Physician-Practice Revenue Cycle • Credentialing • Compliance

Protect your revenue, credential your providers, and keep your practice compliant.

Hands-on, CPC- and CPCO-certified advisory from a revenue cycle leader who ran the function for nearly 30 years — not a vendor reading from a playbook.

Heather Lyn Clifton, CPC, CPCO  •  Charlotte / Gastonia, NC  •  Serving practices regionally & nationwide (remote)

CPC — Certified Professional Coder CPCO — Certified Professional Compliance Officer ~30 Years in Physician-Practice RCM Credentialing for All Provider Types
17 yrs
as Director of Revenue Cycle Management
50+
providers credentialed & managed
$15–16M
monthly billed charges overseen
~8.4%
AR >90 days — well below the MGMA benchmark
What I Do

Three ways I help physician practices get paid — and stay compliant.

Engage me for a one-time project, an ongoing retainer, or fractional leadership. Every engagement starts by finding where revenue is leaking.

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Provider Credentialing & Enrollment

Get and keep every provider enrolled and billable — across all provider types: MD, DO, PA, NP, CRNA, CNM, PhD, and more.

  • Initial credentialing & re-credentialing
  • Medicare, Medicaid & commercial payer enrollment
  • CAQH, PECOS, NPPES & NCTracks maintenance
  • Revalidations, demographic & location updates
  • Hospital privileging, DEA/licensure & CV tracking
  • New-provider onboarding & payer panel management
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Revenue Cycle Management

End-to-end ownership of the claims lifecycle, with a bias toward preventing denials before they happen — and recovering the revenue you’ve already earned.

  • Denial management, root-cause analysis & appeals
  • Payer escalation & reimbursement-dispute strategy
  • Accounts receivable & aged-AR recovery
  • Charge capture, payment posting & reconciliation
  • KPI & AR reporting (denial rate, NCR, days in AR)
  • Underpayment & contractual-variance recovery
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Consulting & Compliance

Senior advisory and audit support across coding compliance, revenue integrity, and RCM operations — with optional fractional or interim leadership.

  • RCM performance assessments & revenue-leak audits
  • Coding compliance & revenue-integrity reviews
  • Multi-specialty, surgical, procedural & pathology coding
  • Oncology & infusion/chemotherapy coding (J-codes, NDC)
  • Fractional / interim RCM leadership
  • ModMed & EHR/PM revenue-cycle optimization
About Heather

The operator who knows where the revenue is hidden.

I’m Heather Lyn Clifton — a CPC- and CPCO-certified revenue cycle leader with nearly 30 years in physician-practice RCM. For 17 of those years I served as Director of Revenue Cycle Management for a high-volume, multi-specialty surgical and procedural group with in-house pathology, leading a 26-person team across 12 locations, 50+ providers, and $15–16M in monthly billed charges.

Before that, I spent 12 years in oncology revenue cycle — including six years of hands-on oncology and infusion/chemotherapy coding (J-codes, NDC units). That range means I’ve coded, billed, appealed, credentialed, and reconciled across the full clinical spectrum, from surgical procedures to chemotherapy administration to pathology.

Most consultants advise on process. I’ve held the seat — owned the denials, managed the payers, credentialed the providers, and recovered the revenue. I bring that operator’s eye to your practice, with a compliance-first, human-in-the-loop approach.

Let’s talk about your practice

Credentials & Scope

CPCCertified Professional Coder (AAPC)
CPCOCertified Professional Compliance Officer (AAPC)
4.5%AR >90 days — down from 25% at hire
30 yrsPhysician-practice revenue cycle
50+Providers credentialed & enrolled
SMEModernizing Medicine (ModMed) revenue cycle
Signature Result

When a national payer quietly stopped paying, I found it — and got it back.

1,848
systematically underpaid claims identified and escalated

A major Medicare Advantage payer began reimbursing a high-volume pathology code at $0.00. I quantified the systemic issue across 1,848 claims, then drove a multi-tier response — a formal appeal, a contracting escalation requesting contract language and notice proof, and a CMS complaint-style letter — to recover revenue the practice hadn’t even flagged. This is the kind of payer-savvy, evidence-based recovery work I bring to every engagement.

Who I Help

Built for specialty & multi-specialty physician practices.

Provider types I credential

Physicians (MD / DO) Physician Assistants (PA) Nurse Practitioners (NP) CRNAs Nurse Midwives (CNM) Clinical Psychologists Advanced Practice Providers & more

Practices I serve

Single- & multi-specialty groups Surgical & procedural practices Oncology & infusion In-house pathology / labs PE-backed & MSO platforms New & growing practices ModMed practices

An operator, not just an advisor

17 years running the function — I’ve done the work I’m advising on, at scale.

Credentialing depth across every provider type

CAQH, PECOS, NPPES, NCTracks, payer enrollment, revalidations — done right, so claims don’t stall.

Compliance-first

CPCO-certified. I protect revenue without creating audit exposure.

Specialty range

Surgical, procedural, pathology, oncology and infusion coding — fluent across the clinical spectrum.

Get In Touch

Let’s find the revenue your practice is leaving on the table.

Tell me a bit about your practice and your biggest challenge — denials, AR, credentialing backlog, a payer dispute, or a leadership gap. The first conversation is free.

Charlotte / Gastonia, NC — available remotely nationwide

Start with a free consult

A focused 30 minutes to pinpoint where you’re losing revenue and what to fix first.

Email to Schedule

CPC · CPCO · ~30 years in physician-practice RCM