Robin Adams Email & Phone Number

Louisville, Ky, Us

Louisville, Kentucky, United States

Louisville, Kentucky Area

Review of healthcare claims that have been denied, recovered, or potentially underpaid. Auditing of contract applications and account history.

Louisville, Kentucky

Responsible for the management of +25 employees. Oversaw two separate units: Accounts Receivable & Credit Balances.On the Accounts Receivable Unit we were responsible for the posting and reconciliation of incoming funds against outstanding accounts for all of KentuckyOneHealth. Traveled to multiple site locations to provide continuous systems training and support. Use of SQL and Excel for weekly and month report compiling. During month end and other important fiscal dates worked with comptroller, bank auditors, and VPs for financial reporting reasons and quantifying our bad debt estimations. During a realignment of the company’s financial institution vendors I worked with the project manager to ensure deliverables were met and mitigated client abrasion. One of the great initiatives I achieved was transitioning our claims processing away from manual adjudication to electronic auto adjudication resulting in substantial savings for the company and increasing the quality of the claim life cycle. This major goal also helped ensure accuracy of overall cash posting.On the Credit Balances Unit I was responsible for mitigating outstanding Credit Balances of existing accounts. Preparing Medicare quarterly financial reporting.

Louisville, Kentucky

Data Analytics

Louisville, Kentucky

Review and audit of patient accounts for correct adjudication of multiple claim types. Auditing and resolution of COB issues. Data mining of our systems for credit balance totals. Working with executive level leadership to reduce overall A/R days and achieving credit balance goals that aligned with our company’s goals and initiatives. Supervised a team of six and mapped out their weekly work assignments. Assisted in development of training materials for McKesson STAR system during the system process overhaul initiative. Responsible for multiple presentations to various groups to ensure proficiency in the new system. Worked with third party vendors periodically.

Louisville, Kentucky

Reviewed healthcare claims for accuracy within a database workflow system. Contacted healthcare providers concerning claim payments.Worked with Medicare, Medicaid, and Commercial health plans for claim payment resolution. Specialized in outpatient claims at this time.

Louisville, Kentucky

Claims processor promoted to senior account auditor/assistant supervisor. Supervisor duties consisted of monitoring calls and work flow to ensure prompt resolution to claim inquiries. I was responsible for handling grievance and appeal issues as well. Senior auditor duties consisted of claim processing auditing for accuracy, training staff to stay current on healthcare regulatory material, and mapping out audit process flows to improve audit efficiencies.

Bachelor'S Degree, General Studies, Gpa: 3.7

Minor in Organizational Leadership

Associate'S Degree, Accounting And Business/Management

Activities and Societies: Member of Beta Society, Member of Sigma Beta Ki

High School Diploma, General