Responsible for Revenue Cycle System support of all Revenue Cycle Management departments.Worked with physicians, nurse practitioners, practice administrators, and office supervisors regarding documentation and coding guidelines to ensure the quality of documentation in the patient medical record, enhance accurate data reporting, and increase appropriate reimbursement.Submitted, reassigned, and escalated all billing system-related requests requiring direct IT support.Reviewed, updated, tracked, and escalated all open billing system requests utilizing IT ticketing system.Monitored billing system requests for trends that may be indicative of a larger billing system core issue.Knowledge of DOL, Medicare, Medicaid, commercial insurances.Achieved and maintain productivity levels as determined by the Manager of Revenue Integrity / Charge Capture and the department’s Audit Compliance Plan.

Interpreted more complex and unusual policy coverages and determines if coverages apply to claims submitted, and escalating issues as needed. Partnered with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insured to develop a focused strategy for the timely and cost-effective resolution of more complex claims.Set activities, reserves and authorizes payments within scope of authority to ensure issuance of disbursements while managing loss costs and expenses.Analyzed claims activities to prepare and present reports for management.Reported overpayments, underpayments, and other irregularities.Maintained claim files such as records of settled claims and an inventory of claims requiring detailed analysis.

Responsible for maintaining a high level of professionalism and working to establish a positive rapport with every patient.Coordinated, followed-up and tracked appropriate problem resolution activities with all appropriate staff to ensure timely resolution.Impact the company’s bottom line by problem-solving and turning frustrated patients into contented patients.Delivered precise and detailed information to patients, care providers, and sr. level leadership.