Payment Manager Analyst Tier II

• Jun 2022 - Present

A/R

• Jul 2019 - Jul 2022

Prepare all accounts for 7 hospitals , including commercial, HMO’s, MCO’s and advantage plans for refunding and recouping over payments. Call insurance plans to verify the overpayment and start the recoupment process. Verify all patient overpayments and send to the refund team for processing. Prepare all accounts for 7 hospitals , including commercial, HMO’s, MCO’s and advantage plans for refunding and recouping over payments. Call insurance plans to verify the overpayment and start the recoupment process. Verify all patient overpayments and send to the refund team for processing.

HR/Compliance Director/Billing/Credentialing

• Jan 2019 - Jun 2019

HR/Compliance/Billing/Credentialing Onboarding new employees Obtained all the information needed for State and Federal Taxes. Discussed and received the signed acknowledgement form for the company handbook. Created a login and password for compliance training for each position. Entered proper information into payroll software, including direct deposit. Provider credentialing Created excel sheet to follow that receipt of all licenses, renewal of licenses. Created (if not already created) Logins and passwords for CAQH, EPREP (Medical Assistance), Insurance companies, PECOS, etc.. Insurance credentialing Calling for and obtaining online all insurance applications. Completing all applications. Keeping track of all applications send and approval received. Enter the approved provider numbers into Athena for billing. Review all aspects of billing, help with A/R. Held monthly meetings with the outside billing company. Reviewed the A/R monthly to keep it at a reasonable percentage. Review all patients accounts before sending to collections. Has billing company resend claims to insurance company as new information was obtained. Review all accounts collections sent back for additional information. Answered all the questions that the collections company sent for review. Show less

Medical Manager

• Mar 2018 - Jan 2019

Chiropractic care, Auto accident treatment, Spinal decompression, Physical Therapy, Nutritional Counseling and support, Medical weight loss, Hormone replacement therapy, Cold laser therapy, Diagnostic procedures, DME products, Tens unit, Lumbar and Cervical Denneroll, Lumbar Pillow, etc.

Practice Manager

• Mar 2018 - Jan 2019

Billing Specialist

• Apr 2014 - Apr 2017

Software Trainer/Billing Specialst

• May 2015 - Dec 2015

Proximal, LLC is a complete billing service. I train all providers and staff on a electronic health records software. We provide all billing services, from insurance to patients and collections.

Electronic Health Record Coordinator

• Apr 2010 - Oct 2015

Train all new employees and Physicians on the current EMR system (Greenway, formally known as Vitera).I make sure that all EP's attest for MU. I continue to cover offices in a front and back office staff capacity as needed.

Office Manager

• Nov 2003 - Apr 2010

My responsibilities included scheduling appointments, prior authorizations (Medical and Rx's), front office and back office. Keeping the physicians personal schedules for meetings etc...I kept up with all medical licenses, DEA, CDS, Hospital and Telemedicine licenses.