Monique Tucker

Monique Tucker

About

Detail

Senior Revenue Cycle Relationship Manager | Enterprise Client Success & Solution Deployment at Qualifacts
Charleston, South Carolina, United States

Contact Monique regarding: 
work
Full-time jobs

Timeline


work
Job
school
Education

Résumé


Jobs verified_user 0% verified
  • Qualifacts
    Senior Revenue Cycle Relationship Manager | Enterprise Client Success & Solution Deployment
    Qualifacts
    Nov 2024 - Current (2 years)
    Own a $475M managed revenue portfolio across 18 enterprise behavioral health organizations, accountable for deployment, adoption, and financial performance across CareLogic, Credible, and InSync.

    Lead implementations and go-lives across all three enterprise platforms — defining configuration requirements, directing technical build teams, and owning client readiness through launch and stabilization
    Act as the liaison between revenue cycle operations and IT, translating client business requirements into configuration specifications engineering can execute against
    Partner with C-suite and executive stakeholders on revenue optimization strategy, platform adoption, and roadmap alignment
    Analyze portfolio performance da
  • Clinic Anywhere
    Senior Revenue Cycle Account Manager | Senior Client Success Manager (Healthcare Operations)
    Clinic Anywhere
    Jul 2024 - Nov 2024 (5 months)
    Owned a portfolio of healthcare clients as the single point of accountability for revenue cycle performance, platform adoption, and account health.

    Served as primary executive contact across the client portfolio, leading recurring performance reviews against defined KPIs
    Analyzed revenue cycle data and workflows to identify leakage, then implemented corrective processes with onshore and offshore delivery teams
    Delivered strategic recommendations on denial prevention, claims management, and documentation improvement
    Drove client adoption of recommended workflows and platform functionality to maximize realized value

    Technology: NextGen Enterprise | Revenue Cycle Analytics | KPI Reporting | Client Retenti
  • Healthcare IT Leaders
    HealthRules Partner Claims SME | Senior Revenue Integrity & Healthcare Technology Consultant
    Healthcare IT Leaders
    Jun 2024 - Aug 2024 (3 months)
    Epic revenue cycle SME supporting an enterprise Epic upgrade for a major academic health system client.

    Provided revenue cycle expertise across claims, billing, and reimbursement workflows during upgrade planning and delivery
    Partnered with technical and operational teams on configuration analysis, testing, and validation ahead of cutover
    Identified workflow risks introduced by the upgrade and drove mitigation with the delivery team
    Supported end-user readiness through documentation, process guidance, and knowledge transfer

    Technology: Epic Resolute | Epic Revenue Cycle | Claims Management | Enterprise Delivery | Testing & Validation
  • Accenture
    Healthcare Technology Consultant – Senior Claims SME & Revenue Integrity
    Accenture
    Dec 2023 - Jun 2024 (7 months)
    Claims SME on a net-new HealthEdge HealthRules Partner implementation for a large payer engagement.

    Served as HealthRules Partner (HealthEdge) subject matter expert across claims adjudication workflows, system rules, and payment integrity
    Defined business requirements and partnered with technical teams on configuration, testing, and QA through implementation
    Analyzed claims trends and adjudication outcomes to identify accuracy and reimbursement improvement opportunities
    Ensured payment processes aligned to CMS guidance, payer requirements, and coding standards

    Technology: HealthEdge HealthRules Partner | Claims Adjudication | Payment Integrity | CPT/HCPCS | CMS Guidelines
  • Avesis
    Senior Analyst, Revenue Management | Healthcare Operations & Technology Optimization
    Avesis
    Jan 2023 - Dec 2023 (1 year)
    Led revenue cycle operations and Epic workflow optimization across dental and vision managed care lines.

    Owned Epic Cadence and Prelude workflows including claims validation, testing, and system optimization
    Managed and coached billing teams, improving consistency, compliance, and throughput
    Analyzed performance data to identify trends and operational gaps, then implemented process improvements with cross-functional teams
    Led claims auditing and denial prevention initiatives supporting revenue integrity

    Technology: Epic | Cadence | Prelude | Claims Testing | Revenue Integrity | Process Improvement
  • CorVel Corporation
    Senior Revenue Cycle Manager – Client Operations & Healthcare Strategy
    CorVel Corporation
    Jan 2022 - Dec 2022 (1 year)
    Led revenue cycle and claims operations for complex healthcare workflows, partnering with internal teams, healthcare stakeholders, and operational leaders to improve accuracy, efficiency, and service outcomes.
    Managed teams responsible for complex claims review processes while driving quality improvement initiatives, workflow optimization, and operational performance.

    Key Contributions:
    • Led and coached revenue operations teams responsible for reviewing complex workers comp claims and ensuring accuracy, compliance, and timely resolution.
    • Partnered with internal stakeholders and external healthcare partners to resolve operational challenges and improve service delivery.
    • Developed quality assurance processe
  • Oral Surgery  Dental Implant Specialists South Carolina Matthew R Barefoot DDS MD
    Clinical Operations Revenue Director | Healthcare Operations & Revenue Strategy
    Oral Surgery Dental Implant Specialists South Carolina Matthew R Barefoot DDS MD
    Jan 2021 - Jan 2022 (1 year 1 month)
    Led revenue cycle operations and optimization initiatives for a multi-location healthcare organization, improving financial performance through workflow redesign, analytics, and operational improvements.
    Partnered with leadership teams to identify revenue opportunities, improve billing processes, and implement scalable solutions supporting growth and efficiency.

    Key Contributions:
    • Managed a revenue cycle team supporting billing, collections, denials, and payment operations.
    • Developed KPI reporting and performance improvement strategies focused on cash flow and revenue optimization.
    • Collaborated with operational and technology teams to improve data accuracy and workflow efficiency.
    • Implemented proc
  • N
    Director of Revenue Management
    Nicklas Dental
    Feb 2018 - Jan 2021 (3 years)
    Directed revenue operations and financial performance initiatives for a healthcare organization, partnering with leadership teams to optimize workflows, improve collections, and strengthen operational processes.
    Served as a strategic advisor focused on revenue growth, process improvement, and sustainable operational performance.

    Key Contributions:
    • Led revenue cycle strategy including claims management, billing operations, collections, and payer processes.
    • Developed workflows and performance standards to improve operational consistency.
    • Analyzed financial trends and identified opportunities to increase revenue capture.
    • Partnered with providers and administrative teams to improve communication and o
  • D
    Senior Revenue Cycle Integrity Manager – Healthcare Operations & Optimization
    DentalHome
    May 2016 - Jan 2018 (1 year 9 months)
    Led revenue cycle operations and optimization initiatives for a multi-location healthcare organization, improving financial performance through workflow redesign, analytics, and operational improvements.
    Partnered with leadership teams to identify revenue opportunities, improve billing processes, and implement scalable solutions supporting growth and efficiency.

    Key Contributions:
    • Managed a revenue cycle team supporting billing, collections, denials, and payment operations.
    • Developed KPI reporting and performance improvement strategies focused on cash flow and revenue optimization.
    • Collaborated with operational and technology teams to improve data accuracy and workflow efficiency.
    • Implemented proc
  • P
    Director of Insurance Operations – Provider Operations & Payer Strategy
    Palmetto Dental Credentialing
    Jan 2016 - Aug 2020 (4 years 8 months)
    Led provider credentialing and payer operations, supporting healthcare organizations with compliance, enrollment optimization, and operational improvements.
    Served as a strategic partner to providers and internal teams, improving workflows, strengthening payer relationships, and ensuring efficient credentialing processes.

    Key Contributions:
    • Managed credentialing operations and supported provider onboarding across dental healthcare organizations.
    • Developed streamlined workflows and process improvements to improve turnaround times and operational efficiency.
    • Partnered with providers, payers, and internal stakeholders to resolve complex enrollment and credentialing challenges.
    • Implemented standardize
  • Medical University of South Carolina
    Epic Revenue Cycle Analyst Lead – Healthcare IT & Claims Optimization
    Medical University of South Carolina
    May 2013 - May 2016 (3 years 1 month)
    Supported enterprise healthcare operations through Epic revenue cycle expertise, workflow optimization, and claims process improvement initiatives.
    Served as a liaison between operational teams, technical teams, and healthcare stakeholders to improve system performance and reimbursement outcomes.

    Key Contributions:
    • Supported Epic revenue cycle workflows across multiple medical specialties.
    • Analyzed claims processes, identified workflow issues, and recommended operational improvements.
    • Collaborated with billing, coding, clinical, and IT teams to resolve complex revenue cycle challenges.
    • Supported testing, validation, and workflow improvements within Epic environments.
    • Provided guidance and t
  • Lowcountry Orthopaedics and Sports Medicine
    Patient Access Manager
    Lowcountry Orthopaedics and Sports Medicine
    Oct 2009 - May 2013 (3 years 8 months)
    Managed patient access operations while supporting healthcare workflow optimization, operational efficiency, and revenue cycle performance.
    Partnered with clinical, administrative, and billing teams to improve patient experience, access processes, and financial outcomes.

    Key Contributions:
    • Managed scheduling, registration, insurance verification, and front-office operations.
    • Improved workflows supporting accurate claims submission and reimbursement.
    • Developed staff training and operational processes to improve consistency and efficiency.
    • Monitored performance metrics to identify opportunities for improvement.
    • Collaborated with billing and clinical teams to improve communication and operatio
Education verified_user 0% verified
  • University of South Carolina
    University of South Carolina
    University of South Carolina
  • Trident Technical College
    Trident Technical College
    Trident Technical College
    Jan 2010 - Jan 2012 (2 years 1 month)