★Client Management and Support★Coding Education★Documentation Improvement★Denial and Appeal Management including escalation to Provider Rep/Derm-AAD Advocacy ★Contract/Credentialing Coordination and Support★A/R Research and Analysis★RAC/TPE Consulting & Oversight★Complex Claim Resolution - MOHS, Repairs, Brachytherapy, SRT, XTRAC Laser★ Global Team Collaboration★Policy/Workflow Process Restructuring★Compliance POC★Maintain Third Party Vendor Relationships★Mentorship and Skill Development

★Management of incoming audit record request and maintenance of spreadsheet status★Gathering requested records★Conducting threshold record review★Organizing requested records in accordance with detailed cover letter summary★Communications with internal staff and external auditors regarding documentation request★Analyze and trend data regarding requested audit info and produce reports/charts for Chief Compliance Officer★Follow up and appeal on documentation denials★Coding research and provider/staff education ★RAC/HMS portal access/maintenance★Other audit related tasks as assigned

★Throughout my lengthy tenure with West Dermatology, I steadily progressed from an entry-level position to eventually become the Billing/Revenue Manager. I am currently accountable for claims submissions spanning over 50 offices throughout California, Nevada, and Arizona.★I successfully centralized a team of 8 Billing Professionals to handle prior authorization for all locations. ★I foster and cultivate collaborative relationships with vendors to resolve denied or unpaid claims.★I serve as primary point of contact with Insurance Provider Representatives.★I employ stellar customer service skills to address and resolve escalated customer service issues.★I attend numerous conferences and training sessions in an effort to stay ahead of billing trends.★I oversaw the management of payments from EFT and mail sources to ensure proper logging, tracking, and posting.★I proactively resolve electronic claim errors from clearinghouse and/or payer.★I analyze daily totals in association with KPIs, identifying under performing operations and develop aggressive action plans to facilitate change, creating spreadsheets/pivot tables/charts.★I collaborated with IT and vendors to resolve technical problems with claims, statements, and accounts.★In addition, I drafted, developed, and implemented comprehensive instructions for all major billing processes.