Healthcare Billing Professional well versed in research and analysis. Seeking a position to develop and implement new and innovative health care billing processes and collections procedures.
Thoroughly investigated past due invoices and minimized number of unpaid accounts.Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.Thoroughly reviewed remittance codes from EOBS/RACompleted appeals and filed and submitted claims.Posted charges, payments and adjustments.Meticulously tracked and resolved underpayments.
Management of revenue stream functions as it relates to all State of Pennsylvania Moss rehabilitation patients. Oversees patient access management, claim submission, and claim adjudication. Direct the decision point planning to increase revenue and streamline denial management functions. Evaluates daily A/R activity to create benchmark standards and develop quality assurance mechanisms to increase revenues.
Administrate daily emergency room patient access operations. Directed, planned, and implemented staffing, team leadership, and workflow design. Responsible for 24 hour patient access management staffing coverage and determining staffing needs as it related to budget guidelines and unit requirements. Maintained PA State, CMS, and JACHO regulator requirements as it related to patient access management. Developed and maintained policies and procedures for emergency room access management team members. Monitored quality assurance measures to insure front end revenue cycle functions were met. Departmental lesion for Information Technology. Directed department operations in collaboration with senior level management.
Served as an advisor to management in A/R collections management and staff training recommendations. Responsible for accounts receivable management of $3.2 million to $5.8 million 180 day+ aged open balance accounts for all Philadelphia and Massachusetts Tenet Healthcare facilities. Team lead for new hire training development measures. Assistant to the legal department as it related to bankruptcy account management.
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