Evaluate explanation of benefits, reconcile credit balances, and issue refunds as necessary. Responsible for filing claims to primary and secondary carriers and posting and reconciling cash. Compose all daily reports, manage and maintain files, resolved issues with third party payors and collections departments. Follow-up on all calls made to payers after claims were billed and effectively resolve claims with any billing issues; ensure any claims are paid. Developed, implemented, enforced, and revised policies and procedures; communicated updatesFacilitated and conducted effective training programs for all internal cash posting and collectionsTrained employees and planned and coordinated daily workflow duties to optimize departmental efficiency/productivity

Provide consulting services to interpret / analyze hospital billing and collection functions.Maintain business relationship with business office personnel. Perform billing and collections from atbs /work list. Evaluate receivables and determine appropriate resolution in collections and credit balance research, denial management. Perform inpatient/outpatient scheduling, patient registration, including insurance verification. Proficient with Government payers: Medicaid, Champus, Commercial, Blue Cross Hmo, Medicaid, Medicare. Provide patients with appropriate financial counseling. Process hospital claims primary and secondary. Train new hire on ER registration and Outpatient registration and collections. Train leads/supervisors. Implement new policies and procedures. Revised payments posting dept. Created new forms for payment posting. Train facility personnel on accounts receivable policies and procedures. Manage daily activities, including specific employee work assignments. Review employee activities for accuracy and effectiveness. Monitor and adjust staff workload. Ensure the staff post payments to accounts accordance with departmental policies and procedures. Work with payors, vendors, hospital departments and PFS staff to collect cash for AR services rendered. Work priority pockets of AR and escalate accounts. Proactively review denials, productivity and AR data on a daily basis. Monitor accounts for appropriateness and timelessness of follow-up collector assertiveness in moving accounts toward resolution, clarity of notes, and effectiveness of action. Assist leads and staff on the development of action plans to correct problems and optimize cash collections. Communicate payer changes in ways that put them in the context of the revenue cycle and office practice. Liaison to the staff answering questions and assisting with problems. Crucial roles in reducing aged inventory on projects from $34 -$62 million down to $6-$8 million.

Responsible for computerized accounts payable, accounts receivable, and payroll. Maintain day-to-day office operations as well as end of month closings. Process claims electronically or computer generated. Handle all billings, collections, denials, and monthly statements, follow up on accounts. Manage, train and hire new employeeWork denials, assist patients and third party carriers with problems, collect on past due accounts, turn over unpaid balances to collections companies, work outstanding reports, train new employees.

Managed and monitored cash and aging and worked closely with facilities to effectively resolve issues. Monitored all incoming and outbound calls on a daily basis and interfaced with designated payers to ensure proper reimbursement. Evaluated and analyzed all charity applications and composed relevant correspondence. Supervised, motivated, mentored, and evaluated staff and facilitated training programs.Coordinated and led meetings with admissions management teams to identify and correct errorsCollaborated with various internal departments to resolve and appeal claims denials and led all negotiations to ensure payment; collected payments on delinquent accounts through negotiationsEvaluated or approved various reports of aged accounts, prepared for outside collection agenciesMonitored employee performance, provided feedback through performance reviews, and led employee training and development programs to ensure growth, productivity, and performance. Scheduled patients for surgery and delivery. Assist with patient registration and Financial Counseling.

Process patients' insurance. Provide follow-ups on denials. Prepared contractual and bad debt write off's. Prepare use of collection agency or legal actions for delinquent accounts. Extensive customer service. Utilized proactive measures to ensure that customers and walk-ins issues were resolved.Lead-Accounting Specialist Handle cash applications, account receivables and accounts payables. Create and balance spreadsheets, month end closing reports, reconcile accounts. Process refunds, contractual adjustments, denials and write-offs. Interact with Healthcare Providers, banks and trace monies not received. Train new employees