This document provides a summary of Ruth-Rohini Chawla's experience in the healthcare industry spanning over 18 years. She has held various roles such as operations manager, revenue cycle manager, accounts receivable manager, assistant business manager, and program management specialist. She has extensive expertise in areas such as billing, coding, compliance, and software training. Her most recent role is as a senior financial coordinator at a proton therapy center where she performs financial verification and clearance for patients.

1. Ruth-Rohini Chawla
Phone: 732-997-8861
Email: rohini3331@gmail.com
SUMMARY: I have 18+ years of experience in the Health care Industry . Positions and roles ranged from Op erations, Revenue
Cycle Manager, Accounts Receivable Manager, Assistant Business Manager, Sr. Provider Relations/Consultant, Sr. Program
Management Education Specialist, Customer Service Manager Operations and Medical Office Billing Manager, Trained staff
for Inp atient and outp atient billing and guidelines, Project Manager, Program M anagement, Workman’s Comp
Manager, Compliance Committee Coordinator and FinancialCounselor. I also have extensive knowledge of HIPAA, HCFA,
OSHA, ICD9, I C D - 1 0 , andCMSpolicy procedureguidelines, CPT, HCPCS and Medical Terminology; PQRS, RAF, Meaningful use
for best practices. I have successfully Managed large staffs and M anaged up to 30+ Physician practice, also assisted in
Physician Credentialing, Managed Care Contracting and Recruiting. Training Physicians & employees/staff on various s o f t w ar e
programs and new technologies for practice enhancement, such as, Relay Health, Nextgen, SharePoint, McKesson, Medical
Manager, Lytec and Mosiaq. Also experience in multiple areas as, Healthcare benefits, employee relations, and organizational
development, Interview and hire staff as needed. Human Resources. Remotely handle and troubleshoot issues arising from
provider practices. As consultant, provided practice assessment to identify performance improvement opportunities and
recommendations. Software Trainer of various software and new technologies. CCD editor. NCD, LCD reviewer. Preparing
Budgets and review Physician Fee Schedules and Patient rosters.
EXPERIENCE:
7/27/15-Present
ProCure Proton Therapy Center
Somerset, NJ
Sr. Financial/Billing ManagementCoordinator
The Patient Financial Management/Coordinators/Supervisors are part of a multidisciplinary team, in charge with the responsibility of
providing accurate and professional financial clearance to patients seeking Radiation Oncology Services or Proton Services at Princeton
Procure Proton Therapy Cancer Center. The PFCs are responsiblefor the analysis, validation and regulatory and compliance activities
associated with thefinancial clearance process. ThePFCs mitigate thefinancial risk to Procure by performing an accurate financial
clearance review along with a comprehensive analysis of patient and payer specific benefits and patient liability. Coordination and
communication with the patient, clinical teams including physicians, nurses, social workers pharmacists and Managed care Payers.
Provide education to staff and physician concerning compliant and comprehensive billing charge capture. Performs daily review of
charge export to billing service. Performs audit and adjudication of charges and responds to ProCure’s billing agency assigned edits.
Provide analysis and responseto performance reports. Assist in financial arrangements and advise self-pay patients on alternative ways
to meet their financial obligation, including but not limited to financial hardship screening and payment plans.
Essential Duties & Responsibilities:
 Communication with theclinicians occurs daily to confirm some visit requirements; on-going financial review /analysis for
accurate billing. Review and analyze patients’ eligibility, benefit changes and financial status. Review contracts and obtain
clarification from Managed Care payers
 Process New Referrals for Evaluation / Analyzebenefit ,Insurance Verification/Clinical Coordination: Analyze, organize, and
utilize complex data and rules related to contracting and patient benefits to provide financial clearance
 Review all charges prior to export to ProCure’s billing agency to ensure completeness of demographics, insurance information
compliant and comprehensive charge capturewith supportingdocumentation
 Work with Payers, Managed Care Contracting, Pharmacy assistance programs in the development of agreements for
International, self-funded patients and patients with limited benefits;
 Work with clinical staff to obtain additional clinical information for benefit review in particular as it relates to Appeals and
clinical trials and off label drug use
 Share financial screen daily / weekly with the clinical teams at each of their respective meetings; notify the patient if not
financially approved for evaluation at Procure and redirect these patients to the insurance payer’s case manager
 Interact with Radiation Oncology Clinical teams (Medical Oncologists, RN Coordinators and Therapists and Administration)
to obtain treatment plans, discharge planning, concurrent and retrospectivereview and patient demographics to begin
insurance verification process
 Interview patients to obtain required information to begin verification; financial clearance, providing key information and data
regarding benefits, support and patient financial liability; preparefinancial packets based on each individual benefits, patient
financial interview, and calculated estimated expenses based on patient benefits
 Explain billing to patients according to Procure credit and collection policies; evaluate patient requests for financial assistance;
Seek clinical assistance as needed; refer patients to theManufacturer Drug program and Pharmacy Assistanceprograms as
needed for medications.
 Responsible for review and appeals of claims as they relate to all professionaland technical radiation therapy services
performed
 Share financial screen daily / weekly with the clinical teams at each of their respective meetings
 Notify thepatient if not financially approved for evaluation at Procure and redirect these patients to theinsurance payer’s case
manager.
 Responsible for daily monitoring and charging of Physician Quality Reporting Initiatives (PQRI)

2.  Serves as a contact to patients and patient families by providing basic information in responseto inquiries and/or complaints
regarding eligibility status /during treatment changes/concerns
 Maintains expert, current knowledge regarding code-capture, applicability to the services provided and compliance for
documentation and correct coding, CCI edits.
MedAssets-Oceanport, NJ
Revenue Cycle Manager
01/15/13-05/2015
Job responsibilities included:
This position is responsible for Managing, supporting, and overseeing Revenue Operations, performance and productivity of the
team as it relates to AR management, Revenue Cycle and pre-defined goals/targets. Provides continual feedback and guidance to
the team. Acts as the recipient of all escalated and trended issues and is responsible for resolving and/or taking appropriate action
on all escalated issues. Recommending new technologies and software’s for improving workflow and efficiency. Work remotely
from home to assist, evaluate, identify performance improvement opportunities for Client, research data and reports to identify
trends and address them.
Essential Duties & Responsibilities:
● Optimizes staff performance through process redesign, policy procedures, professional development, empowerment,
quality and address any training or performance issues on a regular basis
● Effectively functioned as a liaison among Hospital managers in coordinating inter-departmental billing efforts and
addressing major charge and billing and reimbursement matters and provided training to staff
● Development of options and provided recommendation for client improvement
● Responsible for analyzing, evaluatingand reporting any detected trends in payments or denials, as well as procedural
problems and makes recommendations regarding the correction of these trends or problems. Identify potential
performance improvement opportunities
● Conduct routine account activity quality audits to verify accounts are being worked appropriately
● Monitor internal processes for all functions of the unit revised and developed consistent protocols for all business
that meet the needs and are aligned appropriately with the core values of the unit
● Maintains /Develop knowledge of applicable rules, regulations, policies, laws, and guidelines that impact patient
accounting, effective internal controls that promote adherence to these guideline and programs.
 Demonstrated correct and safe technology/ technique in the use of equipment according to the specific product
information and hospital policies and procedure
● Maintained the confidentiality, security and integrity for the management of associates/patient information
according the specific product information and hospital policies and procedures
● Demonstrated correct and safe technology/ technique in the use of equipment according to the specific product
information and hospital policies and procedure
 Provided recommendations to Providers/clients on how to integrate new process/best practiceinto current workflow
● Establish realistic goals and priorities concurrent with organizational objectives
11/1/11-12/1/12
Medical Diagnostic Associates, PA, Clark, NJ
Senior A/R Analyst Cancer Programs Coordinator / Cancer Center Billing A/R Manager for 5 Oncologists
Job responsibilities included:
● Oversee, train and direct day to day operation, manage, and evaluate Revenue and A/R
 Researched and assisted patients to enroll in various cancer drug programs through
pharmaceutical companies to help with their out of pocket expense for treatments.
● Supervised chemo treatment drugs coding and inpatient hospital billing.
● Manage and train staff to Verify coverage through Navinet, Passport and Pre-certification for treatment and
drugs
● Monitored and reviewed payment postings, EOBs, to ensure maximum reimbursement of claims and
handled A/R Appeals and claim reviews with all Health Plans.
● Assisted in cancer drug pricing AWP calculations and negotiated fee schedule for the practice

3. 1/5/06 - 8/1/11
John Muir Physician Network, IPA & Hospital-Muir Medical Group, Walnut Creek, CA(Multi specialty
Group 950+ Physicians)
Senior Physician Relations Education Specialist:
As a Physician Relations Education Specialist, my primary role was to act as a liaison between Physician Network/Muir Medical
Group and the Physician Practices. The Job responsibilities included, support and training for the physician practices, building
strong relationships with physicians and staff to improve efficiencies and enhance work environment and productivity. Also
provided human resources policy interpretation, employeerelations, compensation/benefits and recruitment.
● Acted as primary department liaison between JMPN and the other operating departments such as Claims,
Eligibility, Utilization Management and Compliance. Proactively supported thephysicians and their staff by
keeping them abreast of policies, procedures, communicated contract changes, educational literature, updates,
and supplied information & materials on various programs and network resources
● Provided training for Relay Health, promoted EMR / EHR/NextGen, Value Added Services, reviewed
Managed Care Dashboard reports and RAF reports with the physicians. Met with the Physicians every 6
months to review the annual Primary Care Physician Bonus Program
● Conducted quarterly in person site office visits, to resolve / review practice issues, New Office Orientations,
immediate response to individual physician demands and inquiries with rapid communication, promotion of
programs / services and marketing initiatives. Identify areas of concern, opportunity of improvement.
Promoted events for Women’s Health Center
● Maintained territory roster on Share Point, including detailed practice information and practice needs
● Telecommute, documented and responded to all telephone calls and written inquiries and maintained an issue
log.
● Submitted weekly status reports, which included the issues log, physician(s) sites visited, internal and
external meetings, projects accomplishments and recommendations
● Participated in hosting community health events/open enrollment and benefit fairs in conjunction
with John Muir Health
 Credentialing and preparingBudgets and review Physician Fee Schedules and Patient rosters
Accomplishments:
● Achieved highest score in my team on customer satisfaction survey.
● Exceeded my goals with the level of my productivity and quality of my work
● Converted several nonexclusive physicians into John Muir exclusive physicians
● Received several appreciation letters from physician practices
● Won the Relay Race for promoting and signing up highest number of physician practices for
Relay Health and promoting and training for Nextgen EMR/HER system
1/1999 – 4/2003
Medical Diagnostic Associates, Clark, NJ
Accounts Receivable Manager:
The practice consisted of 30 physicians including Primary Care Physicians and Specialists such as,
Cardiology, Radiation Oncology, Nephrology, Gastroenterology, Internal Medicine and Infectious Disease.
Position responsible for Managing Operations, supporting, and overseeing performance and productivity of the team as it relates
to AR management, Revenue Cycle and pre-defined goals/targets. Provides continual feedback and guidance to the team. Acts as
the recipient of all escalated and trended issues and is responsible for resolving and/or taking appropriate action on all escalated
issues. Recommending new technologies and software’s for improving workflow and efficiency. Work remotely from home to
assist and research data and reports.
Responsibilities included M anaging 15 Claims Coordinators and the company accounts receivables.
● Monitored and reviewed payment postings, EOBs, to ensure maximum
reimbursement of claims
● Reviewed and implemented all CMS/Medicare updates
● Conducted troubleshooting for site offices on various billing & accounting software.
● Negotiated fee schedules with various insurance companies

4. ● Conducted monthly meetings with the physicians and staff to provide updates and review
account receivable reports, and practice status reports
● Conducted in-house chart audits for the practices as Medical Compliance
Committee Coordinator
1/1997 - 12/1998
Prime Care Medical Group, Rahway, NJ
Billing Manager and Assistant Business Manager:
This practice consisted of 10 office sites for the PCP’s as well as specialists such as, Cardiology, Endocrinology,
Gastroenterology, Internal Medicine, OB/GYN and General Practice.
● Responsibilities included, managing staff and providing the physician managers with weekly reports and
updates
● Conducted weekly staff meetings, training on billing and coding, medical software, recruiting and payroll.
● Performed annual staff evaluations
● Supervised insurance follow-up, electronic billing to Medicare, Medicaid and other commercial insurances.
● Negotiated /Fee Schedule and payments with insurance companies and attorneys
● Handled, account inquiries, CPT and ICD-9 coding, correspondence, A/R reports and collections
● Complete knowledge of hospital, nursing home and office billing and multiple procedures involving
modifiers
● Coordinated with the billing Software Company for updates and any software related questions and issues
EDUCATION: Delhi, JM College6/1983 - Art and Economics
SKILLS:
● Proficient in relevant computer skills: MS Office applications, including Word, Excel, Visio, Office
Project, Publisher, and Power Point.
● Experience and comfort working at All levels of a health care organization
 Excellent and extensive knowledge of the complete Healthcare Revenue Cycle Management, in patient
outpatient billing
 In-Depth knowledge of various operating systems, as Medical Manager, Mosaiq , Lytec, SharePoint,
Facets, Nextgen, Relay Health andMcKesson
● Excellent Presentation andskill set training skills with attention to detail and time management
● Excellent organization, interpersonal, written and oral communication skills
● Ability to adapt to flexible scheduleandenvironment
● Self-Starter Solid work ethics, flexibility, versatility, desire to excel, meet deadlines, exceptional
listener, andextraordinary factual recall, ability to identify problems and develop solutions
● Demonstrate leadership, ability works independently.
● Ability to excel in a fast-paced, team environment
● Relay Health Certified Deployment Trainer from Relay Health University
● Certified Professional Coder.
● Extensive knowledge of Ingenix and Claim Check software.
Membershipand Organizations:
 AAPC
 Healthcare Financial Health Association
 American Health information Management Association