Mark Peracchio Email & Phone Number

Cleveland, Oh, Us

Middleburg Heights, Ohio, United States

* Research and resolved technical issues pertaining to remittance processes.* Monitor remittance transmissions between Quadax and payers.* Work with payers to obtain missing remits.* Setup and maintain remittance parameters, Xpeditor settings, 835 splits, posting files, and mapping NPI to the corresponding client code

Middleburg Heights, Ohio

* Review patient medical record and payer medical policies to determine validity of denials.* Contact payers to challenge denials and request re-processing where denials are invalid.* Submit and follow-up on payer reconsideration requests; providing additional challenges to payers. * Recognize and report payer trends to Management and Client.* Research payer medical policies and insurance plan types to ensure up-to-date information is on file.* Review case history… Show more * Review patient medical record and payer medical policies to determine validity of denials.* Contact payers to challenge denials and request re-processing where denials are invalid.* Submit and follow-up on payer reconsideration requests; providing additional challenges to payers. * Recognize and report payer trends to Management and Client.* Research payer medical policies and insurance plan types to ensure up-to-date information is on file.* Review case history, payer history, and state requirements to determine challenge and appeal strategy. Show less

North Olmsted, Ohio

Revenue Cycle Team Lead: Intake / Verification, Billing and Collections Departments* Member of a Corporate Lean Six Sigma project chartered to reduce cost per treatment at hemodialysis clinics resulting in a 6% cost reduction per treatment.* Coached, trained and provided ongoing leadership and support for up to 10 team members.* Audited department work to ensure compliance with company policies and government regulations. Intake / Verification Department* Verified… Show more Revenue Cycle Team Lead: Intake / Verification, Billing and Collections Departments* Member of a Corporate Lean Six Sigma project chartered to reduce cost per treatment at hemodialysis clinics resulting in a 6% cost reduction per treatment.* Coached, trained and provided ongoing leadership and support for up to 10 team members.* Audited department work to ensure compliance with company policies and government regulations. Intake / Verification Department* Verified patient benefits and obtained authorizations as required for insurance payer reimbursement.* Followed up with clinic personnel to ensure required patient documentation was received.Billing Department* Significantly expanded electronic billing (EDI) of claims resulting in expedited insurance payments. * Utilized external clearinghouses to identify and resolve rejected claim issues. * Researched complex coding and electronic routing issues and initiated corrective actions. Collections Department* Lead a team accountable for $18.5M in monthly revenue, primarily on Managed Medicaid plans. * Department subject matter expert responsible for escalated team issues.* Collaborated with other departments to resolve insurer or patient claim submission issues.* Followed up with insurance companies and third-party payers on unpaid and underpaid claims. * Documented department procedures and maintained archive of specific insurance company data.* Established relationships with payers to resolve reimbursement issues.* Monitored workflow and team performance to meet department key performance indicators.* Generated reports and analyzed accounts to identify trends in insurance payer inconsistencies. * Contacted patients and sent follow-up letters when patient involvement with insurers was required. * Reviewed staff correspondence to ensure compliance with HIPAA guidelines.* Presented Managed Medicaid department insurance payer issues in management meetings. Show less

Solon, Ohio

Team lead for 8 individuals focused on packaging and shipping radiation meters and barriers.* Member of 3 individual Six Sigma teams with focused goals related to improvements in inventory flow and product delivery.* Restructured shipping process to improve quality and efficiency. * Identified computer system changes designed to improve shipping processes and worked with management and IT to implement changes.

Westlake, Ohio

Warehouse manager for up to 6 team members responsible for receiving, inventory, packaging and shipping

Cleveland, Ohio

Managed 4 supervisors and 100 individuals responsible for providing service for two Fortune 500 clients.* Managed projects that launched invoice processing systems ahead of client deadlines. * Automated client business rules to ensure accuracy of payment and accounting requirements. * Developed performance metrics to provide service at a level exceeding client expectation.* Conducted regular meetings with clients to discuss current issues and upcoming client initiatives. *… Show more Managed 4 supervisors and 100 individuals responsible for providing service for two Fortune 500 clients.* Managed projects that launched invoice processing systems ahead of client deadlines. * Automated client business rules to ensure accuracy of payment and accounting requirements. * Developed performance metrics to provide service at a level exceeding client expectation.* Conducted regular meetings with clients to discuss current issues and upcoming client initiatives. * Served on the team responsible for the continuous improvement of the invoice processing system.* Oversaw customer service and handled escalated calls from clients and their customers.* Participated in implementation meetings to customize system edits to meet specific client needs.* Conducted regular staff meetings to review department objectives and process changes. Show less

Cleveland, Ohio

Began as claims processor, promoted to claims supervisor and then to claims manager.Managed 4 supervisors and 50 individuals responsible for all PPO claims operations. * Trained and developed department supervisors and delegated responsibilities.* Monitored staffing levels within department budget to maintain appropriate processing timeframe.* Integrated new products, lines of business and Electronic Data Interchange into the claim workflow.* Documented department… Show more Began as claims processor, promoted to claims supervisor and then to claims manager.Managed 4 supervisors and 50 individuals responsible for all PPO claims operations. * Trained and developed department supervisors and delegated responsibilities.* Monitored staffing levels within department budget to maintain appropriate processing timeframe.* Integrated new products, lines of business and Electronic Data Interchange into the claim workflow.* Documented department procedures as required to obtain NCQA accreditation.* Interviewed, hired and counselled staff, wrote corrective actions and performance evaluations. Show less

Bachelor Of Arts - Ba

Activities and Societies: Pi Lambda Phi Fraternity, Dayton C. Miller Academic Honor Society, Omicron Delta Kappa Leadership Honorary.

Master Of Arts - Ma, Education

Activities and Societies: National Dean's List. I presented my Master's Thesis at the annual convention of The Ohio Academy of Science.