, adhering to Federal and State regulations as well as documentation guidelines support and training; travel 50-75%
III. Managed off-site revenue cycle management operations; managed a team of medical coders, billers and accounts receivable personnel
IV. Provided marketing and sales support for business development; travel 25-50%
EXPERIENCE
Client Accounts Manager; Healthcare Revenue Cycle Management; Coding and Compliance
January 2013 ? present
? Client Account Manager
■ Serves as point of contact for clients of medium to large size, independently providing high level client management services as well as ensuring client access and exposure to specialized financial, reimbursement strategic and information management services
■ Regularly conducts client meetings to review accounts receivable performance, payer issues and trends, client's business strategies; including A/R measurement statistics and payer trends, fee schedules and ad hoc financial reports
■ Performs periodic billing audits for assigned clients to ensure that utility files, billing parameters, electronic transmissions, demographic, billing, payment and insurance verification interfaces are utilized as appropriate
■ Auditing and Coding for both Physician and Facility: Interventional Radiology, Diagnostic Radiology, Pediatrics, Surgical, Women?s Health, Orthopedics, Internal Medicine, Physical Therapy, Urology, Pulmonology and Behavioral Health
■ Provide Regulatory and Compliance updates to physicians and their office staff
■ Construct agenda and educate physicians on annual changes from the AMA for their respective specialty
■ Constructs training for: Coding, Compliance, PQRI, Meaningful Use, eRx and now ICD-10.
■ Stays on top of Managed Care, State and Federal guidelines, changes to policy and trends through ongoing education provided through the entities and associations.
■ Carefully watching for variances in payor changes and denials and act when appropriate to appeal or have a discussion with the provider representative.
■ Co-manages teams of Billing Specialists in multiple locations
Business Operations Coordinator; Medical Group and Office Management; Physician Documentation and Coding Auditor
January 2012 ? September 2012
● Business Operations
○ Manages daily operations of a nineteen-provider hospitalist group
○ Supervises a staff of coding and charge entry personnel; accuracy auditing and entry timeliness
○ Develop and adhere to an annual budget
○ Performs coding and documentation audits for the practice to ensure that providers and staff stay compliant with Federal, State and Payor guidelines
○ Auditing and Coding for other in-patient specialties: Pulmonology, Cardiology, Infectious Disease and In-Patient Psychiatry
○ Provide Regulatory and Compliance updates to providers and office staff
○ New provider on-boarding and orientation
○ Hiring, termination & discipline of office staff; Payroll for providers and office staff
○ Maintain CME files for Boards, Malpractice Insurance and facility-contract adherence
○ Keep all providers up-to-date on State medical licensure, DEA licenses and Board certifications
Client Accounts Manager; Medical Group Practice Administration and Revenue Cycle Management
September 2001 ? January 2012
● Physician, Group and Facility Administration
○ Serves as point of contact for clients of medium to large size, independently providing high level client management services as well as ensuring client access and exposure to specialized financial, reimbursement strategic and information management services
○ Regularly conducts client meetings to review accounts receivable performance, payer issues and trends, client's business strategies; including A/R measurement statistics and payer trends, fee schedules and ad hoc financial reports
○ Maintains day-to-day relationships with existing clients, medium to large in size, collecting and clarifying information with the client, communicating project or program plans and progress, and answering client questions
○ Performs periodic billing audits for assigned clients to ensure that utility files, billing parameters, electronic transmissions, demographic, billing, payment and insurance verification interfaces are utilized as appropriate
○ Auditing and Coding for both Physician and Facility: Interventional Radiology, Diagnostic Radiology, Endoscopy and In-patient Pain Management consults
○ Provide Regulatory and Compliance updates to physicians and their office staff
○ Construct agenda and educate physicians on annual changes from the AMA for their respective specialty
○ Negotiate Commercial Insurance payer contracts
○ Physician credentialing and licensing
● Billing Operations and Revenue Cycle Management
○ Supervise office of Revenue Cycle Management personnel, 10+ employees, on-site and remotely (coding, demo/charge entry, payment posting, denial management, collections)
○ Ensures claims are billed in an timely and accurate manner, and in accordance to payer requirements
○ Develops procedures to reduce claims errors and ensures that denied claims are resolved in a timely manner
○ Identifies slow paying accounts and recommends a course of action to collect on past due balances
○ Provides training and development of reimbursement A/R associates and ensures that all associates are compliant with Federal, State and departmental policies
○ Helps develop, implement and monitor employee performance to measure productivity and to identify areas for improvement
○ Conducts employee reviews, coaching and counseling sessions and disciplines associates when appropriate
● Marketing & Sales Executive
Marketing: Exhibit at state chapter and national society meetings for radiology and pathology
Outside Sales: Territories including: Virginia, Maryland, Pennsylvania, Ohio and West Virginia
Prior Employment History Available Upon Request
EDUCATION
Certification: CPC (AAPC), October 2012; 80-hour Instruction completed August 2012
The Oz Principle, Steps to Accountability, May 2012
Winning Ways, six-week leadership course with Myers-Briggs Type Indicator: INTP, May 2012
ICD-10 Compliance: (AAPC) February 2014
Certification: Radiology Certified Coder (RCC) - April 2008 ? April 2014
Nominated & Appointed: Coding Subcommittee, RBMA; 2011 - 2014
Ongoing Medical Coding Updates, Governmental Regulatory Seminars & Commercial Carrier Compliance Seminars
RBMA Summits and Conferences, 2004 - 2011
Nominated & Appointed: Data Committee, RBMA; 2008 - 2009
ACR & SIR Summits and Meetings, National and Virginia, 2004 - 2012
Memberships
AAPC; American Association of Professional Coder
RBMA; Radiology Business Managers Association
Software and Office Equipment
Microsoft Windows (Office - Excel, Word, Outlook, Power Point)
Online Web Applications (Citrix, SalesForce.com, Anthem Point-of-Care, Palmetto GBA, TimeKeeper Payroll)
Healthcare Software (Merge ? Sentinel, Next Gen, MediTech, GE Centricity, EMRge )
Natural Language Processors (CodeRyte, A-Life/Optum)
Equipment (computer, scanner, fax, copier, printer, telephone)
Interests
Lee National Denim Day, Breast Cancer Fundraiser, Family/Co-Worker Organizer; 2007 - current
One Warm Coat, Winter Clothing Drive, Regional Organizer; 2007 ? current
Volunteer, RBMA & ACR State and National Meetings; 2004 - 2012
I. Manage, maintain and grow client accounts; developing relationships to enhance and maintain satisfaction
II. Support customer retention and contract renewal by providing on-site visits; focusing on compliance concerns, process improvement, adhering to Federal and State regulations as well as documentation guidelines support and training; travel 50-75%
III. Managed off-site revenue cycle management operations; managed a team of medical coders, billers and accounts receivable personnel
IV. Provided marketing and sales support for business development; travel 25-50%
EXPERIENCE
Client Accounts Manager; Healthcare Revenue Cycle Management; Coding and Compliance
January 2013 ? present
? Client Account Manager
■ Serves as point of contact for clients of medium to large size, independently providing high level client management services as well as ensuring client access and exposure to specialized financial, reimbursement strategic and information management services
■ Regularly conducts client meetings to review accounts receivable performance, payer issues and trends, client's business strategies; including A/R measurement statistics and payer trends, fee schedules and ad hoc financial reports
■ Performs periodic billing audits for assigned clients to ensure that utility files, billing parameters, electronic transmissions, demographic, billing, payment and insurance verification interfaces are utilized as appropriate
■ Auditing and Coding for both Physician and Facility: Interventional Radiology, Diagnostic Radiology, Pediatrics, Surgical, Women?s Health, Orthopedics, Internal Medicine, Physical Therapy, Urology, Pulmonology and Behavioral Health
■ Provide Regulatory and Compliance updates to physicians and their office staff
■ Construct agenda and educate physicians on annual changes from the AMA for their respective specialty
■ Constructs training for: Coding, Compliance, PQRI, Meaningful Use, eRx and now ICD-10.
■ Stays on top of Managed Care, State and Federal guidelines, changes to policy and trends through ongoing education provided through the entities and associations.
■ Carefully watching for variances in payor changes and denials and act when appropriate to appeal or have a discussion with the provider representative.
■ Co-manages teams of Billing Specialists in multiple locations
Business Operations Coordinator; Medical Group and Office Management; Physician Documentation and Coding Auditor
January 2012 ? September 2012
● Business Operations
○ Manages daily operations of a nineteen-provider hospitalist group
○ Supervises a staff of coding and charge entry personnel; accuracy auditing and entry timeliness
○ Develop and adhere to an annual budget
○ Performs coding and documentation audits for the practice to ensure that providers and staff stay compliant with Federal, State and Payor guidelines
○ Auditing and Coding for other in-patient specialties: Pulmonology, Cardiology, Infectious Disease and In-Patient Psychiatry
○ Provide Regulatory and Compliance updates to providers and office staff
○ New provider on-boarding and orientation
○ Hiring, termination & discipline of office staff; Payroll for providers and office staff
○ Maintain CME files for Boards, Malpractice Insurance and facility-contract adherence
○ Keep all providers up-to-date on State medical licensure, DEA licenses and Board certifications
Client Accounts Manager; Medical Group Practice Administration and Revenue Cycle Management
September 2001 ? January 2012
● Physician, Group and Facility Administration
○ Serves as point of contact for clients of medium to large size, independently providing high level client management services as well as ensuring client access and exposure to specialized financial, reimbursement strategic and information management services
○ Regularly conducts client meetings to review accounts receivable performance, payer issues and trends, client's business strategies; including A/R measurement statistics and payer trends, fee schedules and ad hoc financial reports
○ Maintains day-to-day relationships with existing clients, medium to large in size, collecting and clarifying information with the client, communicating project or program plans and progress, and answering client questions
○ Performs periodic billing audits for assigned clients to ensure that utility files, billing parameters, electronic transmissions, demographic, billing, payment and insurance verification interfaces are utilized as appropriate
○ Auditing and Coding for both Physician and Facility: Interventional Radiology, Diagnostic Radiology, Endoscopy and In-patient Pain Management consults
○ Provide Regulatory and Compliance updates to physicians and their office staff
○ Construct agenda and educate physicians on annual changes from the AMA for their respective specialty
○ Negotiate Commercial Insurance payer contracts
○ Physician credentialing and licensing
● Billing Operations and Revenue Cycle Management
○ Supervise office of Revenue Cycle Management personnel, 10+ employees, on-site and remotely (coding, demo/charge entry, payment posting, denial management, collections)
○ Ensures claims are billed in an timely and accurate manner, and in accordance to payer requirements
○ Develops procedures to reduce claims errors and ensures that denied claims are resolved in a timely manner
○ Identifies slow paying accounts and recommends a course of action to collect on past due balances
○ Provides training and development of reimbursement A/R associates and ensures that all associates are compliant with Federal, State and departmental policies
○ Helps develop, implement and monitor employee performance to measure productivity and to identify areas for improvement
○ Conducts employee reviews, coaching and counseling sessions and disciplines associates when appropriate
● Marketing & Sales Executive
Marketing: Exhibit at state chapter and national society meetings for radiology and pathology
Outside Sales: Territories including: Virginia, Maryland, Pennsylvania, Ohio and West Virginia
Prior Employment History Available Upon Request
EDUCATION
Certification: CPC (AAPC), October 2012; 80-hour Instruction completed August 2012
The Oz Principle, Steps to Accountability, May 2012
Winning Ways, six-week leadership course with Myers-Briggs Type Indicator: INTP, May 2012
ICD-10 Compliance: (AAPC) February 2014
Certification: Radiology Certified Coder (RCC) - April 2008 ? April 2014
Nominated & Appointed: Coding Subcommittee, RBMA; 2011 - 2014
Ongoing Medical Coding Updates, Governmental Regulatory Seminars & Commercial Carrier Compliance Seminars
RBMA Summits and Conferences, 2004 - 2011
Nominated & Appointed: Data Committee, RBMA; 2008 - 2009
ACR & SIR Summits and Meetings, National and Virginia, 2004 - 2012
Memberships
AAPC; American Association of Professional Coder
RBMA; Radiology Business Managers Association
Software and Office Equipment
Microsoft Windows (Office - Excel, Word, Outlook, Power Point)
Online Web Applications (Citrix, SalesForce.com, Anthem Point-of-Care, Palmetto GBA, TimeKeeper Payroll)
Healthcare Software (Merge ? Sentinel, Next Gen, MediTech, GE Centricity, EMRge )
Natural Language Processors (CodeRyte, A-Life/Optum)
Equipment (computer, scanner, fax, copier, printer, telephone)
Interests
Lee National Denim Day, Breast Cancer Fundraiser, Family/Co-Worker Organizer; 2007 - current
One Warm Coat, Winter Clothing Drive, Regional Organizer; 2007 ? current
Volunteer, RBMA & ACR State and National Meetings; 2004 - 2012