Sylvia Powell

Freelance Admin Support Freelancer & Project Manager

Location:United States
2 Skills
Sylvia Powell
12130 Simmons Rd. ? Jacksonville, FL 32218 ? 904-707-4226 ?

Twenty-three years experience in healthcare industry claims payment,billing, collections and provider education. Expertise in all aspects of revenue cycle optimization begin with registration to collections. Indepth knowlege of medical terminology, CPT, HCPCS and ICD9 coding. Including identifyingissues with charging and documentation, and reviews audit reports with the appropriate personnel from revenue integrity to work toward prevention of future losses.Provided quality training, staff management and prioritize work tasks effectively, within HIPAA guidelines. Quality training and mentoring within HIPPA guidelines. Exceptional communication, interpersonal and analytical skills that facilitate an excellent approach for development and management. Utilizing these talents in any role is a proficient combination for success.

? Charge Capture
? Denial Management
? Vendor Liaison
? Process Improvement & Optimization
? Training and Development
? Medical Billing & Collection
? Configuration
? Medicare SME
? System Implementation
? Medical Collections
? Project Management
? System Configuration
? Quality Assurance


Incepture Jacksonville, FL
Business Analyst, 2011 to Current

? Work on project teams that are developing or modifying moderately complex enterprise systems. Includes analysis and documentation of system requirements
and functional testing
? Analyzed business requests and understands business requirements, works with various technical staff members to determine possible solutions.
? Responsible for all artifacts and tasks produced in the Requirements and Analysis disciplines of the Rational Unified Process (RUP), including Use Cases, Business Rules, User Interface requirements, Mapping documents, Supplementary Specifications and associated diagrams.
? Developed system specifications by interpreting business requirements and transforming them into system requirements
? Lead sessions with business and IT partners
? Maintained the application, provide consultative support for, and understand interface points for Enrollment and Billing systems
? Consult with business and IT clients to resolve business and technical issues
? Meet with IT staff to ensure that designs meet business and technical requirements
? Understanding in reading and interpreting Healthcare data models
? Exposure to business intelligence tools and technologies
? Experience in metadata definition and master data analysis

Prestige Resource Consulting Jacksonville, FL
Sr. Revenue Cycle Consultant , 2008 to 2011

Meeting project milestones and achieving measurable performance outcomes. Over a 20 year experience in hospital Revenue Cycle consulting environment. Posses’ strong written and verbal communication skills. Strong financial background ability to develop budgets, forecast revenue, developed early warning signs and adapts the organization to achieve financial targets. Superior analytic and problem solving skills with an understanding of various clinical and financial operational processes within the healthcare industry. Demonstrates leadership and organizational skills with the ability to facilitate and influence decisions by motivating others to achieve excellence in both the quality of work and their approach to team work. Ability to develop and manage relationships with team members and clients.

Cobre Valley Community Hospital Globe, AZ

? Coordinates the scheduling of audits with client Representatives, to initiate the charge audit process
? Audit packages for cases selected, including itemized bills and other necessary document needed to initiate the audit process
? Ensures that accounts selected for audit are in compliance with clients internal policies and/or payor guidelines
? Coordinates or requests medical records for preparation of charge audits, including patient authorizations as defined by the client additional documentation to finalize audit. Conducts follow-up as needed.
? Documents and summarizes findings in a clear, concise, and effective manner to facilitate improvements in the charge capture process and submission of root cause analysis
? Develops and maintains professional working relationships with external customers and audit representatives
? Responsible for keying agreed upon charge audit discrepancies off accounts in the appropriate system.
? Reviewed and corrected chargemaster coding and charges in coordination with Health Information Systems and the clinical departments to reduce denials and optimize reimbursement.
? Educated ancillary departments regarding proper charging and coding.
? Created and implemented a Registration Q.A. program.
? Created and successfully implemented training programs for billing, collections, and patient access.
? After analysis of operating system and electronic billing systems, corrected crossmapping, updated software, and implemented electronic billing, posting and account statuses for all available payers. Provided excellent, offsite billing support

Revenue Cycle Consultant , 2006 to 2008
Assessing, planning implementing and directing the transformation of key revenue cycle business processes for Cap Gemini, Accenture, and Ernst & Young. Strong management skills possess a track record of successfully managing high performance. Meeting project milestones and achieving measurable performance outcomes.

Bethlehem Central Business Office Allentown, PA

? Provide client’s representatives with an orientation to the hospitals Audit Policy and Procedures
? Maintains internal systems used for tracking and reporting of findings, including but not limited to, patient accounting systems, spreadsheets, databases, and to facilitate monthly management reporting
? Created and implemented a website reference tool for Medicare billers and collectors, in order to streamline processes and increase cashflow.
? Educated ancillary departments on proper charges and coding techniques.
? Identified coding issues with Health Information Management, implementing corrective action and education.
? Identified and corrected Charge Master errors, in conjunction with the clinical departments. Provided training to avoid future errors.

Carolina’s Health System Florence, SC

? Created and implemented a quality assurance program for the Patient Financial Department, Pre-Registration, Emergency Room, Women’s Center, and Outpatient Mental Health.
? A process was initiated a document scanning process which greatly enhanced productivity. In addition to the financial departments, all ancillary departments were thoroughly trained in its uses.
? While implementing the Q.A. program, a Q.A. Officer was appointed, and given responsibility for updating and maintaining the scanning system.

Revenue Cycle Consultant 2001 to 2006

Assessing, planning implementing and directing the transformation of key revenue cycle business processes for Cap Gemini, Accenture, and Ernst & Young. Strong management skills possess a track record of successfully managing high performance. Meeting project milestones and achieving measurable performance outcomes.

SoundShore Regional Medical Center New Rochelle, NY

? Created a website reference tool for Medicare billers and collectors
? Reviewed electronic billing system, correcting mapping and errors in conjunction with IT and the vendor.
? Adheres to client Charge Audit policies, principles, and practices as they relate to billing audits
? Educated ancillary departments on proper charges and coding techniques.
Educated and assisted Medical Records with coding errors.
? Install and implemented ePremis billing system, automated 60% billing process with 85% clean clam acceptance rate.
? Trained managers and staff on new billing system features claim review, rebill and status process.

Watsonville Community Hospital Watsonville, CA

? Provided process and methodology for processing Medicare denials, RTDs, and rejected claims
? Provided training support to medical records director in resolving coding edits.
? Implemented PFS departmental training program for billing and collections.
? Maintained daily cash flow reporting and trending.
? Created implemented Q.A. program for Registration department.
? Provided charge master review and recommendations.

Laredo Medical Center Laredo, TX

? Appealed medically denied to Medicare.
? Maintained monthly a Medicare denial log.
? Review and resolved Medicare denials, returned claim and rejected claims.
? Trained and provided client billing and collections department with educational material.
? Trained and provided support to Registration department.
? Updated date of death on Social Security files.
? Updated patient MSP files.

Riverwest Medical Center Plaquemine, LA

? Developed process to appeal claims denied by Medicare for medical necessity.
? Assisted billers resolve massive unbilled claim backlog pending in SSI Billing system.
? Developed a process for PFS to resolve external and internal issues.
? Implemented PFS departmental training program for billing and collections, identifying all available resources for ongoing internal education.
? Initiated daily cash flow reporting, analysis and trending.
? Provided training support to medical records director to resolve coding edits from 3M and utilization of the daily edit report.
? Reviewed Medicare denials, RTDs, and rejected claims, and provided a process to prevent and resolve them.
? Supervised and provided support to Registration department for multiple shifts
? Created and implemented Q.A. program for Registration department.


? Captured multi-million dollars of missing cardiac and Orthopedic implants
? Increase clients total cash flow four million in one year
? Maximize billing system automation decrease Billing Department two FTE’s
? Increase client’s billing system clean claim acceptance rate from 0% to 80%
? Managed four hospitals listed as top 10 in the country
? Created, implement, and educated a quality assurance program for five national known

Computer Skills:
MS Word, Excel, PowerPoint, Access, Outlook, Visio; Oracle, SharePoint

System Experience:
Diamond, CBC, ICB, Siebel, SSPT, Code Repository,Facets, Amisys, AS400, MHS, Rims, Cigna Claims, Star Prizm, Texan, Erisco

SSI, Medical Manager, HBOC, Medisoft, HMS, IDX, Medpro, ePremis, Caremedic, Ivans, Visions, Florida Shared (FSS), Star, SMS, Medipac, Allegra, EC2000, CCSM
Skills (2) Rating
Admin Support
Project Management