Berniedeth Corpuz
Tuguegarao City,CAG
Summary
Meticulous Revenue Cycle Manager with strong background in continuous improvement and revenue performance analysis. Focused and organized with demonstrated success in achieving company goals through increased efficiency initiatives illustrated over 12 years of RCM success.
Diligent Revenue Cycle Manager aiming to leverage 12 years of financial reporting expertise and budget monitoring experience to add value to the team. Well-versed in billing cycle operations and revenue performance analysis.
Efficient Revenue Cycle Manager highly skilled in procedure optimization and revenue metrics analysis to increase financial performance. Aiming to utilize 12 years of account monitoring to drive profit and contribute immediate value.
Overview
12
12
years of professional experience
Work History
Revenue Cycle Manager
Lunajoy Health
04.2024 - Current
- Manage internal billing teams and external billing vendor to ensure end-to-end RCM efficiency
- Lead weekly meetings with vendor to review KPIs, resolve RCM issues, and track tasks via Asana
- Review and approve platform invoices and vendor billing invoices for accuracy and alignment with contract terms
- Perform weekly and monthly audits of front desk, billing, claims submission, payment posting, MR requests, and unbilled reports
- Monitor A/R and revenue trends to ensure targets are met and claims are submitted accurately and on time
- Collaborate with RCM Director on finance and accounting reports
- Develop and implement streamlined billing/front desk communication policies and procedures
- Research billing and coding guidelines to maintain compliance and maximize reimbursement
- Follow up on outstanding tasks in Asana and billing issues via email to ensure timely resolution
- Present monthly performance updates to the CEO and COO; hold weekly 1:1s with senior leadership
- Support credentialing team with ad hoc projects
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Created and managed financial models to evaluate corporate investments and acquisitions.
- Completed financial reporting and analysis for billing revenue cycle.
- Checked payroll, vendor payments, commissions and other accounting disbursements for accuracy and compliance.
- Created financial dashboards to provide insights into key performance indicators.
- Supported financial director with special projects and additional job duties.
- Complied with established internal controls and policies.
- Improved overall billing reporting by streamlining control processes and reporting structures.
- Established and checked coding procedures, monitored reports and updated internal files.
- Collaborated with C-level executives and stakeholders to develop long-term financial plans.
Revenue Cycle Manager
360 Clinic
10.2020 - 03.2024
- Responsible for collection, aging, establishing write-off standards and claim denial management
- Manages the billing team, auditors,AR/Denial Management and Payment posting team
- Evaluates effectiveness of the process, recommended, and implement changes to policies and procedures
- Screening, recruiting, hiring and training new staff
- Developed, implemented, and continually improved policies, processes, and procedures
- Organizes regular meeting with the Clinicians, Billing team, Business Analysts, Finance, Credentialing and client representatives
- Maintains an accurate account of all A/R and collections processes
- Established policies, procedures, guidelines and project schedules
- Responsible for providing training and analytical support to the Revenue Cycle Senior Leaders and employees
- Researches and analyzes revenue and reimbursement trends
- Reviewed and/or conducted the research needed for reimbursement management decisions for managed care contracts
- Monitors revenue cycle and reviewed with Practice Administrators monthly financial reports
- Oversees various healthcare function such as: Interpretation of Managed Care Contracts and confirmation of correct reimbursement, negotiated reimbursement from all LOA's, Pre-registration, Insurance verification, Billing, Account Follow up, Registration, Coding, POS Cash collections, Cash Posting, Bad debt, Credentialing, Medical Records, Financial Counseling, Customer Service Collections
- Analyzes the top denials and identifies solutions to increase cash and A/R days
- Reduced average days in A/R from 117 to 60 ina. 3-month time period. Increased net collections from 65% to 95%.
- Works with the clearinghouse and the payers to ensure all claims were processed and received by the insurance companies in a timely manner.
- Maintains a strong relationship with all clients and presented trends to them on a monthly basis
- Wrote policies and procedures for billing, collection, and posting.
- Built RCM dashboard & report to monitor KPI's
- Works with the EMR engineers and managers & escalated system issues
- Conducts weekly and monthly coding, billing & payment posting audits
- Assures coding is compliant and up to date
- Initiates claims, ERA & EFT enrollment for payers & coordinates with the clearinghouses
- Provides daily, weekly, and monthly RCM reports
- Monitors pricing negotiations
- Monitored and guided revenue cycle operations.
- Supported clinical team members with revenue cycle procedures and addressed issues.
- Identified discrepancies between budgetary targets and actual revenue and expenses.
- Completed financial reporting and analysis for billing revenue cycle.
SME/RCM Supervisor and Clearinghouse Liaison
Optum360
07.2015 - 10.2020
- Provide support and subject matter expertise to the billing/collection/accounts receivable department
- Coordinate,supervise and accountable for daily/weekly/monthly activities of a team of 50-100 Medical collections representative
- Coordinate work activities of team with other supervisors, managers, and departments
- Participate in the recruitment, training and staffing functions for the department to ensure timely hiring of qualified new employees, that all employees are properly trained in all aspects of their roles and that staffing levels are adequate to meet the business demand
- Provide regular coaching and feedback to team members, including formal corrective action when needed as well as completing annual performance reviews
- Identify and resolve operational problems using defined processes, expertise, and judgment
- Provide expertise and support for escalated calls and/or situations from both internal and external customers as needed
- Consistently provide practical/relevant recommendations for improvements to process or practices and participates in the implementation
- Coordinates, supervises and is accountable for the daily activities of business support, technical or production team or unit
- Impact of work is most often at the team level
- Comply with the terms and conditions of the employment contract, company policies and procedures, and all directives (such as, but not limited to, transfer and/or reassignment to different work locations.
- Identify current and potential problems in proper revenue management such as identification of trends and coming up with a solution
- Maintain good client relationships and provide customer service in line with the issues & complaints raised by the clients
- Develop policies and plans that will improve the cash flow & reduce AR aging
- Built techniques and strategies for Denial Management
- Lead the Unapplied cash Infusion teams and Waystar Enrollment liaison
- Monitor and initiate professional claims, ERA & EFT enrollments
- Developed effective improvement plans in alignment with goals and specifications.
- Conducted regular reviews of operations and identified areas for improvement.
- Generated reports detailing findings and recommendations.
- Evaluated staff performance and provided coaching to address inefficiencies.
Claim Specialists
ACS Xerox
06.2013 - 07.2015
- Followed up with customers on unresolved issues.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Reviewing and analyzing claims for accuracy, investigating any discrepancies or potential issues, and working closely with healthcare providers, insurance companies, and internal teams to resolve claim inquiries efficiently.
- Excel in leveraging technology platforms and claim processing software to streamline workflows, enhance productivity, and minimize claim denials.
- Build collaborative relationships with stakeholders, addressing inquiries, providing status updates, and offering guidance on claims-related matters.
- Committed to maximizing revenue recovery, reducing claim turnaround times, and maintaining high levels of customer satisfaction.
- Calculated adjustments, premiums and refunds.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient finances, records, and health statuses.
- Checked documentation for accuracy and validity on updated systems.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Education
Bachelor of Science - Business Administration
Cagayan State University
Tuguegarao City, Province Of Cagayan, Philippines04-2013
Skills
- Medical Billing
- Medical Coding
- Revenue Cycle Management
- Leadership
- Detail Oriented
- Technical Facilitation
- Process Improvement
- Compliance
- Reporting
- Procedure optimization
- Account monitoring
- Revenue enhancements
- Revenue optimization
- Claims management
- Data analytics
- Revenue performance
- Revenue metrics analysis
- Billing cycle performance
- Operations management
- Organizational skills
- Teamwork and collaboration
- Team management
- Relationship building and management
- Negotiation
- Payment posting
- Auditor
- Regulatory compliance monitoring
- Financial reporting oversight
- Build customer relationships
- Effective communication
Languages
English
Advanced (C1)
Timeline
Revenue Cycle Manager
Lunajoy Health
04.2024 - Current
Revenue Cycle Manager
360 Clinic
10.2020 - 03.2024
SME/RCM Supervisor and Clearinghouse Liaison
Optum360
07.2015 - 10.2020
Claim Specialists
ACS Xerox
06.2013 - 07.2015
Bachelor of Science - Business Administration
Cagayan State University
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