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Click here or scroll down to respond to this candidateCandidate's Name
Profile Highly knowledgeable and efficient Revenue Cycle Manager / Medical Practice Administrator with over 25years of experience. Proficient in Centricity, NextGen and Avatar. Extensive background in developing, recommending, and implementing operational policies and procedures for the entire practice, including direct supervision over professional, back office and clerical staff. Vast knowledge of pertinent Federal, State, and local laws and regulations pertaining to a medical practice. Expert knowledge of Revenue Cycle Operations within a physician clinic setting as it relates to processes and procedures including revenue recognition, cash reconciliations, internal controls, and basic revenue cycle-related accounting principles. QualificationsCertified Medical Office Manager (CMOM)Certified Medical Coder (CMC)Billing Software (Centricity, NextGen, Avatar)Electronic Medical Records (Centricity, NextGen)Microsoft Office (Word, Excel, Outlook,PowerPoint)QuickBooks (basics)Bilingual (Spanish)Experience Jan 2024 Present Dr. Alejandro Rocha Remote Medical Transcriptionist (Part-time)Transcribe providers dictations for patients medical records in the specialty of general healthcare.Highly organized and detail-oriented with extensive knowledge of medical terminology with a focus on accuracy and timeliness.Oct 2022 March 2024 Netsmart RemoteTeam Lead, Revenue Cycle ManagementLead team accountable for managing day-to-day billing processes and procedures for assigned clients to ensure optimal outcomes for the financial health of both Netsmart and our clients.Manage, coach, train, recognize and evaluate associates to foster a productive team environment.Build strong working relationships that balance the needs of our clients, associates and Netsmart.Address and effectively communicate client issues; escalate as appropriate.Assist with forecasting appropriate staffing based on incoming work logs.Understand and manage relevant performance indicators including days in A/R, cash/net revenue, A/R aging, denials management, credit balances.Propose, execute and complete effective KPI improvement plans.Ensure team meets productivity and quality standards and maintains healthy client relationships Aug 2018 May 2023 North Texas Allergy & Asthma Center Remote Revenue Cycle ManagerDevelop and propose revenue cycle management functions including, but not limited to, registration, medical records, chart audit, coding, billing, follow-up, cash posting, trending of denial adjustment, utilization review, compliance, and customer service.Experience and knowledge in federal, state and commercial billing, compliance and reimbursement regulations.Responsible for processing/posting ERA payments, adjustments, and denials according to insurance guidelines including working EDI claim rejections.Work claims and claim denials to ensure maximum reimbursement for services provided.Review medical record documentation to identify services provided by physicians as it pertains to claims being filed.Monitor, track, and evaluate staff productivity and performance. Identify training needs among staff and make recommendations. Communicate with staff to provide or obtain corrected or additional claim information.Up to date knowledge on all billing guidelines including appropriate submission of CPT codes, ICD-10 codes and modifiers.PHONE NUMBER AVAILABLE CellMcKinney, TX 75071 EMAIL AVAILABLEAug 2018 Apr 2023 AIR Care Allergy Respiratory & Immunology Center Plano, TX Medical Practice AdministratorManage practice for 2 physicians and 2 mid-level providers at 2 locations.Work with administration to develop budgets, marketing strategies and to implement any new business plans or growth strategies.Establish departmental organization, work priorities, workflow, and team responsibilities due to change in workload and/or schedule changes and communicate to staff accordingly.Recruiting, hiring, orientation, and managing performance for all employees.Maintain NextGen EMR/PM system and updates.Oversee all medical billing aspects of the practice including balance daily batches, post daily charges, post extract charges, post ERA and bank lockbox payments into NextGen. May 2014 - 2021 Genentech USA, Inc. San Francisco, CA Speakers Bureau ProgramSpeaker presentations related to the FDA approved uses of Genentechs products and/or non-branded product specific content. Including presentations relating to disease education, mechanisms of action, co- pays, reimbursement, or managed care and similar practice related programs.Light travel for live presentations.Aug 2009 Aug 2018 Dallas Allergy & Asthma Center Dallas, TX Medical Practice ManagerManage practice for 4 physicians to include building provider schedule templates in Centricity for optimal patient scheduling and provider efficiency.Perform recruitment, selection, appraisal, and development of staff. Remarkable knowledge of principles of supervision, training, and performance evaluation.Manage all daily operations, including patient scheduling, check in/out, posting charges, daily balancing, close batches in Centricity, employee scheduling, and back-office staff.Maintain physician credentialing (hospitals and commercial insurance). Perform routine audits regarding commercial insurance contracts and reimbursements.Conducted a detailed operations review (employee and operational expenses), netting a savings of $44,000 in my first year and an automatic $7,500 savings the second year. Implemented patient insurance verification and patient payment policies that increased in-office patient collections to 33% of all payments (2.3M in charges), that resulted in an increase of $50,000/year collected at the time of the patient visit and a decrease in A/R from 58% to 31% outstanding every month. Jan 2001 July 2009 Urology Clinics of North Texas Dallas, TX Medical Practice ManagerConsulted with individual site managers (9 divisions/190 employees) to analyze and execute strategic changes to improve the efficiency of patient care and operational procedures for the front and back-office staff.Fully directed the management of a Pediatric Urology practice with 3 doctors, 1 nurse practitioner and 3 locations. Promoted superior patient and surgical care for over 150 weekly pediatric patients through supervision of 12 administrative and back-office employees.Coordinated multiple office functions that focused on computerized scheduling, electronic billing, reimbursements, collections, accounts payable/receivable, patient records, data management, and payment plans with a demonstrated knowledge of insurance carriers, medical terminology, and CPT/ICD-9 codes.Responsible for monthly practice meetings, setting the agenda and scheduling individual meetings between Practice Manager, CEO, Physicians, back-office staff, and clerical staff to discuss the day-to-day management of the practice, implemented new policies and directives, evaluated new strategies, gathered data for monitoring and quality assurance purposes, reviewed and maintained finances and operational expenses within tight constraints.Served as primary point of contact for, and liaison between, patients, physicians, administrative staff, and back-office staff to facilitate proper lines of communication and expedient problem resolutions.Managed all daily operations, emergency, and doctor calls, check in/out, posting charges and balancing, employee scheduling to cover all locations. Managed all scheduling, including surgeries, in-office visits, Drs call and business meetings.Liaison between the practice, all surgery centers (PSC, PHOP, TIS, PHD, MCD, CMC), referring doctors and our CEO of Urology Clinics of North Texas (28 doctors). Project Manager/ Human Resource ManagerProject Manager for NextGen EPM (billing and appointment software) conversion. Trained 190 employees and implemented and coordinated the conversion for 9 divisions at 17 locations.Human Resource liaison between 9 divisions, 17 locations and 190 employees including recruitment, pre- employment screening, drug testing and background checks.Developed and maintained Employee Manual including labor laws and regulations. Dec 1996 Sept 1999 Columbia Physician Services Dallas, TX Senior Administrative AssistantSupported senior management, prepared monthly financial and operational reports for VP.Physician recruiting and contract preparations/negotiations. Human Resource AssistantPrepared benefit packages for all new employees and physicians.Responsible for all communication products and services for senior management and physicians. Assistant Office ManagerSupported office manager in all operations of a four-physician medical office.Responsible for physician on call calendars and managed care contracts. Education1989 - 1991 Southern Methodist University Dallas, TXBasics1991 - 1993 University of Texas at El Paso El Paso, TXAccounting Major |
