Celeste Stauffer Email & Phone Number

Tampa, Florida, United States

Tampa, Florida

The Billing Analyst works as a department liaison within CareCentrix to support NBC billing and collection activity. Responsible for timely EDI billing transmissions, file analysis, report retrieval, and reconciliation. Acts as a point person for all NBC inquiries regarding payer rate and billing issues. Billing Analyst is responsible for communicating inquiries to Data Management to ensure the accurate set up of payer accounts. Responsible for generating and reviewing A/R Balancing Reports, Financial Revenue Code Reports, Provider Recoup Reports and miscellaneous AR reports. Responsible for the timeliness of daily EDI Transmissions. Billing Analyst will review system reports for billing errors, identifies, and escalates issues to appropriate department for resolution, and communicates to all business lines accordingly. Utilizes HIPAA compliant billing software to ensure EDI and payer requirements are met. Reconciles daily EDI transactions through payer confirmation reports and up lines variances to clearing house/payer for resolution. Reviews weekly paper invoicing and responsible for resolving issues to assure timely submission. Reviews specific billing, pricing, and coverage rules for new and existing payers. Utilizes Data Management Request Portal to ensure accurate table loading. Billing Analyst will QA payer accounts, test, and obtain sign off from impacted business lines. Generates and reviews weekly A/R Balancing Reports to ensure financial controls meet company requirements. Responsible for identifying and escalating variances for resolution and communicates to all business lines accordingly. Reviews weekly Unity Pre-Billing Edit reports to ensure timely and accurate. billing. Reviews daily Financial Revenue Code Reports and makes necessary adjustments to ensure all financial transactions and plan changes are recorded in the billing system. Works miscellaneous AR reports to ensure billing timeliness.

Coordinate & facilitate implementation of new contracts for approximately 85-90* Branches at any given time. Acts as a liaison between Billing, Contracts, Data Management, and I/S staff to implement payer billing requirements. Assisted in maintaining a low DSO by setting up new accts in a timely manner. Establish & maintain Account ID's within the Unity/HEAT Payroll/Billing system, as well at the automated system, Cerner. Assist with training FSU (Financial Service Unit) staff on new payers, as well as modifications to formats of existing payers. Assist in work distribution and completion of special projects. Was also the Website Administrator for the US Department of Labor for all of Gentiva, and assisted in any questions or requests that came in for that payer. The Billing Analyst department was decentralized and the function moved to the regional offices in Kansas, Phoenix and Atlanta. (*Territories were often moved around to ensure cross-training. I have had experience and am very familiar with payers in the North

Responsible for maintaining the Commercial/Medicare/Medicaid AR for several Branches by contacting the providers either by phone or internet to determine if and when payment will be received on a claim. Also responsible for reviewing and identifying any problems which may cause claims to be pended or denied by provider. Once Medicare Department was "de-centralized" I assisted in training the new collectors that would take over the Medicare product from the various offices.

Responsible for maintaining the AR for a doctors' office by calling Insurance companies, patients, or third party vendors to determine why, if, and when payments will be received on outstanding Medical claims. Responsible for posting payments to the patients' accounts based on EOB received from the insurance companies. Also responsible for billing claims on a daily basis, via Electronic or paper means, to ensure prompt payment. Created a training matrix and trained new employees upon hire, and continued to be the "answer person" for any question they had until comfortable to handle the accounts on their own.

Coordinates the payroll portion of the conversion process with new clients. Acts as a liaison between new client and internal departments to include payroll and any other questions the client may have. Handles all aspects of conversion by analyzing client specifications, determining the appropriate method for payroll input and ensuring correct setup features. Also accountable for the successful transition of new accounts through the conversion process. Auditing the deductions and taxes on each individual 's payroll to determine that the correct amounts are being deducted from their checks for the first few payroll cycles. Also responsible for answering any questions the clients/employees may have regarding their payroll and/or deductions.

Receiving various types of correspondence, via paper or the Internet, from Members, Providers, and/or other Units within the office requesting a review on members files or individual claims to ensure proper claim processing. Receiving, reviewing and responding to Department of Insurance Complaints and/or Presidential Complaints members have submitted for various reasons. Handling telephone call overflow on a "business need " basis. Assisting members and/or providers with different questions or concerns they may have with claims that have been or will be processed.

Aa, Business Administation

Business, General Diploma