Provider Relations Manager Resume Example

• Recruit, hire, and manage business office staff of 19 individuals.
• Monitored aged balances for approximately $23M, ensuring timely and efficient resolution.
• Prepared monthly financial analysis on accounts receivables, collection percentages including extensive focus on payer & denial trends.
• Created and implemented reimbursement policies and procedures, ensuring compliance with appropriate industry regulations

Accomplishments: 

• Decreased credit balances from $1Million to $100k
• Decreased Days Sales Outstanding from 55 to 27 while increasing collections and reducing bad debt write off
• Reduced staff by 50% while increasing efficiency
• Reduced receivables over 120 days from 30% to 5%, exceeding company expectations by 50%
• Created and implemented goal enriched environment and shifted receivable focus from 180 days to 60 days

• Supervise, mentor, and encourage staff of 8 by offering consistent and supportive feedback, assisting with goal setting while clearly defining expectations.
• Responsible for timely and accurate billing and collections of approximately 3.5M for fourteen nursing branches in four states.
• Developed positive relationships with business partners through extensive communication and collaboration

Accomplishments: 

• Due to new business in one month's time, total accounts receivables portfolio increased by $1Million while receivables over 60 days declined from 30% to 20 %
• Total credits kept to less than 5% of accounts receivables.
• Maintained team accuracy of 99%
• Awarded Gentiva's National “Gold” award for the individual in the company who best exemplified “TEA” (Timeliness, Efficiency, Accuracy)

• Supervised staff of 18 individuals in satellite claims processing/call center operation.
• Maintained inventory control of claims; responsible for managing the adjudication of infusion claims.
• Collaborated with Regional Care Centers to ensure proper creation of authorizations

Acomplishments: 

• Days claims outstanding maintained at 10 days or less
• Awarded Gentiva's Customer Service Award in December 2001
• Claims adjudication average of $12Million per month with 98% accuracy

• Coordinated national vaccination clinics with Delta Airlines and Cigna Healthcare

• Researched patient accounts, verifying accuracy of adjustments and payment applications.