Health Care Revenue Program Manager
CurrentThe Arizona Partnership for Immunization (TAPI) is a nonprofit coalition that addresses immunizations, reproductive health and other critical care needs in the State of Arizona.Responsible for overseeing revenue cycle operations for immunizations, reproductive health, and recently COVID-19 encounters, for 10 County public health departments, including managing staff involved with billing, EOB/ERA payment posting, denial management, A/R follow-up, eligibility verification and provider credentialing.Key Responsibilities• Serve as the principal reimbursement contact and subject matter expert for county health department front office and clinical staff• Identify, implement and enhance revenue cycle processes and policies• Lead special projects, including IT planning, data analysis and reporting, and billing systems assessment• Monitor clearinghouses to capture rejections for immediate staff re-work and re-submission, proactively reducing the number of days in A/R• Ensure compliance with relevant regulations, standards and directivesKey Achievements• Effectively navigated through the complexities of billing for COVD-19 vaccine administration of hundreds of thousands of claims• Successfully implemented billing programs at three new public health county department clinics, allowing for reimbursement of additional services• Identified the underpayment of the vaccine administration code for claims from AHCCCS health plans, resulting in the reprocessing and additional reimbursement of thousands of claims• Collaborated with major payers and had denied claims reprocessed and paid in compliance with the Arizona State statute that provides for reimbursement of required school-aged immunizations at in-network rates, resulting in reimbursement of over $400k in the first year• Identified underutilization of the practice management system, implementing required use of features such as “task scheduler” to ensure timely follow up of outstanding A/R