Eileen Lang Email & Phone Number

Santa Rosa, California, United States

Calistoga, California

Healdsburg, Ca

Novato, Ca

• Manage inventory of assigned accounts for various clients • Ensure timely and accurate billing and follow up for accounts assigned• Analyze accounts for underpayments or denials and submit appeals in a timely manner• Review overpayments to determine appropriate resolution• Follow up on all denied appeals• Recommend write offs as appropriate and communicate reasoning to clients• Work with unit Manager and Director in developing goals for client groups• Daily oversight of account flow to prevent missed deadlines for Appeals• Develop, monitor and improve optimal account flow strategy• Ongoing analysis of overall project to ensure high level of performance and maximum reimbursement per insurance contracts• Provide high level of customer service to internal and external customers• Act as an expert resource in Insurance Follow Up for coworkers, clients and customers

Novato, Ca

• Audit percentage of accounts worked by Follow-up staff daily.• Audit percentage of accounts not worked over 45 days monthly• Develop & maintain audit logs for each staff person, including productivity & error rates.• Deliver feedback to the staff & weekly summaries and analysis of audits to department manager and trainer.• Identify trends and areas of training opportunity. Provide recommendations for training to department Manager and Trainer & re-audit as necessary to determine success of training.• Track recommendations and results• Prepare monthly audit report for Manager and Director.• Ensure that all staff are consistent in their processes and work flows.• Respond to staff inquiries regarding appropriate processes related to billing and follow up. Support any training initiatives as needed and directed by the Manager and Trainer.• Notify Department Manager and Trainer immediately of any potential compliance issues.

Novato, Ca

• Supervise multiple teams of up to 25 employees• Direct and organize work flow, establishing deadlines and providing direction, best practices, and work techniques• Monitor staffing, attendance and timecards • Review KPI reports to identify problem areas or trends and help establish action plans• Monitor productivity and audit for accuracy of work performed and evaluate efficiency• Provide high level of customer service to internal and external customers• Provide mentorship and coaching to multiple team leads, specializing in all payers• Provide feedback and training as needed for staff development. • Mentor staff and assist with career development. Identify and groom high performers for next level of responsibility• Effectively communicate with team & Upper Management regarding policies and procedures• With guidance from Management, delivered disciplinary action when appropriate to correct team member’s non-compliance to policies/procedures.• Assist in hiring process including interviewing and HR paperwork

• Lead team of up to 15 Early Out and Insurance representatives. Responsible for setting and monitoring team member’s schedules and attendance. • With guidance from Management, delivered disciplinary action when appropriate to correct team member’s non-compliance to policies/procedures.• Provided training, mentoring, coaching and feedback to under-performing representatives to increase production• Ensured account inventory was worked to acceptable standards• Handled escalation calls when requested by caller. • Maintained unit and client process and procedures. Communicated any changes of such to team and ensure team understanding and adherence to them.

• Follow-up with commercial and government insurance payers on new and aged claims.• Analyze accounts for underpayments or denials and submit appeals in a timely manner.• Escalate accounts for Coding, Supervisor or Record review as per Client Policy• Bill/invoice secondary-tertiary payers or evaluate for patient responsibility after the primary has paid• Working onsite at client office as liaison and other duties as assigned/needed

Sebastopol, Ca

 Responsible for loading claims into Billing Software, billing both Professional and Facility claims for Medicare, Medi-Cal, and Commercial Insurances electronically and via paper on a daily basis for a small acute care hospital. Use DSG Billing Software, CPT and HCPC books to edit claims for billing compliance. Responsible for pulling and printing Medicare Part A and Blue Cross Remittance Advices, billing Secondary Insurances, working Medicare denials/rejections so the account is billed properly in a timely manner. Run Medicare Eligibility and claim status through the Florida Shared System. Navigate multiple Insurance websites to find claim status, print EOBs, and verify Eligibility. Responsible for training new employees on policy and procedure, navigating the billing software, and guidelines in general. Provide excellent customer service using experience, knowledge and proper resources in answering and resolving account inquiries.  Responsible for working & filing Medicare Credit Balance Report per Centers for Medicare/Medicaid Services (CMS) guidelines. Responsible for pulling Medical Records and completing Medi-Cal Treatment Authorization Request (TAR) for inpatient claims and sending TAR requests to EDS for outpatient radiology services. Follow up as necessary for status of TARs. Pulled to work Special Projects as needed such as searching system for Credit Balance accounts to determine if refund needs to be given or if reversal of write-off needs done.

 Responsible for billing Medicare Part A electronically on a monthly basis for over 45 providers. Use the Florida Shared System to correct any errors, adjust any Medicare claims, and to manually key in claims. Responsible for training new employees on policy and procedure, the Medicare on-line system and guidelines in general. Provide excellent customer service using my Medicare experience when answering and resolving phone calls. Aid patients in understanding their Medicare benefits. Work Aging and Trial Balance reports to adjudicate overdue accounts. Work Medicare Credit Balance and Cost Reports per Medicare and the Centers for Medicare/Medicaid Services (CMS) guidelines. Review Plans of Care and Prescriptions to determine if Medicare certification requirements are met before billing. Bill and follow up with other insurance as secondary to Medicare. Be proactive by looking for trends on denials & claims processing for potential bigger problems