Melanie Coleman Email and Phone Number

• Hold direct oversight and manage preauthorization and appeals support for all customers (hospitals, clinics, physicians, and patients) seeking assistance with in-house preauthorization and/or appeals services, including consultations, trainings, and hands-on assistance virtually and onsite. Coordinate, process, and file prior authorizations and appeals with Medicare, Medicaid, and private payor insurance companies for CI surgeries and all external parts and accessories with or on behalf of clinics, hospitals, and patients.•Claims filing and processing with public and private payors, including primary and secondary filings. Invoicing/billing with accounting software and claims entry/processing with reimbursement software. Working knowledge of ICD-10, HCPCS and CPT code classifications.•Assist patients and customers with claims status, billing inquiries, and other reimbursement matters, in a courteous, efficient, and timely manner.•Assist in educating and act as a resource to clinicians and support staff regarding authorizations, insurance requirements, coding issues, etc.•Working knowledge of federal, state, local and intermediary specific billing requirements.•Compiles information and prepares contracts for submission for credentialing and network status updates for various insurance companies including Medicare, Medicaid, and private payor plans.•Responsible for updating and training the Reimbursement team on contracting issues, changes and process improvements related to contracts and other issues as needed.•Assist leadership with developing strategies and implement action plans to successfully maximize efficiency, profitability and consistent cashflow with respect to prior authorizations, claims, denials, billing, and collection for all company related products.•Assist with preparation of performance objectives and outlines for new employees or newly promoted employees within reimbursement department for appropriate job title.