Katie Mcnulty Email & Phone Number

Boston, Ma, Us

Boston, Ma, Us

Woburn, Ma

Directly oversees all managed care contracts with special attention to language, rates, facilities included and billing specs. Works on expanding managed care portfolio for all providers.Responsible for credentialing and recredentialling facilities with all insurance providers. Manages and maintains the integrity of Managed Care Insurance Grid to include renewal, negotiating and/or changes needed. Provides ongoing updated Managed Care Insurance Grid to Central Admissions, Clinical Liaisons, VP RCO, VPO’s, CFO, Quality Assurance Liaisons and facilities to ensure current information is always available. Responsible for the management and distribution of the Insurance Reference Cards (IRC’s) for each managed care insurance payor. Ensures each payors’ IRC is uploaded to the individual facility folders ensuring it is accessible to Central Admissions, Clinical Liaisons, VP RCO, VPO’s, CFO, Quality Assurance Liaison, and facilitiesAttends all Managed Care Monthly/Quarterly/Annual Provider Meetings and ensures that all facilities are up to date on changes and new initiatives.System Administrator for all managed care portals to maintain HIPPA compliance with user access permissions and restrictions for all new hires and terminations.Responsible for all education and training of existing staff as well as onboarding new hires as it relates to the managed care portals. Develops and maintains user guides. Acts as liaison between Managed Care companies and the organization regarding outstanding claims, collections and special projects as needed.Works collaboratively with all managed care providers regarding potential concerns the organization has pertaining to contracts, claim issues, and/or any other issues that may arise. Lead in creating and the continuous management of the organization’s Insurance Gap Tool in Point Click Care for each individual insurance payor.

Lowell, Ma

Assess inquiries when necessary and respond to referrals within one hour whenever possible, facilitates admission decision and ensures positive admission experience for customer and family.Verifies Medicare, Medicaid, and managed care verifications.Meets census goals by working with the center’s interdisciplinary team and Network entities to coordinate customer flow into and through the nursing center.Coordinates tour, application, and sales process with customers, families and referrers, either personally or with appropriate back-up systems.Works with Administrator and appropriate staff to ensure consistent, effective admissions, discharge and transfer meetings.Conducts follow-up on all inquiries which have not yet been converted to admissions.Works to initiate, nurture and maintain contacts with physicians, social workers, and discharge planners as valued customers to maximize referrals and facilitate admissions.Works with Administrator to ensure customer satisfaction and to assess/respond to customer satisfaction surveys.Leader of the customer excellence team which focuses on improving customer experience.

Winchester, Ma

Established and manages the central admission process for Salter Healthcare.Bed Management for 384 beds in three facilities.Communicates efficiently to our clinical liaisons on bed availability daily to allow them to offer beds in field in a timely manner.Complete benefit assessments promptly by performing Medicare, Medicaid, and Managed Care verifications.Completes all pre-registration authorizations on all Managed Care patients and obtains authorization from managed care case managers.Provides clinical documentation to the facilities regarding all new admissions and readmissions. Provides assistance to the Administrator, Social Worker, and Business Office by resolving any problematic concerns that may arise on new admissions or current patients.

Andover Ma

Receives and properly distributes new referrals to Clinical Admission Liason whom screen patients in Hospitals throughout the New England regionMonitors electronic referral via E-Discharge, All Scripts and 4-Next.Maintains 7 Skilled Nursing Facilities benefit verifications in a timely manner. Provides clinical information to the skilled nursing facility regarding all new admissions and readmisisons. Assist Administrator,Social Worker and Business office in resolving any problematic concerns that may arise.Performs Medicare and Medicaid assessment verifications as well as managed care pre-registration.Participates in the on-call rotation once bi-weekly, in which I am responsible for assisting Case Managers, Facility staff, and customers 24/7. Reports daily bed management to clinical liasons for 7 Skilled Nursing Facilities.

Andover, Ma

Receives and properly distributes new referrals to Clinical Admissions Directors whom screen patients in Hospitals throughout the New England regionEnters demographic information into our database that is provided by hospitals, E-Discharge, All Scripts and 4-NextMaintains the southeastern Massachusetts centers by closely monitoring that all benefit verifications are checked in a timely manner, assuring that all clinical information is provided to the skilled nursing facility by the clinical admission directors for scheduling of admission, Provides assistance to Admission Directors in resolving problematic concerns that may arisePerforms Medicare and Medicaid assessment verifications for all skilled nursing facilities within the northeast regionParticipates in the on-call rotation once a month, in which I am responsible for assisting Case Managers, Facility staff, and customers during nights and weekends, on weekends assist with placement of new and returning patients to their current centers from hospital staysRun daily census report for all skilled nursing facilities in the northeast region, Notifies facility and clinical admissions directors in the for information so that we can follow patient’s progress for return to facility

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