Joaquin R. Bermudez

JOAQUIN R. BERMUDEZ- •-• LinkedIn Will be relocating to Central Time zone as of middle of December 2023. HEALTHCARE REVENUE CYCLE MANAGEMENT LEADER CORE COMPETENCIES • • • • • • • • • • Revenue Cycle Billing Manager and Billing Director: oversee direct reports, comprehensive knowledge of revenue cycle operations and flow; with 29 yrs. in the RCM Healthcare field. Diligent communication with interpersonal at various levels and in coaching /motivating staff Acumen for Troubleshooting/Providing Billing Solutions and answers to key office personnel. Proficient and Solid Bookkeeping background KPI and metric based reports for decision-makers Organizational aptitude to lead a team or work independently. Strong Public Speaking skills and Analytical skills Working knowledge of payer reimbursement rates Skilled A/R follow-up with variety of payers along with developing payer relationships Experienced with many billing for many specialties: Peds, Internal Medicine, Family Practice, Podiatry, PT, OT, SLP, some Telemedicine, Chiropractic, Ophthalmology, and Urgent Care TECHNICAL SKILLS • • • MS-Office Applications, Excel; Outlook, .PPT, Word, Quickbooks and Quicken experience. EDI Claims (835-ERA/837-Claims transactions); Clearinghouses: Office Ally, Waystar, Navicure. Software’s: Nextgen, Medisoft, Office Practicum, Clinicient Practice Management Software’s PROFESSIONAL EXPERIENCE BILLING MANAGER THERAPY SPECIALISTS/HEALTHPRO HERITAGE, CHULA VISTA, CA For 3 Outpatient Therapy sites, with about 20 therapists (PT, OT, and SLP) 06/2019 to 04/2023 My role was to oversee the Billing Department for these outpatient clinics and to be involved or assist in the A-Z aspects of the billing workflow. Throughout my almost 4 years there, I reported to, at various times: the Clinic Director, the President Therapy Specialists/VP of Ops, and company CPA. • • • • • Within a short time of being hired, was able to assist in negotiating .5% off monthly billing service contract fee with 3rd party billing/software, representing about $20,000 in savings per year in Billing Service fees. Successfully negotiated lien PI cases with attorney offices that at times would result in $100-$120/visit payment average. Was able to deep-dive into the A/R and highlight key areas that needed more efficiency efforts from our 3rd party billing team that yielded more increased attention on our A/R. Involved in negotiating payer contracts; for one work comp payer that resulted in a $30 -$35 increase per initial visit with one W/Comp plan and $4/more per visit on follow-up visits. I provide updated information to our administrative team and clinicians with specific payer-related information: CPT Billing updates, modifiers, and other payer specific information pertinent to eligibility and billing efficiency. JOAQUIN R. BERMUDEZ- •-• LinkedIn Will be relocating to Central Time zone as of middle of December 2023. PROFESSIONAL EXPERIENCE Practice Management Healthcare Consultant & GM ADVANCED BILLING SOLUTIONS, LLC, ROGERS, AR. Nov. 2010 to Dec. 2022 My objective was to support and provide Practice Management Billing Solutions clients based on their needs, goals, or internal processes. From solo practitioners to medical groups, to being hired by a billing company. I would report to Medical Doctors, Practice Managers, and/or other key personnel based on per client. • • • • • • • • • Within a short time of working with a client, was able to negotiate a percentage reduction in fee with EHR. Was involved in helping a medical group improve their statement to patients which resulted in cleaner statements. Increased a clients’ net collections by reviewing and updating them as to their allowed amounts per specific CPT codes with their payers. Discovered for one client an error in a report in their billing program whereby the stats were not accurate Would provide KPI’s for: Net collections, Gross collections, QTD/YTD comparisons. Would review payer contracts, insurance credentialing on numerous payers. Would create and train others to use Excel Dashboard reports. Recommended and got approval for a more efficient way for remote billers to communicate with key medical staff personnel that kept PHI secure. Very familiar with Patient Eligibility verification and addressing patient account questions. Summary: With my extensive Healthcare management billing experience, along with professional references that will concur, the skills I have learned and gained, lead to being a solid contributor to a Healthcare organization for a Revenue Cycle leadership position that wants to better manage their A/R procedures and improve Days in A/R. My attention to detail and being precise at tracking KPI’s and stats necessary for a successful RCM Department, allow me to demonstrate my value and skill set. My attention to detail allows me to focus on getting to the root cause of an issue by pinpointing specific elements in the RCM process that may need improvement or change. Moreover, ran a successful Medical Billing business for 10+ yrs. along with being a VAR for a Practice Management Software. EDUCATION ATTENDED, MT. SAN JACINTO COMMUNITY COLLEGE, CA., GPA 4.0 (10/93-04/94) Courses Completed: • Computer Accounting • Principles of Accounting I and Accounting II • Medical Billing (HMO’s-W/Comp)/Electronic Medical Billing ATTENDED, HORIZON HIGH SCHOOL, CA., Some of the courses completed: • Geometry/Trigonometry • Budgeting REFERENCES UPON REQUEST