Experience

DrChrono

• United States
• Technology, Information and Internet
• 100 - 200 Employee

• Senior Product Manager, Payments

  • May 2022 - Present



Cultivated Bohemians

• Wellness and Fitness Services

• Founder/Owner

  • Aug 2020 - Present



Oscar Health

• United States
• Insurance
• 700 & Above Employee

• Manager, Insurance Ops, Process Design & Strategy

  • Nov 2021 - Apr 2022



quip.

• United States
• Wellness and Fitness Services
• 100 - 200 Employee

• Director, CX Operations

  • Oct 2019 - Feb 2020

• Senior Manager, Care Experience

  • Jul 2019 - Oct 2019



ELLKAY

• United States
• Software Development
• 300 - 400 Employee

• Senior Product Manager

  • Sep 2018 - Aug 2019

  ● Executing the development, SRP plans, go to market strategies and shipping of RCM products. ● Working with Marketing and sales with product launches and sales readiness plans; contribute to articles, case studies and webinars as and when needed. ● Maintaining product roadmaps (short & long term) as well as a well-groomed and organized backlog for assigned product, and coordinate efforts with corresponding Product Teams, including enhancements, production support, etc. ● Working with other product teams to understand key workflows and identify necessary data elements to support functionality. ● Developing and managing metrics for performance; ensuring the delivery against department goals and objectives, i.e. meeting commitments and coordinate overall schedule. ● Managing EMR data conversion projects for financial data and AR rundown (converting data from/to various systems including EPIC, Cerner eCW, Athena, NextGen, GE Centricity, Meditech, etc.) ● Conducting research, attending webinars and reviewing other informational resources to develop high-level requirements for new projects and product functionality assuring all requirements adhere to government regulations, internal guidelines, and organization style guides. ● Developing use cases, workflows and outlining business requirements for RCM clients ● Assisting with securing clients for focus groups and acceptance testing. ● Assist with documentation and communication necessary to provide sales and marketing teams with information regarding roadmaps, priorities, timelines, features, competitive information, and product positioning as needed. Show less



Med-Metrix

• United States
• Hospitals and Health Care
• 300 - 400 Employee

• Sr. Revenue Cycle Product Workflow, Assessment and Implementation Consultant

  • Aug 2017 - Aug 2018

  • Client assessments and the development of recommendations that involve Med-Metrix solutions • Acting as lead Product Manager for Med-Metrix ARS clients • Serves as the primary point person for clients, and independently provide updates on the status of work plan activities, as well as their operational and financial performance against goals and benchmarks • Identify areas of operational inefficiencies and translate improvement strategies into system functionality • Lead a client through the change management process, working directly with Hospital Management as well as end-users • Develop and present future-state process design recommendations • Execute on project plans to meet external timelines and resource capacity • Design application configuration logic and see it through to implementation • Serve as primary contact between the client and our Programmers to translate business needs into programming requirements Show less



DaVita Kidney Care

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Operations, Claims Formatting and Product Release Management

  • Jan 2017 - Aug 2017

  • Successfully created two new teams to support the companies homegrown billing system • Establishing and supervising two separate teams in the operations and billing setup department. • Defining the scope for each project for system releases and developing project plans for all projects for both teams • Managing the workflow and project plans for the release management team for new billing system update • Acting as a liaison between the claims submission team and claims formatting • Developing audit process for the claims formatting to ensure that there are clean claim submissions • Monitoring and gatekeeping ServiceNow tickets • Assesses the impact of new billing requirements on the operation and recommends procedural or system changes as necessary • Creating and producing weekly feedback reports to be utilized by the client for front office staff training and education. Show less



GoHealth Urgent Care

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Cycle Manager and Project Manager

  • Jan 2016 - Jan 2017

  Provide subject matter expertise and training in all areas of the healthcare revenue cycle which includes: Patient access (scheduling, preregistration, insurance verification/financial counseling) Registration/Admission (ED, inpatient, outpatient, ambulatory) Patient financial services (charge capture, pre-billing, billing, follow-up, cash posting, account resolution) Decision support and analytics Developing training plans for staff on EPIC (PB) and EClinicalWorks Health Information Management (transcription, coding, clinical documentation improvement) Managed care contracting Identify client accomplishments barriers in achieving operational excellence Understand client business metrics and results Evaluate and analyze client data to understand trends in all areas of the operation Development of options and recommendations for client improvement Collaborate with other departments in order to facilitate resolution of process issues and implement revenue cycle solutions Assist in managing the billing team Assist in the hiring process for billing specialist and coders Develop work plans, project tasks and manage projects in accordance with budget Provide interim staffing services as required Show less



Optum

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Regional Manager (Hospital Account Products)

  • Oct 2013 - Jan 2016

  • Running daily and weekly credit balance reports • Reviewing hospital credit balance accounts to resolve insurance overpayment • Provide expertise in credit balance adjudication by reviewing, researching, and resolving all types of accounts as well as providing resolution outcomes for health plans, commercial customers and government entities • Following up on insurance vendor letters concerning overpayments, recaps, and retractions • Extensive insurance revenue recovery • Auditing all accounts with credit balances • Processing and submitting insurance refunds for various types of insurance (including commercial, auto, and Workman’s Comp) • Auditing and correcting improper insurance adjustments • Analyzing various insurance patterns concerning overpayment • Presenting audit results to hospital clients Establishing working relationships with clients in hospital to ensure operational efficiency Show less



Sheridan Healthcare

• United States
• Medical Practices
• 700 & Above Employee

• Reiumbursment Analyst

  • Jan 2013 - Jun 2013

  • Reviewing and correcting patient and insurance account issues • Collecting on patient accounts • Extensive revenue recovery • Completing insurance and responsibility module’s on Misys Vision • Following up on unpaid aged claims with managed care insurance companies • Analyzing various insurance patterns concerning denials and underpayment • Researching denied claims and making informative decision’s as to whether appealing is necessary • Entering charges and ensuring that they are submitted to insurance in a timely fashion Show less



Cypress Creek Therapy

• United States
• Health, Wellness & Fitness
• 1 - 100 Employee

• Account Control Officer

  • Aug 2012 - Jan 2013

  • Collecting on and resolving aged patient accounts with insurance issues • Reviewing and correcting patient account issues • Following up with Medicare, Medicaid, and private insurance companies on all denied claims and claims in pending status for 90+ days • Contacting and updating patients on their aged claims status’s • Verifying that all coding and charges on pending claims are correct • Collect various information from patient charts pertaining to patient medical claims • Running and analyzing daily and weekly claim reports • Researching denied claims and writing detailed appeal letters • Ensuring that all claims that were sent out and processed are received by insurance so that timely filing standards are meet Show less



Century Rehabilitation Inc

• Dallas/Fort Worth Area

• Office/Intake Coordinator

  • Feb 2011 - Feb 2012

  Assisting with Medicare Part A PT/OT/SLP appeals. Making sure all appeals meet redetermination, reconciliation, and ALJ requirements and deadlines. Maintaining and updating EMR systems. Updating and processing all denials so that clients would be credited for therapy services. Implementing a new filing system for current office appeals. Contacting various facilities to get in MDS and nursing documentation. Entering information into Theratrack and meeting appeals deadlines. Running and preparing denials reports. Tracking denials and credits for each clients and all of their facilities. Preparing appeals packets to go to Trailblazer, Maximus, and Medicare Hearings offices. Handling all front office and administrative duties in the office. Show less



Animas Corporation

• West Chester

• Customer Care Position

  • Jul 2009 - Jul 2010

  Educating Diabetic patients on OneTouch Ping glucose monitoring system. Taking orders for Diabetic DME supplies. Calling doctors and insurance providers to verify prescription and insurance plans. Extensive administrative duties in the customer care department. Updating customer data information. Processing patient orders with insurance and making sure all managed care guidelines where meet. Calling customers for supply ordering reminders. Data entry, customer service, and other office support responsibilities. Show less



Maximus

• United States
• Government Administration
• 700 & Above Employee

• Operations Support Clerk

  • May 2008 - May 2009

  Responsible for Medicare appeals case processing, reviewing accounts, telephone contact with payers, researching and working daily reports and issues, data entry, customer service and telephone contact with payers, provide call center support for other issues as they apply to appeals, research fees and medical records Responsible for Medicare appeals case processing, reviewing accounts, telephone contact with payers, researching and working daily reports and issues, data entry, customer service and telephone contact with payers, provide call center support for other issues as they apply to appeals, research fees and medical records