Experience

Stratus

• United States
• Hospitals and Health Care
• 100 - 200 Employee

• Special Project Manager

  • Aug 2022 - Present

  As the Special Projects Manager, I am responsible for providing technical solutions within the Brightree EHR system, including the resolution of ERL rejections, insurance profile creations and updates, and various AR activities. Other duties include establishing EDI services for all current Stratus entities servicing patients nationwide with various payers; concluding insurance adjudication through patient refunds and issuing checks or credit card returns appropriately; managing help desk tickets to resolve; creation and distribution of training material designed to aid staff with HIPAA compliant access to provider portals and other various requests. developing ad-hoc reports, analyzing the data, and disseminating that data aiding in the identification of trends used to improve the submission of clean claims and enhance reimbursements while maintaining compliance with Stratus by-laws and external regulatory agencies. All tasks are completed with extensive knowledge and routine execution of HIPAA guidelines. Additional duties include direct reporting to the CFO, CIO, and Director of RCM. Show less

• Medical Records & Reporting Clerk (Remote)

  • Mar 2019 - Present

  Transfer – March 2019 to currentDuties include operation of various healthcare database systems that allow access to patient sensitive information and doctor interpretations of completed studies. Strict adherence to state and federal laws when disseminating information to payors, providers, and patients. Utilization of various spreadsheets to enter, capture, and retrieve data integral to billing, collections, and AR procedures. Consistent in exceeding strict metrics adherence.

• Verification of Benefits - Supervisor

  • May 2016 - Mar 2019

  Alliance a Family of Companies provides inpatient and outpatient diagnostic services for sleep studies and EEG testing in over 39 different states. Part of the process to service patients is to verify insurance benefits and obtain authorizations and referrals as needed. I supervise and direct the verification of benefits team sized between 15 to 20 representatives with in-depth knowledge of various insurance plans including medical groups. Duties include: interviewing candidates; new hire training; training; employee development; performance reviews; development and dissemination of company policies and procedures; producing reports reflecting productivity metrics to reflect individual, team production and comparisons; liaison for department between Executives and all department heads. Increased department productivity by 22% last quarter. Show less



Health Net

• United States
• Insurance
• 700 & Above Employee

• Utillization Managing Coordinator

  • Jan 2015 - May 2016

  Health Net Medi-cal is a California state Medicaid managed care organization that provides coverage to low-income families. As a Utilization Management Coordinator my duties included the following: verification of insurance eligibility and claim inquiries; receiving and processing routine and urgent authorization requests; processing letter of agreement requests; coordination with providers and independent physician associations to obtain approval for procedures and durable medical equipment; scheduling peer to peers for the Medical Director; working directly with clinical staff to ensure authorizations were approved or denied, per the local coverage determination guidelines. Consistently exceeded call quality expectations and all production related metrics with less than 3% error margin. Show less



University of Washington

• United States
• Higher Education
• 700 & Above Employee

• UWMC Customer Care Representative

  • Jan 2014 - Dec 2014

  University of Washington contact center is the fast-paced headquarters for patients to register, schedule and refill prescriptions as well as other inquires for University of Washington, Harborview Medical Center and Northwest Hospital facilities. As a Patient Care Coordinator, I was responsible for receiving 80-120 patient inquiry calls daily with in-depth training on the medical EPIC EMR system. Duties included the following: full patient registration; working knowledge of various payors including workers comp; verification of insurance; receiving and creating referrals and authorizations; prescription refills; patient follow up calls; following over 180 clinical cadences with an average 97% accuracy; utilizing interpreter services; assisting in triage calls for emergency patient symptoms and sending the clinic messages. Show less



Loan Resolution Corporation

• United States
• Financial Services
• 1 - 100 Employee

• Quality Auditor Supervisor

  • Dec 2010 - Oct 2013

  Loan Resolution Corporation is a third-party administrator servicing HAFA short sale loans for Bank of America. As a Quality Auditor Supervisor, I was responsible train, coach and mentor 40-50 call center representatives. Additionally, assisted with quality metrics planning to stay within the guidelines of Bank of America while actively utilizing six sigma techniques. Other responsibilities included data analytics to identify areas of improvement and develop performance improvement plans for employee; resolve escalated matters and create coaching guidelines to assist staff in avoiding similar situations. Show less



Arizona Center of Faith, LLC

• Phoenix, Arizona Area

• Owner/Operator

  • Jul 2006 - Dec 2010

  Co-owned and operated a telemarketing company that sold household products while employing disadvantaged workers. As an owner and operator, I directed the daily operations of the business for 20-30 employees. Responsibilities included the following: human resources and recruiting; compliance with OSHA and workers comp; payroll; production reporting and budgets; new-hire training; marketing strategies; customer service; coaching in all departments and customer complaint resolution. Increasing company profit margin averaging 15% annually. Show less