Billing Manager:
Cleveland Clinic Abu Dhabi
Total years of experience :30 years, 9 Months
Billing Manager: Cleveland Clinic Abu Dhabi -July 2012 to January 2014
Worked on establishing a Billing, Collections and Denial Management departments which include EPIC Resolute build and implementation, Cross function deliverables, staffing, and creating SOP’s specific to cover 3 departments.
Hospital: Currently Under Construction. Opening March 2015
Primary Duties and Responsibilities
• Directs and manages the daily operation of the billing function to ensure that all charges are processed and billed timely and accurately.
• Managed denial issues and worked towards reducing denial risks.
• Coordinated liaison issues activity issues related to billing needs between departments.
• Worked with IT to identify and approve billing related financial reports including quality metrics.
• Supervised staff and assisted in the training of new employees.
• Ensured staffing and scheduling of staff were optimum to meet operational needs.
• Handled employee performance evaluation and feedback.
• Maintained integrity of the charge description master file to ensure accurate billing and compliance to HAAD updates.
• Insured hospital is compliant to HAAD billing regulations.
• Maintained current knowledge of health insurance business in the UAE.
• Worked to keep information current on US trends relating to healthcare insurance. Shared and trained others on those trends.
• Maintained collaborative relationship with other stakeholders within RCM including registration, HIMs, as well as clinical operations to resolve any billing deficiencies.
• Medical Records Documentation
• Maintained integrity of payer contracts and kept current on updates to change to benefit plans and communicated and trained the RCM team on those changes.
• Focused on continuous improvement of team efficiencies and RCM collection techniques to provide accelerated accounts receivable recovery.
• Created both the Departmental strategy document and the Departmental Manual.
• Drafted the Department Standard Operating Procedures for Director and CFO approvals.
Position- Revenue Data Quality Analyst-Locum Consultant-(Revenue Cycle Management)
• Helped in the identification of process changes and worked with key process owners such as Revenue Cycle Management. HIM, Registration, and Authorization to promote and support change that results in empirical sustainable improvements.
• Worked with IT to develop comprehensive reports of metrics as defined by the Director of Revenue Cycle Management. These reports are used to identify areas of the claim denial process for increase recovery percentages.
• Conducted a needs analysis to understand the inputs, outputs and critical areas of a process. Determined areas of risk and criticality. Identified key sources of data to support change proposals and monitor the effectiveness of business processes in place.
• Assisted in the developing of any education that may be related to charge capture, coding, documentation, and the reconciliation processes.
• Analyzed business and user needs, documented requirements, developed metrics for current state and suggested improvements in the workflow for use in the project plan. Analyzed researches and coordinated information to define requirements for process changes.
• Metrics - Assisted with establishing metrics for areas in which workflow improvements have been initiated. Provided analysis of prior state to current state, and suggests continuous process improvements and enhancements for the workflows addressed
• Helping in the identification of process changes and worked with key process owners such as Revenue Cycle Management, HIM, Registration, and Authorization to promote and support change that results in empirical sustainable improvements.
• Assisting IT to develop comprehensive reports of metrics as defined by the Director of Revenue Cycle Management. These reports are used to identify areas of the claim denial process for increase recovery percentages.
• Metrics - Assisted with establishing metrics for areas in which workflow improvements have been initiated. Provided analysis of prior state to current state, and suggests continuous process improvements and enhancements for the workflows addressed
PHd, in Laws with speciality in Criminology. GPA 4.0