ELIZABETH GABLE
Forreston,IL
Summary
Professional Billing, and Hospital Billing Analyst with over 30+ years of experience in healthcare billing settings. Diverse management background in the health insurance and healthcare billing Strong background in Professional Billing to create contracts, fee schedules, adding new codes, pricing for new procedures, charge review, rev guardian, HB/PB estimates and charge router work ques for both Professional Billing and Hospital Billing
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Contract Analyst II
Ensemble Health Partners
07.2022 - Current
- Create and maintain PB and HB contracts for multiple health systems including testing and troubleshooting
- Meet with clients on their want/needs for contract management
- Monitored incoming contracts and service agreements for correct pricing and information.
- Assessed risks inherent in contract changes and potential impacts, informing management in detail of concerns to avoid liabilities.
- Provided training to team members on best practices in contract management, enhancing overall departmental proficiency.
- Maintained a high level of industry knowledge by staying updated on current trends and regulatory changes affecting contracts.
- Enhanced contract compliance by meticulously reviewing and analyzing contractual documents.
- Established performance metrics to monitor contract progress, enabling timely intervention when needed.
Contract Management Analyst
Medasource for Ensemble Health Partners
02.2022 - 06.2022
- Create and maintain PB and HB contracts for multiple health systems
- Achieved higher levels of contract compliance by conducting regular audits and addressing non-conformance issues swiftly.
- Enhanced internal stakeholder satisfaction by providing prompt responses to inquiries and offering guidance on contract-related matters.
- Developed comprehensive training materials for new team members, resulting in faster onboarding and increased productivity.
Senior Epic Analyst
Randstad USA for MetroHealth Systems OHIO
06.2021 - 12.2021
- Troubleshoot, consolidate, and update all Benefit Engine packages including components, component groups, adjudication formulas and table
- Redesign and rework all follow up work queues to mirror Epic’s Foundation System
- Assist with system support tickets regarding Benefit Engine
- Assist with creating service type codes for implementation of Estimates
Revenue Integrity Analyst
SwedishAmerican Health System
01.2016 - 12.2021
- Lead Benefits engine build, creation, and maintenance including attaching packages to insurance plans and creating new packages
- Professional Billing: create contracts, fee schedules, adding new codes, pricing for new procedures, charge review, revenue guardian, and charge router work ques for both Professional Billing and Hospital Billing
- Create and build charge estimates via MyChart and patient request
- Evaluate and create pricing for new services and supplies
- Create and maintain fee schedules for charging and pricing/reimbursement contracts
- Create and maintain reimbursement contracts for the hospital and physicians
- Troubleshoot problems relating to charge capture
- Integral member of cross facility team to initiate the use of patient estimates and pricing transparency at our facility
- Implemented the automation of self-pay discounts
- Complete assigned Service Now/Help desk ticket; member of the on-call team for Epic Help desk
- Conducted root cause analyses for identified issues, recommending appropriate actions for resolution and prevention of future occurrences.
- Enhanced revenue integrity by identifying billing errors and implementing corrective measures.
- Participated in ongoing professional development opportunities to stay current on industry best practices and emerging trends, applying new knowledge to enhance job performance.
- Collaborated with cross-functional teams to ensure timely and accurate billing for all services rendered.
Revenue Cycle Analyst
SwedishAmerican Health System
01.2016 - 12.2021
- Review legacy system to determine conversion to HealthLink
- Create Fee Schedules for pricing and reimbursement by payors for both hospital and physicians
- Create reimbursement contracts for payors to determine correct reimbursement for both hospital and physicians
- Create upfront warnings for referrals and prior authorizations through creation of Benefit Engine records
- Review workflows to determine consistency with UW Health Madison
- Integral member of the cross functional team responsible for successful transition from Meditech and Epic to UW Health Madison Healthlink (Epic)
- Collaborate with management to enhance contract and billing accuracy
- Collaborated with cross-functional teams to develop strategies for optimizing the revenue cycle process.
- Optimized charge capture procedures, contributing to more accurate billing statements and higher collection rates.
- Collaborated with other business analysts to streamline tasks and duties in effort to improve overall efficiency.
- Monitored daily reports, identifying trends or discrepancies that warranted further investigation or action from the revenue cycle team.
- Maintained up-to-date knowledge of payer requirements, ensuring accurate billing practices across all departments.
Education
AA - Business Administration
Highland Community College
Freeport, IL05.2023
Skills
- Microsoft office
- Ethics and integrity
- Contract reviews and edits
- Contract performance monitoring
- Verbal and written communication
- Interpersonal and written communication
- Contract analysis
- Problem-solving
- Teamwork and collaboration
- Time management
- Attention to detail
- Problem-solving abilities
- Organizational skills
Certification
Epic Systems Corporation, Benefits Engine Basics, Benefits Engine AP Claims, Resolute Professional Billing Administration for SBO, Resolute Hospital Billing Expected Reimbursement Contracts, Data Courier Mover Badge
Timeline
Contract Analyst II
Ensemble Health Partners
07.2022 - Current
Contract Management Analyst
Medasource for Ensemble Health Partners
02.2022 - 06.2022
Senior Epic Analyst
Randstad USA for MetroHealth Systems OHIO
06.2021 - 12.2021
Revenue Integrity Analyst
SwedishAmerican Health System
01.2016 - 12.2021
Revenue Cycle Analyst
SwedishAmerican Health System
01.2016 - 12.2021
Epic Systems Corporation, Benefits Engine Basics, Benefits Engine AP Claims, Resolute Professional Billing Administration for SBO, Resolute Hospital Billing Expected Reimbursement Contracts, Data Courier Mover Badge
AA - Business Administration
Highland Community College
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