Mandy Meza Email & Phone Number

Colorado Springs, Co, Us

Colorado Springs, Colorado Area

• Maintains Revenue Cycle Billing Software, including creating claim edits, billing holds, translations, formatting, payment import profiles and mappings, and system maintenance of SQL scheduling and modules. • Maintains Chargemaster, advanced fee schedules and carrier contract rates. Loads and Maintains Profile Variance Tracking to monitor payer compliance.• Initiate and create SOW enhancement requests, outlying business case.• Maintains relationships with departmental leadership and staff for continuous support and evaluation of workflow and payer requirements. Analyzes, revises existing system logic, and implements system enhancements as needed for increased functionality and streamlined processes. • Works with over 20 vendors to maintain sFTP sites, file transfers and new Center implementations. • Researches, detects trends and resolves a wide variety of complex issues to include internal system issues, payer system issues and merchant vendor issues. • Ensures claim files, payment files, statement files, and collection files are sent and properly received by the vendor; troubleshoots and corrects any issues encountered. Works with individual payers as needed to correct issues expeditiously. • Identifies opportunies for internal carrier swap logic based on 837 eligibliity returns to provide accurate patient exam TOS estimates. • Provides project management support to new Revenue Cycle and Patient Access initiatives.

Jackson Hole, Wy

• Coordination of all activities within the Billing Department, to include Scheduling, Supply Requisitions, Precertifications, Claims and Denials Management, Refunds And Cash Posting.• Maintained policies and procedures that ensured Regulatory Compliancy, as well as approval of Single Case Negotiations with Non Contracted Payors.• Maintained the claims billing system. This included creating claim edits, rules and translations to ensure accurate payer based billing.• Worked closely with both HIM And Utilization Review Departments for determining Medical Necessity for NCD's And Appeals.• Assisted IT in documentation for creating service orders.• Successfully transitioned the Precertification process from the Scheduling Department to the Billing Department.• Involved in the updates, training, and seamless transition from ICD9 to ICD10.• Successfully spearheaded projects and initiatives that increased revenue, as well as positive relationships between departments and individuals. • Exceeded financial goals and ageing goals, at 40 days.• Prepared compliant Physician, Inpatient, Outpatient, Long Term Care and Skilled Nursing Facility claims to all Regulatory, Managed Care and Commercial payers. • Gather documentation and wrote appeals for denied claims.• Reviewed EOB's for accurate reimbursement, and posted contractual adjustments. • Created Billing Manuals and actively trained new employees on policies, procedures and systems.• Systems utilized: Paragon, Claims Administrator, Receivables Workstation (RWS), HPF, E ClinicalWorks (eCW), Medicare HIQA and FISS.

• Created and submitted compliant medical claims to Medicaid, Workers Comp and Commercial Carriers. Billed 2ndary payors with appropriate documentation. • Reviewed Eob's for accurate reimbursement and posted contractual adjustments. • Appealed denials.• Assisted the Audit Department in identifying CCI edits, coding inaccuracies and payer trends.• Assisted SSI team with queue management, 2ndary claims assignments and Crystal reporting.• Systems Utilized: Medipac, Meditech, SSI, RWS, Winasap