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12/07-Present St. Christopher’s Hospital for Children, Philadelphia, PA
Revenue Cycle Management Decision Support Data Analyst
o Perform data collection, tracking and analytical duties in support of revenue cycle operations and third-party contracting compliance supporting the decision making process of leadership.
o Serve as a key resource in the design, deployment and ongoing utilization of the analyzer and other systems for data management.
o Responsible for ongoing development, maintenance and reporting of executive summary reporting as well as detailed key revenue cycle indicators, MIQ Reports and contract performance metrics, as well as various adhoc data requests.
o Provide assistance and support to the management team in addressing any identified special project within Revenue Services- including troubleshooting reporting issues, evaluating receivables performance, coordinating special analysis, etc.-all with the goal of optimizing receivables performance.
o Perform audits and assured contractual compliance of vendors working accounts receivables.
o Respond to key Revenue Services issues and developed reporting to support appropriate action plans from multidisciplinary perspectives.
o Ensure all reports and information are accurate, timely, and consistent and that they satisfied all executive levels’ needs.
03/07-12/07 Rockland Orthopedics and Sports Medicine Airmont, NY
Revenue Cycle Manager (Relocated to Wilmington, Delaware)
o Provided direction to billers to ensure adjudication, admissions and billing functions are being performed accurately and in compliance with established policies and procedures to achieve the goals as defined by the practice administrator through delegating responsibilities and hands on activities.
o Responsible for receivables, coding, collections, dealing with insurance companies, collections, overseeing EOB postings, assisted and trained billers & front desk personnel.
o Monitored quality of work and productivity on a daily basis to provide coaching and mentoring to associates to ensure work quality and maximize reimbursement.
o Established specific associate goals, department wide goals and performance tracking.
o Worked with practice administrator to identify, interview, hire and train new associates.
o Conducted follow up training with associates in groups or one-on-one to ensure new policies and procedures are implemented timely and accurately within the department.
o Acted as the first line of management resolution in handling escalated calls from patients, payors or staff to ensure proper resolution.
o Managed Revenue Cycle and prepared various reimbursement and AR Analysis
o Significantly reduced accounts receivable for the practice.
o Reviewed all open accounts receivable on a regular basis
o Identified target problem with payers and accounts and developed solutions.
o Reviewed and renegotiated payer agreements and insurance contracts and ensured reimbursement.
o Coordinated insurance grievances and appeals.

08/05-03/07 The Whole Heart Center Cardiology New York, NY
Revenue Cycle Consultant (Contract/Freelance)
o Managed all operations, billing/collections and staff.
o Resolved problems and errors in electronic file data.
o Analyzed encounter processes, identified inefficiencies and discrepancies and made recommendations for change.
o Assisted in the implementing and monitoring of risk and delegated arrangements.
o Assisted in the development of work-flows for use by internal staff as well as delegates to facilitate and implement quality improvement initiatives.
o Communicated updates and findings in person and via email to all levels of management.
o Attended and participated in IPA meetings (monthly/daily) and conference calls.
o Performed cost/benefit analyses to determine areas for business improvement.
o Directed the companies’ reimbursement and negotiation strategies.
o Ensured consistency in adherence to medical center policies and procedures.
o Managed daily operations of the Billing Department for outpatient receivables.
o Responsible for the activities involving reviewing and posting of the electronic remittances.
o Responsible for supervision of staff and coordination of personnel training, review of policy and procedures and in service of departmental and system guidelines.
o Responsible for collection of specific Financial Reports and review of
reports to work on account adjudication and claim denials.
o Responsible for productivity standards and strategic planning to
optimize collections.
o Responsible for monitoring outside vendor activities and collections.
o Scheduled routine staff meetings, developing written policies and procedures.
o Provided audit methods and procedures of front and back end billing functions to improve efficiency.
o Update staff on current coding issues and communicate to billing vendor appropriate information.
o Responsible for employee performance appraisals on an annual basis.
o Responsible for the strategic and tactical direction of all activities related
to specific healthcare service categories, i.e. Mental health services, OB/GYN, Internal Medicine, ENT, etc.
o Overall leadership in all aspects of the department, including operations,
strategic planning, business development, finance, physician compensation and reimbursement.
o Directed the companies’ reimbursement and negotiation strategies.
o Provided direction to management level positions and working across departments.
o Directed and assisted in timely and accurate implementation of several programs simultaneously.
o Responsible for medical and business information systems, grants administration, development, regulatory and institutional compliance.
o Worked with providers and health plans to design and implement new health service delivery models for high cost Medicaid cases.
o Managed consortium activities to promote information sharing and problem solving.
o Monitored project activities, assist with evaluation, and document lessons learned from implementation process.
o Promoted dissemination of project activities through drafting and making presentations at conferences and meetings.
o Screened & interviewed all prospective candidates for established positions and made recommendations for employment.
o Developed and implemented new policies and procedures for the improvement of
patient service and collaborative team efforts among department staff.
o Trained new technician and reception staff on the departments’ standard operating procedures.
o Ensured environmental & procedural compliance to JCAHO & NYS DOH standards.
8/04-8/05 H&D Physical Therapy New York, NY
Revenue Cycle Director (Practice Merged)
o Managed all operations, billing/collections and staff for Multi-Site Physical Therapy Practices.
o Actively served on the Board of Directors as well as the IT Board.
o Coordinated and prioritized staff responsibilities and schedules.
o Initialized and implemented authorization procedure.
o Obtained authorization for in network treatment for patients with no out of network benefits.
o Monitored and assessed quality assurance with all staff to ensure maximum reimbursement.
o Through comprehensive analysis of monthly reports, made recommendations regarding budgeting and finances.
o Increase accounts receivables to a 90% intake, while minimizing write-offs.
o Decrease write-offs to 10% adjustments.
o Implemented training procedure for new hire as well as established staff.
o Conducted cost benefit analysis for practice.
o Monitored and ensured compliance with all applicable government and funding agencies.
o Coordinated staff seminars.
o Developed and administered educational opportunities.
o Integrated outside consultants work with ongoing project management.
o Ensured practice compliance with current Medical compliance standards and HIPPA regulations.
o Analyzed and compiled statistical reports.
o Prepared client audits, ensuring all letters, case files, policies and
procedures, etc. were available for the auditor.
o Prepared any responses or necessary corrective action plans as a result of audits.
o Monitored and reported revenue received vs. revenue expected.
o Conducted on-site visits to enhance communication amongst the billing and collections department and clinics.
1994-2004 Worthington Consulting Group Norwalk, CT
Revenue Cycle Analyst (Company Merged with JMI Consulting Group)
o Actively performed practice manager and billing manager positions for hospitals, multi specialty practices, private practices and groups.
o Tri-State traveling to multi-specialty practices and hospitals analyzing financial productivity, procedure, and staff.
o Managed all key Account Reporting projects, including project plans, documentation, training, and troubleshooting.
o Reported project status and made recommendations.
o Conducted formal training sessions with key national and local accounts to ensure the client has a clear understanding of the terminology used in reporting and methods used to analyze utilization and cost trends.
o Through comprehensive analysis of quarterly reports, make key account recommendations regarding benefit plan design and purchase of medical management and disease management programs.
o Coordinated and prioritized staff responsibilities.
o Assisted in running entire account reporting unit to establish and ensure the achievement of accounts customer service, productivity and quality goals.
o Managed office stats and assignments to ensure proper coverage of reception, phones, scheduling, coding and correspondence, as well as participation in these activities.
o Coordinate and create office procedures, policies and documents.
o Successfully increased and maintained patient volume.
o Monitored quality assurance to ensure standards of quality of care and effectiveness of work.
o Managed all billing representatives including third party billing, workers compensation, no fault, liability and commercial insurance companies.
o Managed physician participation in insurance plans, HMO’s, etc. including applications for participation, renewals, physician credentialing, maintaining fee schedules, and assistance in negotiation and renegotiation of contracts.
o Monitored and ensured compliance with all applicable government and funding agencies.
o Supervised maintenance of all internal PC networks.
o Prepared requisitions and position descriptions for new and replacement staff.
o Guaranteed major projects do not exceed budgetary limits and deadlines by effective tracking of costs and schedules.

References: Available upon request.

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