Account Representative⦁ Research and re-bill unpaid claims.⦁ Responsible for verifying insurance benefits or payment sources on all patients.⦁ Responsible for setting up patient financial files.⦁ Responsible for accurate computer data input on all patients, notes, and claims.⦁ Generates invoices for insurance billing, individual account billing, and follow-up billing for deductibles and copays.⦁ Research denied or pending claims and provides additional information to facilitate claim payment. Utilized ERA payment information to document payment trends.⦁ Negotiates with the responsible party on accounts more than sixty days past due. When unable to secure an agreement satisfactory to both parties, submit these accounts to the Client Services Manager for review prior to turning to private collection.⦁ Responsible for collection of patient information and verification of reimbursement source. Maintains patient financial files. Generates billing invoices and is responsible for collections.⦁ Required to maintain confidentiality at all times.⦁ Research and resolve accounts appearing on Follow-up Reportsto avoid delays w/ carriers such as HMO, PPO, MCD, and MCR⦁ Worked w/ other venders as needed to resolve accounts receivable. Made appropriate decisions and calls to worked.carriers to maximize reimbursement on accounts to be paid⦁ Correct all errors on electronic error reports using all the available information.⦁ Articulated payment delays to healthcare payor and government agencies⦁ Meet production and quality standards.⦁ Assists in identifying current and/or potential billing issues specific to outstanding receivableParticipates in daily production assignments that will continue to develop an understanding and⦁ Ability to take patient phone calls and assist Customer Service when business needs arise.⦁ Answer a multi-line phone.⦁ Assist in other duties as assigned.

Reviewed job descriptions and worked with executives to clean up and strengthen employee duties to attract qualified candidates. Responsible for maintaining records and compiling statistics by performing job analysis with market data to benchmark jobs and establish competitive salary ranges. Assisted with the training of new/existing employees Responsible for reviewing incentive plan agreements and processing the payouts. Collaborated with HRIS and business planning analysis. Managed the annual projects - annual bonuses and merit increases, including budget forecasting, Created spreadsheets and tools for executives to use to calculate and distribute their budget money, collecting the finished worksheets and processing them, error-checking, making last-minute updates, producing the letters to go to employees telling them how much they were getting Worked with payroll to get the final payouts processed. Coordinated and prepared reports for federal or state audits, compliance reviews Evaluated jobs, researched market pays, and prepared analysis and reports supporting with recommendations for appropriate salary ranges. Initiated employee surveys and maintained data. Participated in ad hoc reports, by staying on top of researching FLSA laws monthly or as needed, interpreting compensation, and analyzing trends. Ensured compensation/benefit levels were offered at fair market rates and skill level. Responsible for meeting with leadership quarterly to discuss goals and strategize outreach ideas. Managed the company wide merit and bonus cycles. Managed competitive compensation programs Collaborated with the Manager of Compensation on the development and presentation of education and training materials related to compensation policies, tools, and programs. Assisted staff with recruiting strategies in the preparation of budgets to monitor budget variances as they aligned with company goals.

Administered medical, dental, vision, Flexible Spending Accounts (FSAs), short-term (STD) and long-term disability (LTD), life insurance, voluntary benefits, and family and medical leave act (FMLA). Also administers 401(k) and HSA plans, including reconciliation and timely remittance of contributions. Communicated complex concepts and insights to senior business leaders and providers in a relevant and actionable manner. Researched and resolved issues externally by collaborating with vendors, and internally with other human resources’ teams and individual employees, as necessary. Supported HR Resource Team (HRRT) in resolving escalated employee benefits’ issues by acting as a liaison to benefits vendors. Supported HRRT Leave Specialist in reviewing and analyzing the coordination of company leave programs with state and other regulatory leave programs. Provided reports, audits, analyses and summarizes plan and employee data, as requested. In coordination with Data & Analytics, create and propose new value-based methodologies for deployment to specialists and other providers. Responsible for identifying targeted providers for re-contracting opportunities. Researched problems and negotiated with internal/external partners to resolve highly complex and/or escalated issues. Assisted with Value Based strategics Assisted with the management of vendor accountability. Actively participates in preparation for and administration of Annual Enrollment. Reviews, audits and coordinates payment of benefit vendor invoices. Accurately documented, developed and maintained department processes to ensure consistency. Worked collaboratively in organizations, external partners, and agile teams. Responsible for maintaining accurate employee benefits data in Workday and vendor systems, as applicable. Assisted the Workday Technology team with testing and reviewing benefits’ integrations to ensure system operation is consistent with benefit plan provisions.

• Responsible for entering employee’s hours and issuing checks.• Making sure checks were created and issued properly• Billing insurance companies for Medicare/Medicaid• Responsible for calling and reconciling payments from insurance companies.• Calling insurance companies daily to verify payments and amounts• Other duties include filing and answering phones.

• Responsible for daily posting for incoming mail for patient pay/insurance• Heavy data entry into Epic billing system• Responsible for pulling EOB’s and entering billing Claims paid for Physician/ Hospital• Responsible for posting $0 EOB for collection follow up• Responsible for reading EOB’s and calculating amounts being paid/under paid• Responsible for reconciling daily spreadsheets on all money received daily thru mail and wire.• Responsible for preparing checks for daily bank deposits• Collections follow up on unpaid accounts for patient payments• Responsible for posting discounts to aged accounts• Responsible for follow up on Unidentified accounts in a timely manner.• Mail Opening/Sorting for both Hospital and Physician• Contacting insurance carriers to reconcile billing issues• Responsible for initiation of patient/insurance refunds• Other duties as assigned

Completed financial impact analysis of contract negotiations, including modeling of contract proposals, reporting of contract proposal impact, performance and quantifying financial impact of these proposals and developed alternative proposals within the budget parameters. Presented analysis and recommendations to leadership. Prepared multiple analyses and presentations by extracting data from systems including EPIC systems and relational databases utilizing Excel. Responsible for developing alternative financial proposals that were within the budget parameters, based on analysis and modeling of contract performance by developing and preparing revised models using sound rationale, and presenting recommendations to Managed Care leadership. Analyzed contracts and prepared all supporting schedules necessary to update/maintain the EPIC system on a current basis. This included o reviewing all new contracts/amendments, meeting with Patient Financial Services staff to review changes, communicating with the payors to receive all updates on current basis, researching and downloading data form payor sites, analyzing and comparing new fee schedules to the prior fee schedules, preparing all uploads, validating input and updating EPIC reimbursement contracts. Responsible for leading my associates by conducting monthly/quarterly meetings with physicians in office or virtual meeting for issues concerning the achievement of quality outcomes, provider satisfaction, medical cost targets, network growth and/or efficiency targets. Ensured contract eligibility and authorization systems maximized efficiency to convert contracts. Responsible for maintaining the contract database, including reporting of key contract components. Responsible for developing network relationships, network communication, physician recruitment, and network partnerships as well as expansion of network and products offered by Health plan partners.

Managed marketing-related responsibilities, business development efforts, and client relationship management. Develop and support annual marketing and business development plans focused on priorities outlined by business development leadership• Insured smooth transition of patient care upon discharge from facilities and hospitals. Cultivated relationships with provider offices to insure preferred provider status for our services.• Plan, execute, and attend business development focused meetings, events, conferences, webinars and other client- facing initiatives. Conduct analysis aroundAccomplishmentsPROFICIENCIEScompetitive intelligence-gathering for strategic planning, competitive firm positioning, and business development activities• Formulate and design marketing materials to showcase firm’s expertise and capabilities • Responsible for contacting resident's families and educated them on our services. Responsible for meeting monthly referral goals• Maintain a list of updated referral sources, and facility. Cultivated relationships with facilities and Families and responded in a timely and professional manner to their concernsRecognized by executives and colleagues for excellent leadership and attention to detail.

Providing member with fast and accurate transactions.• Opening, and closing checking, savings, and CD accounts.• Data entry for credit card and loan applications.• Meeting goals and exceeding member’s expectations.

Providing member with fast and accurate transactions.• Opening, and closing checking, savings, and CD accounts.• Data entry for credit card and loan applications.• Meeting goals and exceeding member’s expectations.

Providing customers with fast and accurate transactions.• Heavy Cash handling• Data entry• Customer Service

Providing customers with fast and accurate transactions.• Heavy Cash handling• Data entry• Customer Service