Sandy Phillips Email & Phone Number

Roxboro, NC, US

Roxboro, NC, US

Responsible for leading a team of project managers in the overall delivery and execution of Large & Complex Provider RCM implementation projects.

• Responsible for managing the scope, schedule, and quality of Large & Complex implementation projects.
• Lead implementations to help drive project activities, implementation schedule and team resources to produce measurable outcomes.
• Deliver an exceptional customer experience beginning with the sales hand-off throughout the entire implementation process through support hand-off.
• Improve and maintain up-to-date organizational process assets, including templates, to ensure that… Show more
• Improve and maintain up-to-date organizational process assets, including templates, to ensure that processes are thoroughly documented and followed.
• Develop project teams by holding teams accountable for their commitments, removing roadblocks.

• Work with all levels of Availity management, Program Management, Account Management and Sales to organize the resources needed to accomplish project tasks. This includes leading client-based projects and managing.
• Responsible for managing the overall implementation process for our largest, most dynamic clients, primarily Epic Professional and Hospital Billing clients.
• Primary point of contact and subject… Show more
• Primary point of contact and subject matter expert for clients for accountability, escalation and resolution of issues originating from assigned clients.
• Focus on project management and client facing activities during product implementation by documenting implementation decisions and coordinating work for the assigned Implementation Coordinator and Analyst to ensure.
• Responsible for developing project plans, creating long- and short-term plans, which includes setting targets for milestones, adhering to deadlines and allocating resources.

• Responsible for managing the overall implementation process for new client sales, with a focus on project management and client facing activities during production implementation.
• Primary point of contact and subject matter expert for clients for accountability, escalation and resolution of issues originating from assigned clients.
• Coordinate cross-functional teams through meetings and progress measurement activity which bring distinct, specific projects to completion both on time… Show more
• Coordinate cross-functional teams through meetings and progress measurement activity which bring distinct, specific projects to completion both on time and within budget.
• Manage all tasks for Premier client implementation from Sales Hand-off to Go Live.
• Customize agendas, reporting, training plans and project plans to ensure implementation project success. Show less

• Account Management for Large Tier 1 Strategic clients (100+ provider count)
• Primary point of contact for accountability, escalation and resolution of issues originating from assigned clients.
• Provide Revenue Cycle Management support to specific clients to include daily monitoring and management of issues of high revenue clients.
• Work with Administrative Leaders within to discuss, define and help accomplish organizational revenue goals.
• Maintain knowledge of… Show more
• Maintain knowledge of client operation systems and goals to provide recommendation on Availity RCM solutions that would assist in meeting operational goals and/or KPI metrics.

• Responsible for managing revenue for all Non-Governmental Payer mixes which include NC Blue Cross, Out of State Blue Cross, Managed Care and Commercial Payers for Duke University Hospital and Duke Regional Hospital
• Identify process improvements, including staff education/training, operational workflow modifications, system enhancements and external payer policy changes and work with appropriate personnel to implement improvements.
• Oversee internal auditing department to ensure… Show more
• Oversee internal auditing department to ensure proper auditing procedures are performed.
• Oversee internal training efforts to ensure employee development within Hospital Billing and Collections department. Show less

• Coordinate, prepare and analyze complex accounts receivable and/or financial records
• Conduct detailed research to identify root causes of insurance denials, advising PRMO leadership regarding conclusions and recommendations
• Identify process improvements, including staff education/training, operational workflow modifications, system enhancements and external payer policy changes.
• Organize and lead committee meetings to communicate denial analysis outcomes and operation… Show more
• Organize and lead committee meetings to communicate denial analysis outcomes and operation improvement recommendations
• Assist in testing system functionalities related to enhancements and/or claim logic updates Show less

• Supervise up to 25 employees
• Specialize in Cardiology, Radiology, Pathology, Nephrology, Dermatology, Oncology & Hematology insurance accounts receivables, denials and follow-up
• Perform Quality Audits of employee work against quality standard requirements
• Monitor productivity levels and provide feedback for evaluation purposes
• Provide new and existing employee training
• Review and evaluate payer denials

• Assist in overall revamping of all HCFA-1500 and UB92 claim form edits to reduce denial rates and improve reimbursement
• Retrieve, review, research and analyze claim form change requests provided by various DUHS departments in efforts to improve overall billing processes
• Update IDX claim form logic in the TEST system while acquiring extensive knowledge of all fields on claim forms
• Load and process daily Interface files
• Download files for testing HIPAA changes to ensure… Show more
• Download files for testing HIPAA changes to ensure proper billing techniques for 837/835 formats

• Research complex Workers Compensation accounts to determine reasons for non-reimbursement and follow-up for maximum reimbursement for aged A/R
• Analyst complex accounts to determine appropriate actions in resolving TES edits, Claim Edits, Denials, Correspondence and Refund Requests
• Complete charge corrections for proper billing of Professional and Hospital claims
• Analyze patient accounts to determine proper resolution of credits
• Initiate refunds to insurance companies and… Show more
• Initiate refunds to insurance companies and patients for overpayments on credited accounts