Experience

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  Interactive Health, Inc

  • Owings Mills, MD

  • Claims Billing Manager

    • Feb 2015 - Feb 2018
    • Owings Mills, MD

     Established the claims billing department Developed policies & procedures (S.O.P of the claims billing department) Manage all aspects of the Claims Billing Department Implemented billing software and procedures. Produced the action plans to resolve A/R and operational issues. Monitor payer reimbursement issues and trends. Research & analyze all accounts to ensure that CPT codes, modifiers and DX codes are billable according to insurance guidelines. Manage & monitor the workflow and staff development needs. Approve/process charge backs/refunds to insurance carriers. Provide ongoing systems training to the current/new employees. Assist in acquiring new business Assist Comptroller with reconciling revenue for all services billed. Assist the Directors of Acct. Management, VP of compliance with any questions related to the claims billing guidelines for all commercial insurance carriers.  Responsible for interviewing, training, terminations and evaluations of the claims billing department staff.  Attend weekly/Monthly/Quarterly operations meetings/conference calls internally and with major partners.  Assist major partners with any questions and or set up of new claims billing business partners.

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  Community Care Nursing Svc

  • Parkville, MD

  • Regional Patient Financial Services Director

    • Mar 2013 - Feb 2015
    • Parkville, MD

     Managed the daily Operations Developed policies & procedures Managed the Billing department across 4 states Managed the accounts receivables department Developed action plans to reduce the A/R Oversaw the research & analyze all accounts to ensure that codes are billable according to Medicare/Medicaid/Commercial insurance guidelines. Reviewed/Handled any charge entry, billing, patient registration and or system questions that were escalated. Organized/Attended payer and or vendor meetings. Managed the patient intake, Authorizations, Contracts, Patient reimbursements Managed the interviewing, terminations and employee evaluations Managed the Customer Service department Reviewed and approved the payroll Assist with any patient relations concerns that were escalated Assisted the CEO (yearly budget, Contract renewals, new business)  Created month end reimbursement reports Attend monthly management meetings  Responsible for payer contracts

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  LifeBridge Health

  • Senior Team Lead Billing & Customer Service

    • Sep 2007 - Feb 2013

    Assisted in the start up of a new Community Physician DivisionSupervise 10 employees(Customer Service Reps, Claims Processors, Billing, F/U & Self Pay Specialist)Monitor quality & productivity of the accounts receivable/recovery specialist department staff.Provided system and customer service training to current/new employees. Analyzed A/R reports to ensure collection rate was maintained under the DRO/DSO goal set.Manage & monitor workflow and staff development needs.Assist Director with identifying trends with reimbursement, payer issues and concerns.Assist Director with Policies, Procedures and special projects Develop action plans to resolve A/R issues/operational issues.Contact patients/insurance carriers to resolve any customer service or medical billing issuesAttend monthly manager meetings Managed the A/R follow-up on accounts pending payments.Research & analyze all accounts to ensure that CPT codes, modifiers and DX codes are billable according to Medicare/Medicaid/Commercial insurance guidelines.Process Claims (CMS 1500)Process charge backs/refunds to patients and insurance companies.Dispute/Appeal all accounts that are not paid accurately.Assist providers with any charge entry, billing, patient registration and or system questions.Set on the board of Diversity Council

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  Community Care Nursing Svc

  • Parkville, MD

  • Patient Fianancial Service Billing Manager

    • Sep 2003 - Sep 2007
    • Parkville, MD

     Developed policies & procedures Manage the Billing department Managed the Accounts Receivables department Developed action plans to reduce the A/R Research & analyze all accounts to ensure that codes are billable according to Medicare/Medicaid/Commercial insurance guidelines. Handled any charge entry, billing, patient registration and or system questions. Attended payer and or vendor meetings. Managed patient intake, Authorizations, Contracts, Patient reimbursements Managed the interviewing, terminations and employee evaluations Managed the Customer Service department Reviewed and approved the payroll Created month end reimbursement reports Attend monthly management meetings  Responsible for payer contracts

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  Baltimore City Public Schools

  • Finance Secretary

    • Sep 2003 - May 2006

    Served as key point of contact when Administrators were unavailableProcessed bi-weekly payroll for 80 employees (Oracle)Maintained company benefits tracking log with accuracy.Handled petty cash, Accts Receivables & Supply Chain purchasesGreeted visitors and vendors to help create and maintain business relationships.Filing of student and staff confidential and sensitive documents.Maintained students & staff schedulesSupervised students when needed.Completed special tasks and projectsCustomer Service

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  Nursing Home

  • ASSISTANT ADMINISTRATOR

    • May 2000 - Aug 2003

    Assisted the NHAManaged 15 employees directlyProcessed Medicare, Medicaid & Self Pay BillingResearch & analyze all accounts to ensure accurate billing according to Medicare/Medicaid/Commercial insurance guidelinesReviewed Self Pay accountsDeveloped & Revised Policies and ProceduresAssisted with yearly budgetInterviewing/Training/SeparationsApproved Bi-weekly Payroll for 100+ employeesAssisted the Admissions CoordinatorPatient relationsVendor relationsCustomer Service

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  Butler & Associates Adjusting Company

  • Baltimore, MD

  • Practice/Operations Manager

    • Jun 1996 - May 2000
    • Baltimore, MD

     Assisted the CEO with the yearly budget Managed 15 employees directly Managed Customer Service Department Responsible for HR(Hire, Training, Evaluations, Separations) Approved the payroll (ADP, Probusiness) Developed/Revised Polices & Procedures Managed the posting of cash receipts and claims processing. Assited with processing claims when needed Analyzed the A/R reports Handled patient registration Reviewed all Medicare and Medicaid accounts before billing Managed the accounts payables Reconciliation of accounts Processed credits to vendors and clients. Handled Vendor relations (Established contracts with vendors and new business)