Experience

RevWerx

• United States
• Business Consulting and Services
• 1 - 100 Employee

• Executive Director

  • Jun 2019 - Present

  Revenue Cycle ManagementWhile we provide insurance billing services, we are more than a third party billing company. We believe that by educating providers and optimizing their systems, you create better treatment experiences and outcomes. We believe improved reimbursement, lengths of stay overall coverage is a byproduct of these changes. Our vision is a habitat, where patients, providers and payors all receive value and benefit from working together



Let's Talk Hope, LLC

• Owner and Founder

  • Mar 2019 - Present

  Let's Talk Hope provides counseling services to individuals and families suffering from issues related to substance use and mental health disorders. In addition to counseling, let's Talk Hope also offers intervention services, group therapy and professional development training for clinicians.



Norina Murphy LCSW and Associates

• Clinical Social Work Intern

  • Aug 2019 - Present

  Provides services to clients and families in a manner that is culturally competent and adhere to the philosophy, mission and vision of the Haynes Family of Programs. Understands and upholds best practices and trauma-informed services in an effort to meet the needs of abused, neglected and struggling children/families, and inspire the qualities necessary for children and families to succeedMeets weekly for clinical supervision to review job performance, intervention strategies, case conceptualization and documentation, access support and guidance in working with severely emotionally disturbed children and their families, and identifying areas needing improvement with action plans for performance enhancement or training. Ensures that directives for client care and interventions identified and agreed upon in clinical supervision are carried out as directed, and maintains an openness to such direction and feedbackResponsible for providing any and all services to and on behalf of clients and families that are within the established Scope of Practice for Marriage and Family Therapists, Clinical Social Workers and/or Psychologist within the state of California at all timesAttends and participates in regularly scheduled individual supervision, client-centered group supervision, Mental Health department meetings/trainings, and Agency all-staff meetings/trainings



Southworth Associates

• United States
• Individual and Family Services
• 1 - 100 Employee

• Behavioral Health Insurance Billing/ Medical Necessity Consultant

  • Jun 2019 - Present

  Providing Behavioral Health facilities and Clinicians with In-Depth Medical Necessity Training, Process Review, Restructure and Implementation, Best-Practice Guidelines/ Approach to Clinical Care, Ethical Billing Solutions and Practices, Comprehensive Utilization Review Training, Systems Evaluation and Recommendations, Assistance with Implementing/ Streamlining In-House Insurance Departments, Quality Assurance/ Compliance Standards, Ongoing Consultation and Staff Development.



Northbound Treatment Services

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Utilization Review Director

  • Aug 2016 - Mar 2019

  Oversee daily operations and scheduling of the Utilization Review Department.• Collaborate with the Clinical Team, families, Admissions leadership, and Executive Management to determine coverage, length of stay, and financial responsibility.• Monitor and track employee progress, providing regular assessments and feedback.• Act as a liaison between UR Staff, the Treatment Team, the Business Office, and families to communicate both authorization levels and financial status.• Implement documentation systems to ensure charting meets compliance standards and effectively supports rationales for continued stay.• Implement UR and documentation training's for all staff and conduct trainings on an ongoing basis.• Utilize clinical information and knowledge of Behavioral Health Medical Necessity criteria to effectively communicate plans of care to insurance case managers, facility staff, and health care partners.• Hiring and training of all new UR personnel.• Collaborate in Continuing Care planning to ensure timely discharge, optimal benefit, and financial utilization, as well as compliance with industry discharge standards.• Daily collaboration with Admissions Director, Compliance officer, Chief Of Operations, Billing Director, and Managers to ensure timely Admissions.• Utilize knowledge of specific polices to estimate length of stay, reimbursement rates, and financial implications.• Establish and maintain direct relationships with families, the Treatment Team, Admissions, the Business Office, and direct-care staff.• Prepare and submit appeals documentation to the appropriate entities as indicated.• As needed, conduct assessments and interviews with clients and/or families for the purpose of clinical clearance and/or insurance authorization.• Collect, track, and report metrics.



ABC Recovery Center

• Director Of Admissions

  • Aug 2015 - Aug 2016

  • Provided consultative support for admission inquiries, including pre-admissions assessment and answering pre-admissions/general intake questions from potential clients or their referral sources.• Initiated Verification of Benefits, and discusses insurance coverage and potential out-of-pocket costs with potential clients or the Financially Responsible Party.• Assessed the acuity and needs of potential patients and makes treatment recommendations based on clinical presentation and appropriate clinical fit for programs.• Facilitated effective telephone presentations to prospective clients, clearly communicating the Promises Behavioral Health advantage.• Identifies qualified prospective clients and develops loyal customer relationships.• Generated and followed-up on self-developed leads through intensive research as well as both inbound and outbound calling & follow-up.• Provided treatment recommendations within the Promises network of treatment centers.• Provided outbound referrals based on presenting issues to established referral sources or other behavioral healthcare providers.• Assisted with client retention by supporting current clients as requested.• Maintained a professional, "clinical-style" approach when working with potential clients.• Shared techniques and strategies to execute proactive outbound calls, lead generation, qualifying, overcoming objections, etc. with peers.• Supported team admissions and achievement of department and company assigned census goals.• Collaborated with referring professionals to coordinate client admission.• Tracked and documented the disposition of potential clients from initial call, handoff to facility, up to and including admission.• Researched and expanded knowledge of addiction and treatment programs and facilities to provide relevant and useful information to prospective clients.• Designed and executed strategies for meeting or exceeding all performance goals on a consistent basis*Utilization Review



His House New Creation

• Case Manager / Utilization Review

  • Feb 2013 - Aug 2015



Cedar House Life Change Center

• United States
• Mental Health Care
• 1 - 100 Employee

• Intake Personnel Station Supervisor

  • Jun 2005 - Jan 2012

  Client intake, discharge, transfer of serviceGroup FacilitatorCrisis InterventionMedication ClerkSupervisor



Betty Ford Center

• United States
• Medical Practices

• CD Tech

  • May 2000 - May 2002