Debby Gates Email & Phone Number

Westerville, Ohio

I currently manage all aspects of physician billing. Patient Accounts, Payment Posting, Insurance Follow up, EDI and the Document Center. We are currently implementing an integrated EHR and PM System with E-Clinical Works.

Responsible for the operations and financial activity of a Professional Billing Department. Insure billing and collection regulations are followed in accordance with compliance laws. Managed a staff of 40 employees with three direct reports. Key Accomplishments:Reduced accounts receivable aging by 69%Implemented new Revenue Cycle Management Billing System Received Epic Certification in Resolute Professional Billing Developed Staff Performance Measures which improved performance goalsRestructured Customer Service to improve service by 20%Established standardized payment plan process and financial assistance for families to reduce dollar amounts written off to bad debtDeveloped Incentive Program to reward staff for performance goals being met Developed departmental documentation as it relates to job descriptions and functions as a method for training employees learning new tasks and a training module for new hires

Responsible for the operations and financial activity of Bluecard Claims Adjustment Area. Achieved and maintained Blue Cross Blue Shield Association goals for Bluecard Index for the timely adjustments of claims. Managed a staff of 27 claims adjusters. Key Accomplishments:Recovered over $4 million from overpayments in adjustments of 70,000 claimsDeveloped online Lotus Notes Production Database to eliminate the use of paper reports, to assist staff in daily production as well as monitoring of daily inventoryDeveloped Adjustment Training Manual which improved efficiency and the timely processing of claimsDeveloped Employee Buddy System Program which promoted teamwork and accountability

Responsible for managing the operations and financial activity of a Customer Service Call Center. Responsible for handling inbound-outbound calls from providers, other Blue Cross Blue Shield Plans and National Account Group Sales Representatives. Maintained Corporate Standard Performance Guarantee goals. Managed a staff of 20 customer service representatives. Key Accomplishments:Awarded Manager of the year Anthem National Accounts SurveyDeveloped Staff Performance Measures which improved performance goalsDeveloped Work at Home Program which allowed staff to balance family and work responsibilities which improved moral and productivityImplemented a Voice Response System which improved the percentage of calls abandonedDeveloped Quality Enhancement Program which improved customer satisfaction and improved the overall BCBS Association Quality Guidelines

Supported a large-group sales department servicing statewide accounts. Responsible for 9,000 members in a 34 county region, encompassing health, life, LTD, STD, Cobra and other ancillary products requested by the customer. Key Accomplishments:Conducted Open Enrollment MeetingsFacilitated the implementation of enrollment applications and benefitsPromoted to Manager of National Accounts Customer Service

Responsible for handling of written and oral communications from members, providers and marketing representatives regarding Employer Contract Insurance policies. Key Accomplishments:Worked with The State of Ohio Department of Insurance to resolve disputes with members over insurance inquiriesSuccessfully trained customer service new hires on how to answer customer service phones and resolve written correspondence from members and providersServed as acting supervisor in the absence of the supervisorStarted in 1979 as a Customer Service Representative and promoted to Group Benefit Specialist