Mandy Mendoza

Oversight of Directors and Managers across 7 hospitals including Chicago market, Dallas market and Los Angeles market. Maintaining KPI's such as cash goal, Net days to AR, days in DNFB, credit balances. Overseeing Billing and Collections for Medicare, Medi-Cal, Medicaid, Commercial and Managed Care. Oversight to specialty service lines such as Bariatric, Sub Acute, Behavioral Health, and Oncology. Working with interdisciplinary teams including Patient Access, Case Management, Physicians, Finance and top leadership. Leader of an Inpatient Authorization team to ensure and secure Inpatient authorizations were approved. Developed Power BI's to review denials trending, Authorization approval success rate, and to review accounts in debit, credit, and zero balance as well as productivity. Leading the terms and condition team to ensure accurate expected reimbursement and appeal all underpayments. Successfully met cash goals for all 5 years to date.

Lead the collection efforts for all Non Govt Managed Care for Keck Hospital, Norris Cancer Center and Verdugo HIlls Hospital. Oversaw all facets of AR with Expected reimbursement of over $500M, meeting monthly cash goals of $130M. Providing in depth analysis of AR Inventory including Net AR days, Net to 90 collection days, Denials Management, resolving Aging AR, Calculating PCR, and managing DNFB. Managed the department to ensure compliance with established Policies and Procedures. Integrating multiple software applications across facilities to improve performance and employee productivity. Maintained payer relationships to escalated outstanding AR and improve cash flow.

Oversight of Billing and Collection Managers, Supervisors, and 30 staff in a Community Hospital averaging $12M in monthly collections. Hiring, training, and monitoring staff on billing and collections best practices. In depth analysis in Net AR Days, denial management, resolving aging AR, assisting with PCR, and managing DNFB. Consisteanly meeting all KPI's, including cash goals, reducing days in AR, and reducing DNFB.

Analyze cash flow and offer insight to improve revenue growth. Assist in all system implementation including EHR, billing clearing house, Expected reimbursement software, and Visiquate AI tool. Implemented tools for ER level algorithm, Observation charging, outsourced hemodialysis charges, and all charge reconciliation across all departments. In charge of denials management and reporting to all departments. Provide daily/weekly/monthly reports such at ATB, DNFB, Late Charges, variance reports such as zero payment, zero charges, service out of date range and multiple AD HOC reports. In charge of reviewing variance between contractual rates and actual payments. Worked with multiple departments such as OB, GI, Surgery, and ED to ensure accurate charge capture.

Primary responsibility to develop and implement the Colorectal Center of Excellence with The Joint Commission. Assisted in the development and implementation of the Colorectal Surgery Institute's Strategic Plan including performance improvement projects. Worked closely with multidisciplinary teams to develop timelines and deliverables. Developed and maintained performance reports and summaries. Provide leadership in development of clinical protocols and polices. Analyzed and present data specific to the program to multiple committees. Oversee revenue cycle, CDM, charge posting, charge reconciliation , patient scheduling, and registration processes. Worked closely with the Director to ensue and improve patient and physician satisfaction.

Oversee maintenance of department charges including additional charges and deletions. Analyze new service line and IP/OP procedures, CPT and HCPCS for potential revenue. Reconcile charges on a daily basis and correct rejection as applicable. Create and modify polices and procedures relating to department and reconciliation processes. Prepare various reports relating to department revenue, charge audit status, department charge entry and reconciliation and late charges. Assist with year end financial planning. Assist with appropriate compliant Charge master and revenue capture process for new services. Educate and assist users regarding the function of the charges. Educate staff to policies and procedures.