General Description:Implementing Billing Processes. Responsible for the timely submission of technical or professional medical claims to Medicare, Medicaid, Commercial, VA, Tri Care for the hospice facility. Job Duties• Credentialing all insurance companies • Cap Reporting• Cost Reporting• Revalidation of Medicare every 5 years• Quarterly Credit Balance Report• Room & Board Billing & Invoicing• Negotiating Contracts with Skilled Nursing • Set up contracts with any and/or all billing vendors• Setting up a process for billing and train appropriate staff, as necessary.• Review patient bills for accuracy and completeness and obtain any missing information. • Knowledge of insurance guidelines especially Medicare, Medicaid, Commercial, VA, Tri Care any others not named here. • Follow up on unpaid claims.• Check each payment for accuracy and compliance. • Posting of all cash received to accounts• Call Medicare regarding any discrepancy in payments if necessary. • Identify and bill secondary or tertiary insurances. • All accounts are to be reviewed for Medicare, Medicaid, Commercial, VA, Tri Care any others not named here or patient follow-up. • Answer all patient or insurance telephone inquiries pertaining to assigned accounts.• Weekly Billing Meeting• Monthly AR Meeting• Travel to site as necessaryInstrumental in cutting DSO by 34 points in less than one year. At the present time, all Medicare Accounts are current. And, very few Commercial Account left to collect.

Genesis Health Care is a subsidiary with Hospice and Home Health operations in Idaho, Montana, Nevada, Arizona, New Mexico and California.Support the Director of Finance with procedures pertaining to the reimbursement environment for both Home Health and Hospice. Manage and supervise 16 billing specialists. Supervise and direct the work flow which includes calculating, processing, posting, verifying, and maintaining data for accounts receivable records. Responsible for training, reviewing staff work, implementing systems, policies, billing procedures, receivable processing, identifying new strategies to streamline processes, and other ad hoc projects as directed. Travel to affiliate facility locations.  Oversee and assist billing and accounts receivable department with day-to-day functions.Hire, train, and supervise billing and AR staffProduce monthly key metricsFacilitate the implementation of new regulations and ensure complianceDesign and test new billing reports, evaluate existing reports, and develop more efficient means of gathering and reporting data.Ensure all billing is submitted timely and accuratelyFacilitate and coordinate monthly AR review callsPrepare and present financial data to management for review and decision-making Ensure proper authorizations and re-authorizations are obtained for all clientsManage cash application, ensuring all cash receipts are applied properlyAssist and oversee the researching and reprocessing of denied claimsEnsure all work is performed accurately and efficientlyAbility to analyze and reconcile claims and data to ensure complete and accurate receipts

. Hospice Billing for 5 States and 9 sites..Coordinate the preparation of regular collections i.e.; billings of private pay patients and various commercial Insurance Companies such as Medicare Medicaid.and all Commercial Ins..Knowledgeable in Medicare, Medicaid and Insurance regulations.. Hands on management billing and accounts receivable.Responsible for implementing monitoring tools to reduce company write-offs and improve overall billing efficiency.. Implemented the current placement of balancing payments . Working approximately $4,000,000.00 and 1,000 Claims Daily.

Genesis Health Care is a subsidiary with Hospice and Home Health operations in Idaho, Montana, Nevada, Arizona, New Mexico and California.Support the Director of Finance with procedures pertaining to the reimbursement environment for both Home Health and Hospice. Manage and supervise 16 billing specialists. Supervise and direct the work flow which includes calculating, processing, posting, verifying, and maintaining data for accounts receivable records. Responsible for training, reviewing staff work, implementing systems, policies, billing procedures, receivable processing, identifying new strategies to streamline processes, and other ad hoc projects as directed. Travel to affiliate facility locations.  Oversee and assist billing and accounts receivable department with day-to-day functions.Hire, train, and supervise billing and AR staffProduce monthly key metricsFacilitate the implementation of new regulations and ensure complianceDesign and test new billing reports, evaluate existing reports, and develop more efficient means of gathering and reporting data.Ensure all billing is submitted timely and accuratelyFacilitate and coordinate monthly AR review callsPrepare and present financial data to management for review and decision-making Ensure proper authorizations and re-authorizations are obtained for all clientsManage cash application, ensuring all cash receipts are applied properlyAssist and oversee the researching and reprocessing of denied claimsEnsure all work is performed accurately and efficientlyAbility to analyze and reconcile claims and data to ensure complete and accurate receipts Suggest improvements to current processes to ensure compliance with regulations as well as efficiency of data gathering. Prepare and support the calculation of revenue deductions, contractual allowances, write offs, and other reserves and settlement accounts for assigned facilities; maintain monthly entry models and train staff on their use.

Support the Director of Finance with procedures pertaining to the reimbursement environment for both Home Health and Hospice. Manage and supervise 16 billing specialists. Supervise and direct the work flow which includes calculating, processing, posting, verifying, and maintaining data for accounts receivable records. Responsible for training, reviewing staff work, implementing systems, policies, billing procedures, receivable processing, identifying new strategies to streamline processes, and other ad hoc projects as directed. Travel to affiliate facility locations.  Oversee and assist billing and accounts receivable department with day-to-day functions.Hire, train, and supervise billing and AR staffProduce monthly key metricsFacilitate the implementation of new regulations and ensure complianceDesign and test new billing reports, evaluate existing reports, and develop more efficient means of gathering and reporting data.Ensure all billing is submitted timely and accuratelyFacilitate and coordinate monthly AR review callsPrepare and present financial data to management for review and decision-making Ensure proper authorizations and re-authorizations are obtained for all clientsManage cash application, ensuring all cash receipts are applied properlyAssist and oversee the researching and reprocessing of denied claimsEnsure all work is performed accurately and efficientlyAbility to analyze and reconcile claims and data to ensure complete and accurate receipts Suggest improvements to current processes to ensure compliance with regulations as well as efficiency of data gathering. Prepare and support the calculation of revenue deductions, contractual allowances, write offs, and other reserves and settlement accounts for assigned facilities; maintain monthly entry models and train staff on their use.

Schedule appointments. Teach Self Improvement ClassesImplemented Prison to Community Class.

1. Coordinate the preparation of regular collections i.e.; billings of private pay patients and various commercial Insurance Companies such as Medicare Medicaidand all Commercial Ins.2. Instrumental in cutting the AR 51.6% in one year. Cut AR Days by 20 in oneyear.2. Payroll: Implemented a new format for payroll and payroll distribution as well as set up and organized the payroll system that is currently in place at Hospice of the Sandias.

Analyze and review Union County Medical Center's budget and expenditures forreorganization.Review accounting and related system reports for accuracy and completeness; prepareand review budget, revenue, expense and payroll entries, invoices, and otheraccounting financial transactions.Coordinate the preparation of regular collections i.e.; billings of private paypatients and various commercial Insurance Companies such as Medicare Medicaid andall Commercial Ins.Rural Health and Wrap around bonus billings.Coding for office visits, hospital in and out patients as well as in and outpatient procedures.Wrote Job descriptions for each department as well as Re-Wrote the employeehandbook. Directed a comprehensive, major initiative that redesigned processes,procedure development, documentation, employee training, and auditing for theMedical Center. Created definitive methodology to measure results and produceconsistent and ongoing improvements. The resulting procedure became a model thatwas implemented company-wide.Prepare and review various monthly, quarterly, and annual reports for management.Review adherence to a broad range of regulatory requirements.Have implemented aggressive collection activities, established payment options topatients. Set up payment matrix and terms for private pay patients. Filed claimsin small claims court, on private pay patients.Accts. Rec., Payables, Payroll, Human Resources, Credentialing of Physicians.In less that six months cut the accounts Rec. in half and the company was in theblack for the first time in several years.

Primary Insurance Billing Clerk and various Patient accounting tasks.Provided assistance in the development, implementation, and management ofCollections Accounts Receivables systems and procedures applying basic concepts,methods and techniques for the Financial Assistance Program Funding.Billed Commercial Insurance Companies, Medicare, all Medicaid's, Worker's Comp, andThird Party Insurances. As well as collections from these various InsuranceCompanies and Private Pay.Worked with the various Collection AgenciesFiled claims in small claims court, on private pay patients. Collected 100% of thetime.Instrumental in formation of a committee for Union County General Hospital forms.Complying with state and federal laws.

I began working part time for the Northeastern SWCD in 1992. The basicresponsibilities of the district clerk then were answering the phone, typing andfiling, correspondence and taking district t meeting minutes. The job title waschanged after a time. Most district clerks now are considered AdministrativeAssistants, shortly there after I was hired as a full time employee with vacationpay and sick leave. I immediately began to improve the meeting placement. I tookdistrict correspondence for the month broke it down into short narrative form. Ifthe board was interested in a particular letter or article, it was available andall the material discussed. In 1995, I convinced the District to purchase theirown computer. I also implemented a computer based bookkeeping system for theDistrict, all of which had been done by hand up to my employment with the District.During my tenure with the District, I also introduced a computer budget sheet thatillustrating the District budget status. I also was responsible for all theaccounting. The District's annual budget was approximately $250,000.00, I wasaudited on a yearly basis with only minor comments.Along with the duties of District Employee, secretary for the Natural ResourcesConservation Service, taking phone calls, greeting clients, filing helping writeCRP, Sip Plans and Great Plains Contracts all aspect of the day-to-day operations of the office. Attended computer training to help keep thecontracts updated.The District started a quarterly newsletter with me as editor. The activity wasprocessed in the office with no printing shop expenses.

Took payments, typing, utility billing, ambulance billing, and billed insurance forMedicare patients, filing balance reports, collections. There was no constancy intheir collections and I was instrumental in the placement of this responsibility.

Took minutes at board meetings, reported to board on accounts payables andreceivables . Answered phone did all necessary typing for the variousorganizations. Published a weekly newsletter.

Substitute Teaching from Kindergarten to 12th Grade.

Coordinated all children's programs for nursery through 6th grade. OrganizedVacation Bible School and Sunday school Teacher Workshops.For a time I stayed home to raise my children.

Posted checks, answer phones, file checks, and balance all accounts. Post on proofmachine as needed.

Answer phones, take messages, statements, help fill bins with supplies, wait oncustomers as needed.