Jenna Sorber Email & Phone Number

➤ Monitor network system for billing of Medicaid by district for both direct and administrative claims➤ Review budget to determine fiscal impact, expenditure forecasting, and account discrepancies➤ Track required service delivery and billing audit in accordance with Medicaid policies and procedures and generate analysis forms➤ Oversee and participate in the development of updated Medicaid services manuals for multiple provider types➤ Responsible for billing and audit reports for local, state, and federal audits

Eustis, Florida, United States

➤ Manage multimillion-dollar projects from initiation to completion, consistently achieving project objectives and meeting or exceeding stakeholder expectations ➤ Lead cross-functional teams through the successful implementation of Agile methodologies, resulting in a 20% reduction in project delivery time and a 15% improvement in product quality➤ Implement risk management strategies, reducing project-related risks by 25% and significantly enhancing the predictability of project outcomes➤ Foster a culture of continuous improvement within project teams, leading to a 30% increase in productivity and a 15% reduction in project defects over a two-year period➤ Collaborate with stakeholders to define project scope, objectives, and success criteria, ensuring alignment with organizational goals and values

Maitland, Florida, United States

➤ Oversaw the credentialing and re-credentialing process for healthcare providers, including physicians, nurses, and other allied health professionals in 180+ locations nationwide➤ Ensured compliance with industry regulations, accreditation standards (e.g., Joint Commission, NCQA), and organizational policies during the credentialing process➤ Verified the educational background, work history, licenses, certifications, and other credentials of healthcare providers to confirm their qualifications; obtained NPI numbers for providers and facilities and updated existing➤ Coordinated the onboarding process for newly hired healthcare providers, ensuring all necessary credentialing and compliance requirements➤ Worked with commercial managed care plans such as; Medicare, and Medicaid; negotiated contracts specifically with Medicaid HMO plans

Longwood, Florida, United States

➤ Verified patients' insurance coverage, including eligibility, benefits, and any pre-authorization requirements prior to appointments and/or procedures in a timely manner; confirmed that patients' insurance information is accurate and up-to-date in the practice records➤ Prepared and submitted insurance claims accurately and promptly for services provided by the practice; monitored and tracked the status of claims to guarantee processing and payment➤ Investigated and resolved claim denials and payment discrepancies; identified and addressed common denial patterns to prevent future denials➤ Managed contracts with insurance companies, ensuring that the practice complies with contract terms and that contractual obligations are met; reviewed and negotiated contract terms as needed to optimize reimbursement➤ Ensured that the practice operates in compliance with all healthcare regulations, including HIPAA and fraud and abuse laws; promoted ethical billing and coding practices within the practice

Berwick, Pennsylvania, United States

➤ Oversaw and managed accounts receivable and accounts payable for 80+ healthcare provider practices in the Northeast States; handled both incoming and outgoing financial transactions, billing and collections, and ensured compliance with financial regulations➤ Generated and submitted accurate claims to insurance companies and government payers for services provided by healthcare providers; recorded and posted payments received from insurance companies, patients, and other sources into the practice's accounting system➤ Analyzed and appealed denied claims, working closely with insurance companies to resolve issues and provide accurate reimbursement➤ Ensured that reimbursement rates and terms specified in provider contracts are accurately applied and adhered to; monitored contract renewals and negotiated new contracts as needed

Bachelor Of Science - Bs, Business Administration And Management, Magna Cum Laude

Master Of Business Administration - Mba, Business Administration And Management, General