Experience

Mitchell International

• United States
• Software Development
• 700 & Above Employee

• Supervisor 2, CSG, Medical Bill Review

  • Sep 2023 - Present

• Supervisor 1, Medical Bill Review

  • Sep 2021 - Present

• Client Program Manager 2

  • Aug 2020 - Sep 2021



Avidel Medical Management

• Irving, TX

• Supervisor Medical Bill Review

  • Aug 2018 - Jul 2020

  Manage a team of internal & onsite Bill Review staff. Hire, Train, Discipline, Annual Reviews and Terminate staff as necessary. Manage and create processes, insure accuracy of Medical Bills. Interact with clients, providers, software vendor and Texas Department of Insurance or Division of Workers Compensation Jurisdiction as necessary, answering questions or researching for answers. Create reports as necessary for Clients, Team, Client as needed. Reviewed High dollar and Reevaluation bills submitted with CPT coding, HCPC codes etc. with modifiers for Pharmacy, professional, complex, surgery and inpatient/outpatient hospital bills and compared to Workers Compensation Fee Schedule etc... Show less



Jordan Health Services

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

• HR/Home Office Payroll Specialist

  • May 2016 - Aug 2018

  • Import Payroll, work with location representative to add/delete corrections and create deposit file. • Review requests for New or Re-Hire, Status change, Increases, Terminations etc. then Approve or Deny depending on documentation. • Review requests for FMLA/PLOA to determine which one they qualify for and respond accordingly. Create and mail out packets, track for follow up of certification, extensions, return to work or terminations. • Reporting SSN Verification & Equifax (TALX), and internal Reconciliation reports for Ultipro Tax, Garnishments & Benefits deductions. • Electronic Employment Verification with Texas Workforce Solutions. Show less



NOVARE Texas LLC

• Frisco, TX

• Supervisor, Bill Review Operations

  • Feb 2014 - Aug 2015

  • Provided accurate and pertinent data to VP for use in strategic and tactical planning. • Solve escalated customer issues and research information to answer questions regarding matters such as pre-authorizations, IME, RME, Peer Reviews & bill review denial/recommendations. • Train staff on Fee Schedules and systems in order to be proficient and meet client’s needs and expectations. • Process medical provider bills in accordance with each State’s Workers Compensation rules and guidelines (fee schedule). Show less



Coventry Health Care Workers Compensation

• Plano, TX

• Manager, Bill Review Operations

  • Feb 2004 - Dec 2013

  •Provided accurate and pertinent data to Director for use in strategic and tactical planning. •Promoted and maintained a positive working environment and structure that supports self-directed teams and optimizes their experience, skills, knowledge and capabilities. •Solved escalated customer issues and researched information to answer questions regarding matters such as pre-authorizations, payments and denials. •Analyzed daily, weekly, and monthly statistical reports and made appropriate recommendations and forecasts regarding training trends and staffing matters. •Prepared for and/or conducted customer presentations and lead team meetings. •Assisted supervisors and team members in improving their facilitation skills. •Managed Supervisors and their teams consisting of 20 plus members each. Show less



Intracorp

• Insurance
• 100 - 200 Employee

• Supervisor Bill Review Operations

  • May 2003 - Jan 2004

  Supervised 15 employees in MRS department and handled all human resource issues. Ensured that client quality and timeliness production standards were met. Worked directly with clients to resolve any issues and answer any questions. Implemented available technology to contain cost and increase revenue. Supervised 15 employees in MRS department and handled all human resource issues. Ensured that client quality and timeliness production standards were met. Worked directly with clients to resolve any issues and answer any questions. Implemented available technology to contain cost and increase revenue.



Genex Services

• United States
• Insurance
• 700 & Above Employee

• Supervisor, Bill Review Operations

  • Aug 1997 - Apr 2003

  Supervised up to 14 employees in MRS department and handled all human resource issuesSubmitted payroll for entire bill review unit of 34 employees. Ensured that client quality and timeliness production standards were met.Cross trained staff for multiple duties, thereby increasing unit productivity Worked directly with clients to ensure all needs are met, including meeting deadlines, resolving issues and submitting required reports in a timely manner.Implement available technology to contain cost and increase revenue Show less

• Team Lead

  • Jul 1991 - Aug 1997

  • Reported directly to Supervisor • Answered Provider calls regarding status of their medical bills submitted to TPA or employer.• Trained new hires on software and best practices.• Answered all team questions.



Quality Inc.

• Dallas/Fort Worth Area

• Analyst/Pharmacy Workers Compensation billing secialist

  • Jul 1990 - Jun 1991

  • Implemented TWCC WC Fee Schedule rules and guidelines to RX billings for all clients. • Met and exceeded daily productivity goals. • Gained knowledge of HCFA 1500 and UB92 forms. • Data entry of all workers compensation claimant billings. • Implemented TWCC WC Fee Schedule rules and guidelines to RX billings for all clients. • Met and exceeded daily productivity goals. • Gained knowledge of HCFA 1500 and UB92 forms. • Data entry of all workers compensation claimant billings.