Sandra Janis-Bauman Email and Phone Number

Insurance collections for multiple behavioral health facilities throughout the US. Address claim processing issues and denials for timely reimbursement. Tracking trends for a wide variety of insurance carriers in and out of network.

Responsibilities include supporting the billing/collection team for 5 facilities, special collection/AR challenges and projects, Data entry, ROI status, COB updates, Benefit verification, track repricing trends. Insurance check reissues from virtual pmts and undelivered checks. Payment plans for pt balances set up with clients reducing loss to facilities. Any special project or AR collection needs keep me motivated. Always ready to tackle the task at hand.

Consulting to billing companies/facilities regarding collections, billing for Inpatient Detox, Ambulatory Detox, PHP and IOP.

Responsible for Ambulatory Detox, PHP, IOP, Medication Management, Therapy, Depression Inventory, UA billing, payment posting and claim collections. Gave direction for re-billing rejected claim with reviewed medical records. Closely monitor A/R report, correct UR/authorization discrepancies. Negotiated higher reimbursement on all Multiplan and other TPA claim offers. Negotiated client payment plans with positive communication and follow up. Medical records reviewed and sent for insurance claim appeals/retro review when requested. Initiated QA for undocumented therapy sessions, inaccurate clinical notes, sign off dates etc contributing to claim denials. Addressed insurance audit and record requests.