● Report directly to and support the CMO and CCO as their position and responsibilities relate to Medical Billing and Clinical Compliance● Function as the Liaison between Providers and Billing Department● Collaborate and coordinate with key stakeholders when performing assigned job duties. Includes partnering with assigned department heads, locations, programs and/or service lines to address unique integrity/compliance risks and provide general integrity/compliance visibility and support.● Maintain current knowledge of revenue cycle compliance standards/risks and applicable federal and state laws and regulations, and monitors advancements in risk mitigation strategies to ensure organizational adaptation and compliance.● Plan and coordinate monitoring and maintenance of the revenue cycle with respective department heads, including but not limited to appropriate billing of charges, proper assignment of billing codes, and prices based on a consistent markup of cost in accordance with regulatory requirements and policies and procedures ● Serves as a gatekeeper to ensure that regular and annual updates are in compliance with third party regulatory and coding billing guidelines and reflect clinical practice.● Performs compliance audits to determine if the organization is complying with its policies, procedures and applicable regulatory standards. Collaborates with impacted parties to develop and implement action plans to address audit findings.● Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed. ● Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers. ● Tracks license and certification expirations for all providers to ensure timely renewals

● Reported directly to CFO and COO● Planned, implemented and monitored insurance/patient billing processes and procedures.● Managed department of 5 employees and assisted in management of 10 receptionists● Project Manager for EMR/PM system implementation ● Assisted in company growth to multiple states● Produced and reviewed with executive team multiple monthly financial reports● Managed all physician credentialing and contracting

● Senior Medical Insurance Specialist● Assisted Director in establishing billing department policies● Extensive experience with EMR software implementation and operation● A/R Management● Train new billing staff members● Post medical insurance and patient payments.● Review insurance policy to determine coverage.● Electronically transmit claims for payment or further investigation.● Maintain Physician credentials and updates to CAQH● Establish and maintain group contracts with all major insurance carriers

● Identify, compile, abstract, and code patient data, using CPT and ICD-9 code sets● Resolve or clarify codes or diagnoses with conflicting, missing, or unclear information by consulting with doctors or others or by participating in the coding team's regular meetings● Post insurance and patient payments