• Primary contact between provider groups and insurance carriers for enrollment and contracting • Responsible for all enrollment correspondence with payors • Work closely with Billing departments to ensure providers are enrolled and claims can be submitted for payment • EFT/ERA Enrollment and set up • CAQH Profile updates and maintenance • Generate reports • Work with practice managers to maintain all provider and/ or group information and updates

• Oversee Accounts Receivable Department• Analyze medical claims data to identify trends, pinpoint issues/areas for improvement, and recommend solutions and alternatives• Responsible for analyzing incoming and outgoing revenue sources and measuring different financial cycles • Manages all functions of the organization's billing and revenue cycle to maximize cash flow• Works directly with insurance companies and healthcare… Show more • Oversee Accounts Receivable Department• Analyze medical claims data to identify trends, pinpoint issues/areas for improvement, and recommend solutions and alternatives• Responsible for analyzing incoming and outgoing revenue sources and measuring different financial cycles • Manages all functions of the organization's billing and revenue cycle to maximize cash flow• Works directly with insurance companies and healthcare providers• Knowledge of insurance guidelines especially Medicare and state Medicaid• Ensure compliance with HIPAA regulations to include confidentiality, as required• Knowledge of CPT Codes and ICD-10• Assists in training and development of new staff members Show less

• Review, appeal unpaid and denied claims• Manage Accounts Receivable (AR) reports• Works directly with insurance companies and healthcare providers• Knowledge of insurance guidelines especially Medicare and state Medicaid• Ensure compliance with HIPAA regulations to include confidentiality, as required• Knowledge of CPT Codes and ICD-10

• Reviewed claims that were not paid and file appeals and complaints to the carriers as needed• Processed all appeals including Medicare, Medicaid, and commercial and managed care carriers• Responsible for reviewing all correspondence from Medicare and Medicaid and process according to current policies and procedures• Ensured compliance with HIPAA regulations, to include confidentiality, as required• Knowledge of CPT codes and ICD-9

• Research, enter data, and process health care claims in a variety of systems and tracking tools for a US health care client• Apply knowledge of processes and related systems to identify• Asses and resolve complex issues• Knowledge of CPT codes and ICD-9

• Responsible for ordering, receiving & reviewing background check reports required based on client contract• One of two members of the Onboarding Team to adjudicate the results of background checks • Collected and verified confidential information such as I9 and SSN• Assisted with scheduling of appointments between candidates, recruiters and business partners to present offers of employment• Assist in the hiring of over 600 new hire employees for client

• Responsible for processing transactions in the Unclaimed Property Database• Downloaded escheatable items from various Marriott Accounts Payable Systems• Responsible for assisting the Compliance Manager in maintaining the UCP System as well as the StoneRiver Tracker 2000 program• Assisted with periodic State Escheat Filing (Fall & Spring)• Researched and re-issuance of items incorrectly stale-dated and issuance of statutory due diligence letters

• Provided accurate and appropriate information in response to customer inquires• Demonstrated mastery of customer service call script within specific timeframes• Developed process improvements to enhance efficiency and effectiveness of interdepartmental call center operations