Manager of Medical Staff Services for the WI Northern Market

• Act as resolution manager for billing and eligibility issues for over 40 core market groups • Bill and reconcile premium in a timely matter to assure claims payment • Create and document all work flows for department to be used for quality assurance • Lead two week new hire training classes for all new hires in my department• Act as subject matter specialist for Group Permanent Life product which involves creating new procedures and billing practices

• Head of the Billing Department• Manager to Payroll and Receptionist employees• In charge of billing all insurance companies for reimbursement • Facilitate follow up to insurance companies for the central billing office• Manage all Resident Fund accounts• Member of the Admissions Team who coordinates the entire admission process• Help residents and families complete Medicaid applications and insurance renewals• Complete all contracts which includes going over insurance and financial information, legal documentation, and DNR paperwork• Complete all insurance appeals

• Access Representative in the Precertification Department• Accountable for authorization process for inpatient, outpatient, and mental health services.• Use ICD-9 and ICD-10 coding to obtain all authorizations.• Work with multiple insurance companies every day including Medicare and Medicaid plans. • Obtain and enter all insurance, authorization, and financial information needed for billing and reimbursement of patient visits• Analyze financial information from third party payer and communicate information to patient, registration, and business office.• Assisted with the Billing Department processing denial claims and rebilling denials.