Managing Seva’s largest client, a multi-specialty practice including Allergy/Immunology, Biologics/Vaccinations, Dermatology, Diabetes/Endocrinology, DME, Podiatry, Chronic Care, Primary Care, Rheumatology, and Sleep Medicine.Started with practice of five providers and three locations that grew into 40+ providers and 15 locations; Revenue growth from around $400K/month to more than $2 million/month for last six consecutive month with our highest grossing month to date of $2.55 million… Show more Managing Seva’s largest client, a multi-specialty practice including Allergy/Immunology, Biologics/Vaccinations, Dermatology, Diabetes/Endocrinology, DME, Podiatry, Chronic Care, Primary Care, Rheumatology, and Sleep Medicine.Started with practice of five providers and three locations that grew into 40+ providers and 15 locations; Revenue growth from around $400K/month to more than $2 million/month for last six consecutive month with our highest grossing month to date of $2.55 million in August 2024. Manage team of 11 members in groups for A/R, Payments and Posting, and Charge Entry/Coding; streamlined processes that created: Increased A/R productivity to 100 charge lines consistently worked per day, a daily average posting of $116K in payments (manual and electronic), and an average of 6000 charges posted weekly for services rendered. Hold multiple weekly meetings remotely for my team and leads as well as attend multiple meetings with other departments to foster a broad line of communication.Decreased overall denials rates from 17.6% to 11.3% over the last six months and brought days in A/R down to a practice low of 29.3 days in August 2024.Trained 20+ billers in Epic software and billing practices while streamlining a new hire process and checklist. Answer all questions Epic software related and guide members of other teams such as eligibility, authorizations, and scheduling in the offices.Attended the 2024 Epic XGM conference in Verona, WI to tour and learn about upcoming software upgrades and potential AI rollouts. Work with Epic Analysts and developers to identify and update problems in software specific to our lines of business; implement back-end coding rules specific to our practice needs. Currently creating training presentations for providers in each line of business to improve overall documentation, productivity, and adherence to state laws and compliance which will directly impact and improve patient care and outcomes. Show less

Manage all aspects of pediatric therapy group setting for PT, OT, ST, and feeding therapy for children 0-21 years of age.Work directly with Fusion software coders and clearinghouse to implement needs specific to our practice to prevent disruption of revenue, as we are a small and very new practice.Authorizations management between any commercial payers and all Medicaid CE’s, requiring up to date knowledge of practices and processes in each payer portal for accurate submission… Show more Manage all aspects of pediatric therapy group setting for PT, OT, ST, and feeding therapy for children 0-21 years of age.Work directly with Fusion software coders and clearinghouse to implement needs specific to our practice to prevent disruption of revenue, as we are a small and very new practice.Authorizations management between any commercial payers and all Medicaid CE’s, requiring up to date knowledge of practices and processes in each payer portal for accurate submission and timely turnaround of approvals upon first request.Payments and posting management including ERA/EFT application submissions, coordination with practice owner for credentialing purposes, and streamlining processes for revenue total of $285K YTD and A/R days that are < 20 consistently. Charge posting management including claims scrubbing, working with Fusion to streamline claim posting process and make as automated as possible, and ensuring accurate and timely release of billing multiple times weekly for a total of $577K posted charges YTD. Show less

Performed Office Diagnosis and/or procedural coding for approximately 30 therapists and hundreds of pediatric patients to apply the appropriate diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Contacted Therapists or physicians with questions about treatments or testing given to patients regarding ability to accurately code procedures and diagnoses.Responsible for all commercial and Medicaid… Show more Performed Office Diagnosis and/or procedural coding for approximately 30 therapists and hundreds of pediatric patients to apply the appropriate diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Contacted Therapists or physicians with questions about treatments or testing given to patients regarding ability to accurately code procedures and diagnoses.Responsible for all commercial and Medicaid authorization submission prior to treatment. Highly time sensitive and requires advanced attention to detail.Collaborated with Billing/Payment Coordinator to ensure all bills are satisfied in a timely manner and serve as a resource regarding insurance resolutions and coding questions.Collaborated with Intake Coordinator regarding approval of authorizations prior to evaluation and working charge entry errors regarding authorizations on file.Maintained tracking of authorizations, prescriptions, consents, and multiple daily and weekly reporting regarding CPT/diagnosis coding and scheduling of patients.Cross-trained in all areas of the business office to back up the following positions: Front office/Reception, Intake Coordinator, Billing and Payment Coordinator. Show less

Office/procedure coding CPT and ICD-10 for three practice locations, multiple physicians, and CRNAs and hundreds of pain management patients to apply the appropriate diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Worked encounter resolution report twice weekly to ensure accurate and efficient medical coding while working with supervisor to maintain dictation-based report efficacy and timely… Show more Office/procedure coding CPT and ICD-10 for three practice locations, multiple physicians, and CRNAs and hundreds of pain management patients to apply the appropriate diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Worked encounter resolution report twice weekly to ensure accurate and efficient medical coding while working with supervisor to maintain dictation-based report efficacy and timely filing.Responsible for daily deposits, ensuring accurate accounting and reporting, matching multiple reports and final numbers daily, weekly, and monthly.Processed daily lock box information received from bank, delegating correspondence to correct team member, applying all monies received through EOBs attached, and balancing with external report when completed.Assisted entire billing team with information regarding prior authorizations, reasons for denial of a claim, correspondence needed for appeals, corrections of claims, void/entering/updating payment information, answering patient questions and concerns, and updates regarding new LCD information regarding coding.Counted multiple drawers and securing in locked area daily, working with electronic health record system, medical software for accurate accounting/coding duties, familiarity with electronic filing system, and use of external Excel spreadsheets for reporting. Show less

Worked with the following companies: United Healthcare, Tricare, Humana, Aetna, Cigna, Worker’s Compensation insurances, Mutual Assurance Administrators, Preferred Community Choice, Kempton Group, Community Care, and multiple other carriers.Familiar with appeal processes of most commercial and government insurances, handling correspondence within HIPAA compliance on requests for review, and electronic submission and ERA requests through multiple payer websites.Extensive… Show more Worked with the following companies: United Healthcare, Tricare, Humana, Aetna, Cigna, Worker’s Compensation insurances, Mutual Assurance Administrators, Preferred Community Choice, Kempton Group, Community Care, and multiple other carriers.Familiar with appeal processes of most commercial and government insurances, handling correspondence within HIPAA compliance on requests for review, and electronic submission and ERA requests through multiple payer websites.Extensive experience in answering multi-line phone systems, filing (paper and electronic), data entry, and highly specific chart documentation regarding any and all aspects of patient accounts.Identified trends and changes in A/R and implement processes to increase functionality and claim payment turnaround. Show less