Provide direction to patient accounting staff. Review, evaluate, and resolve billing process issues to increase revenue collections. Examine high-risk claims to ensure contract compliance. Escalate claim disputes when the appeals process has been exhausted, analyze claim inquiry data to determine the root cause of errors, recommend system changes and automations as needed, provide training to staff, and recommend process improvements. Work with external customers, TPAs, and vendors to identify and resolve problems, and assist those affiliate companies with ongoing support of processes and policies. Conduct internal staff audits and give an up-to-date analysis of work to increase the staff's productivity and reduce losses due to timeliness or late filing issues. Monitor accounts receivable, billing, and collection applications (Apex/Paragon Patient Management) for commercial lines of business, and conduct financial management reporting.

Focused on commercial payer reimbursement to determine contract compliance and payment performance. Responsible for reviewing expected payment variance reports for incorrect payments on accounts and denial trends. Developed appropriate tracking tools and kept management informed. Examined accounts to ensure proper write-offs/adjustments and applied corrections to posting errors as required. Identified underpayments and communicated with collection representatives and billers regarding inconsistencies and errors. Delegated follow-up distribution to reimbursement team and provided assistance with complicated issues/appeals as required.

The primary role was to follow-up on all correspondence/denials received from insurance companies and third party administrators. Conduct professional fee billing, collections and insurance authorizations for DME rentals and purchases. Confirm litigation status and refer claims to attorney for collection. Research and resolve customer inquiries/complaints and record information about financial status. Prepare and distribute monthly invoices, assist patients with arrangements or repayment schedules, credit card and check payment processing, and aid staff on various office or administrative procedures as required.