Senior Financial and Operations Executive
Highly motivated business professional and accounting expert with over ten years experience in the healthcare revenue cycle management industry. Possesses a solid ability to increase collections and reimbursements while reducing denied claims and account receivable days through meticulous contract evaluations and trend analyses, seeking to leverage analytical skills and deep knowledge of insurance and governmental payer guidelines and regulations to maximize revenue opportunities.
Skill Areas: ⬥ Revenue Cycle Management ⬥ Charge Capture and Pricing⬥Charge Description Master Maintenance⬥ Contract Evaluation and Analysis ⬥ Cost Reporting ⬥ Denials Management ⬥ Regulatory Compliance ⬥ Data Mining and Analytics ⬥ Trend Analysis ⬥ Patient Billing and Collections ⬥ Account Receivable Resolution ⬥ Auditing and Appeals ⬥ Staff Training and Development ⬥ Healthcare IT Systems ⬥ Epic Electronic Medical Record Configuration and Support ⬥
CAREER HIGHLIGHTS AND ACHIEVEMENTS
● Increased net patient revenue by 8% year-over-year at UC Health through charge master maintenance activities, including developing and implementing annual price adjustments.
● Reduced missed charges by over 20% within six months at UC Health by conducting deep dives into charge capture deficiencies and implementing improved charge review protocols.
● Identified over $500K underpayments by analyzing 50,000+ claims and comparing reimbursements to expected payments based on contractual terms.
● Improved first-pass claim acceptance rate from 78% to 98% at Beckett Springs Hospital through expanded insurance verification and authorization training for 30+ patient access employees.
● Significantly reduced accounts receivable days over 90 days at Beckett Springs Hospital by implementing a variety of initiatives aimed at reducing days in AR across all payer types.
● Obtained letters of agreement for 100+ facilities and 300+ physicians while at CVP Physicians, minimizing the risk of out-of-network reimbursement issues.
● Updated over 500 fee schedule mappings across newly acquired CVP Physician practices within eight months to ensure alignment with contractual terms.
● Educated and trained financial counselors across various healthcare settings on proper insurance identification and authorization protocols.
PROFESSIONAL EXPERIENCE
UC Health – Cincinnati, OH (May 2021 – Present)
Senior Chargemaster Analyst
→ Developed and maintained an extensive charge description master across various clinical settings – inpatient, emergency, clinic, and pharmacy – with over 10,000 singular charge codes.
→ Increased net patient revenue by 8% yearly through charge code pricing analysis and implementation of impactful updates tied to organizational objectives.
→ Reduced missed charging opportunities by over 20% within six months through deep-dive analyses into charge capture gaps and new charge review protocols.
→ Provided Epic consulting and support building reports and work queues while serving as a certified application expert for revenue cycle team members.
Blue Ash, OH (Oct 2020 – May 2021)
Managed Care Analyst, CVP Physicians
→ Evaluated and updated fee schedule mappings for accurate alignment with contractual terms across over 500 schedules.
→ Provided network status information for newly acquired practices; obtained letters of agreement for 100+ facilities and 300+ physicians, preventing out-of-network reimbursement issues.
Blue Ash, OH (Apr 2019 – Oct 2020)
Revenue Recovery Analyst, Ensemble Health Partners
→ Identified over $500K in underpayments through extensive historical claim analyses comparing reimbursement to contract terms.
→ Worked collaboratively with payers to reprocess payments aligned to contract terms, correcting systematic deficiencies.
→ Analyzed write-offs to pinpoint co...
Login or Register to view the full resume.
