Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

Karen Solberg

Southport,NC

Summary

Experienced Revenue Cycle Analyst with 20+ years of expertise in delivering technical information in easily-understood terms. Highly communicative professional with superior problem-solving and troubleshooting skills. Adept at strategizing new data assessment methods. Proficient in Excel and Word, with a strong ability to validate workflows and stay updated with insurance plan policy changes. Known for sharing best practices with management, ensuring optimal performance and success.

Overview

23
23
years of professional experience

Work History

Senior Application Analyst

Adventist Health System
07.2021 - Current
  • Enhanced user experience for clients through regular updates and maintenance of applications.
  • Enhanced revenue cycle efficiency by streamlining processes and identifying areas for improvement.
  • Coordinated with vendor partners on application development projects, ensuring seamless integration with existing systems infrastructure.
  • Collaborated with cross-functional teams to develop strategies for optimizing the revenue cycle process
  • Collaborated with operations, analysts and project managers to expedite incident resolutions.
  • Streamlined application processes by identifying inefficiencies and implementing improvements.
  • Streamlined support processes for improved end-user experience and reduced resolution times.
  • Provided support to clients and end-users, troubleshooting technical issues and resolving problems swiftly.
  • Troubleshot incidents reported by end-users to schedule system changes and identify permanent solutions.
  • Presented progress reports and project updates to stakeholders, facilitating clear communication across all levels of the organization.
  • Conducted comprehensive testing of new enhancement requests, ensuring error-free deployment and user satisfaction.
  • Facilitated the successful migration of legacy applications onto modern platforms without disrupting business operations or end-user experiences.
  • Maintained strong relationships with stakeholders by providing exceptional service and communication throughout issue resolution processes.
  • Supported end-users in navigating complex applications, guiding them through features and functions while troubleshooting issues as needed.
  • Participated in regular team meetings to discuss ongoing projects, share insights on best practices, and coordinate workload distribution among team members.
  • Developed and maintained effective client communications to guarantee client satisfaction.
  • Conducted and supported implementation delivery with client and internal departments.
  • Managed incident tracking system, ensuring accurate records and timely follow-ups on outstanding issues.

Analyst III, Revenue Cycle Analyst III

Northbay Healthcare
10.2019 - 07.2021
  • Validated results and performed quality assurance to assess accuracy of data.
  • Communicated revenue cycle information to non-technical audiences in easily-understood terms.
  • Investigated and addressed system issues to enhance usability and improve functionality.
  • Boosted information sharing by enhancing interfaces between computer systems.
  • Documented procedures and business processes and shared information with appropriate stakeholders.
  • Created well-researched presentations on revenue cycle data to deliver to upper management and executives.
  • Maximized team knowledge and productivity by training, monitoring and directing employees in application of best practices and regulatory protocols.
  • Performed system analysis, documentation, testing, implementation and user support for platform transitions.
  • Expertly extracted necessary data from records and files and assessed how it related to business operations information.
  • Identified and resolved problems through root cause analysis and research.
  • Wrote and distributed to senior management quarterly evaluations of revenue cycle processes, including recommendations.
  • Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
  • Managed multiple projects simultaneously while adhering to strict deadlines and quality standards.
  • Collected, arranged, and input information into database system.
  • Helped meet changing demands by recommending improvements to business systems or procedures.
  • Cultivated positive relationships with vendors to deliver timely and cost-effective supply of services and materials.
  • Provided reporting for forecast analysis and ad-hoc reporting in support of decision-making.

Analyst II, Revenue Cycle Analyst II

Northbay Healthcare
01.2015 - 10.2019
  • External defense audit manager, primary contact for professional billing systems, provider training for electronic super bill,
  • Revenue Cycle contact for reports, system testing, analysis and implementations, responsible to maintain and modify four HL-7 interfaces, assist in building along with implementation of any new systems sending data to financial systems, system maintenance, system upgrades, troubleshooting system issues, builds and deficiencies.
  • Collaborated with other business analysts to streamline tasks and duties in effort to improve overall efficiency.
  • Identified and resolved problems through root cause analysis and research.
  • Performed system analysis, documentation, testing, implementation and user support for platform transitions.
  • Gathered, organized and input information into digital database.
  • Helped solve diverse program problems with in-depth analysis.
  • Maximized team knowledge and productivity by effectively training, monitoring and directing employees in application of best practices and regulatory protocols.
  • Resolved malfunctions with systems and programs through troubleshooting.
  • Expertly extracted necessary data from records and files and assessed how it related to business operations information.
  • Investigated and addressed HL-7 system issues to enhance usability and improve functionality.
  • Investigated and addressed system issues to enhance usability and improve functionality.
  • Maximized team knowledge and productivity by training, monitoring and directing employees in application of best practices and regulatory protocols.
  • Wrote and distributed to senior management quarterly evaluations of revenue cycle processes, including recommendations.
  • Improved internal knowledge sharing by developing comprehensive documentation outlining standard operating procedures for various tasks.
  • Monitored daily reports, identifying trends or discrepancies that warranted further investigation or action from revenue cycle team.
  • Communicated revenue cycle information to non-technical audiences in easily understood terms.
  • Provided valuable insights to leadership by analyzing key performance indicators related to revenue cycle process.
  • Collaborated with cross-functional teams to develop strategies for optimizing revenue cycle process.
  • Enhanced revenue cycle efficiency by streamlining processes and identifying areas for improvement.
  • Managed appeals process effectively, successfully overturning denied claims to secure payment for services rendered.

Analyst I, Revenue Cycle Analyst I, Northbay Healthcare

Northbay Healthcare
01.2013 - 01.2015
  • External audit manager, primary contact for professional fee billing claims, reports, and system issues.
  • Collaborated with other business analysts to streamline tasks and duties in effort to improve overall efficiency.
  • Documented procedures and business processes and shared information with appropriate stakeholders.
  • Validated results and performed quality assurance to assess accuracy of data.
  • Resolved malfunctions with systems and programs through troubleshooting.
  • Collaborated with cross-functional teams to identify opportunities for process improvement and increased efficiency.
  • Improved decision-making processes, providing senior management with detailed analysis and actionable insights.
  • Developed comprehensive training materials for new analysts, improving onboarding efficiency.
  • Generated reports detailing findings and recommendations.
  • Gathered, organized and input information into digital database.
  • Helped meet changing demands by recommending improvements to business systems or procedures.

Patient Account Representative III

NorthBay Healthcare
03.2002 - 01.2013
  • Assisted colleagues during peak periods or absences, showcasing teamwork skills while maintaining personal workload demands efficiently.
  • Maintained office inventory and organized supplies for efficiency and expected needs.
  • Responded to patient, family and external payer inquiries.
  • Worked with outside entities to resolve issues with billing, claims, and payments.
  • Ensured compliance with healthcare regulations while processing claims and managing patient accounts.
  • Prepared reports detailing billing actions, flags and other key information.
  • Promoted positive work environment by actively participating in team meetings and contributing ideas for process improvements.
  • Reduced outstanding balances by implementing effective collection strategies tailored to individual patients'' needs.
  • Provided exceptional customer service, handling sensitive patient situations with professionalism and empathy.
  • Utilized computer programs to create invoices, letters and other documents.
  • Facilitated smooth communications between patients, providers, and insurers, fostering an atmosphere of trust and collaboration.
  • Demonstrated adaptability in navigating complex payer guidelines to maximize reimbursement opportunities for the organization.
  • Educated patients on financial policies, promoting understanding of their responsibilities within the healthcare system.
  • Achieved a significant reduction in aged accounts receivable through diligent follow-up efforts with both patients and insurers.
  • Developed strong relationships with key contacts at insurance companies to expedite resolution of claim disputes or other account-related issues.
  • Reconciled statements with patient records.
  • Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
  • Researched billing errors and discrepancies to initiate corrective action.
  • Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Adhered to established standards to safeguard patients' health information.
  • Optimized reimbursement process with insurance companies by establishing effective communication channels.
  • Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
  • Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
  • Trained new team members in medical billing software, increasing efficiency within the department.
  • Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
  • Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
  • Assisted patients in understanding insurance benefits, leading to a positive experience during their visit.

Education

Bachelor of Arts - Sociology

Chico State
Chico
12.2021

Associate of Arts - Sociology

Solano Community College
Fairfield, CA
12.2019

Associate of Arts - Interdisciplinary Studies

Solano Community College
Fairfield, CA
12.2019

Skills

  • Information gathering
  • Account and revenue tracking
  • Revenue cycle analysis
  • Data research and validation
  • Attention to detail
  • Root-cause analysis
  • Process improvements
  • Time management
  • Documentation and reporting
  • Team collaboration and leadership
  • Decision-making
  • Relationship building
  • Complex Problem-solving
  • Continuous improvement mindset

Additional Information


  • Dual domain consolidation to single domain: Our Healthcare system went through a transition with our financial application from a dual domain to a single domain to remove the custom interface. My role was critical to facilitating issues that were identified in the financial application with the transition. I would quickly identify the issue and escalate to the appropriate team for resolution in a timely manner. This project involved time management, multiple issue tracking, resolution and reporting out to operations for transparency.
  • Ambulatory Surgery Center: This project involved setting up electronic billing for a stand-alone surgery center. I was the point person for Revenue Cycle to test charge flow, charge accuracy and validate all the criteria needed for accurate billing. I was also responsible for creating all financial reports to accurately track this line of business. This project involved working with a large group of people across the entire system to achieve electronic billing and documentation.
  • Inpatient mPage (Electronic Super Bill): I was the lead person responsible to problem solve current system restrains to achieve correct charge capture in our billing system. I was also responsible for building new tables and reports, testing charge interfaces and training physicians on charge entry. In addition, I was instrumental in created work queues in our financial system, creation of new data tables, modifying and updating existing data tables, workflow training and modifications, creation of new reports for financial analysis and reconciliation.
  • Professional Billing: I was responsible for building new data tables, testing interfaces, and the creation of professional fee charge reports. I was the lead analyst for the creation of financial billing and coding work queues, modifying and updating existing data tables, interface modifications, work-flow training and documentation, creation of new reports for financial analysis and reconciliation. This project also involved extensive problem solving, written and verbal communication to all levels of staff along with different vendors.

Timeline

Senior Application Analyst

Adventist Health System
07.2021 - Current

Analyst III, Revenue Cycle Analyst III

Northbay Healthcare
10.2019 - 07.2021

Analyst II, Revenue Cycle Analyst II

Northbay Healthcare
01.2015 - 10.2019

Analyst I, Revenue Cycle Analyst I, Northbay Healthcare

Northbay Healthcare
01.2013 - 01.2015

Patient Account Representative III

NorthBay Healthcare
03.2002 - 01.2013

Bachelor of Arts - Sociology

Chico State

Associate of Arts - Sociology

Solano Community College

Associate of Arts - Interdisciplinary Studies

Solano Community College
Karen Solberg