Sherry Mcclellan Email & Phone Number

Phoenix, Arizona, United States

United States

Served as a link between patients and the main as well as supporting medical staff. Liaison between patients and medical staff. Works directly under the Nursing Manager. Compiles patients’ medical charts and graphs patients’ progress. Schedules diagnostic tests. Transcribe physicians’ reports and prescription. Receives new patients and collects their records. Orients and mentors staff members. Places orders for supplies and assists in storage. Prepares certificates of birth or death. Completes admission and discharge forms. Attends to telephones, forwards pager messages and transfers calls. Supervises maintenance of reception area. Greets new patients and directs them to appropriate consultation. Supervises housekeeping.

United States

Queen Creek, Arizona, United States

ACCOUNT RECOVERY SPECIALIST - MEDICAL - REVIEW CLAIM SUBMISSIONS, REMITTANCE AND DENIALS FOR ACCURACY, POSSIBLE RECONSIDERTION OR APPEAL FOR PAYMENT

United States

The Primary responsibilities and essential job duties effectively and efficiently performed include but are not limited to the following: Billing Reviews and/or scrubs final billed initial claims for accuracy and completeness before submitting for payment Obtains necessary patient records required as attachments to claims Calculates Tier, Outlier, DRG and/or other Fee Schedule based reimbursement Submits electronic and/or hardcopy claims with any attachments as per the contract timely filing criteria Documents all account activity in the hospital system notes and the database insurance follow-up within appropriate time frames, contacts the health plan by phone or website to determine status of claim Documents all follow-up actions in the hospital or provider account notes and database and sets up account for additional review based on client expectations for follow-up of unresolved accounts, post payment review, researches all account information on paid or partially paid claims and analyzes the status of the payment related to the expected payment calculation and itemization provided by the remittance advice Determines if payment is appropriate according to contract specifications Analyzes any denied, disallowed or non-covered claims and determines if non-payment is based on medical or technical reasons Resolves any technical issues when warranted with health plans via phone or website Prepares requests for account balance adjustments in accordance with client specific procedures Prepares claims for clinical audit processing in the case of authorization, coding, level of care and/or length of stay denials Processes overpayment transactions in accordance with client specific procedures Follows guidelines for prioritization, timely filing deadlines, hospital and database documentation Payer enrollment includes the following payer enrollment responsibilities/tasks: Responsible for implementation and oversight of all activities related to payer enrollment for providers

Mesa, Arizona, United States

Responsible for coordinating the schedules of physicians, facilities, anesthesiologists, lab work, required testing and any other required items/staff in accordance with a physician's recommendation for patient care. Receives orders for procedures determines the appropriate diagnostic and procedure codes for procedures and authorizations. Documents eligibility, benefit and authorization information in accordance with established guidelines. Research patient accounts due to invalid and/or missing authorization information and correspond with clients, insurance companies, patients, sales representatives to obtain the necessary information. Verifies prior authorizations and/or pre-service requirements are met. Proactively manages and maintains all outstanding authorization accounts to increase billing of clean claims. Provides outstanding customer service to patients and developed and maintain positive working relationships with internal and other external customers. Documents all account activity and corresponded to inquires in a timely manner. Reviews accounts on a daily basis while meeting or exceeding all daily, weekly and monthly production goals. Performs daily activities of billing and auditing of accounts to ensure accurate claims submissions and to optimize reimbursement for patient treatment from clients, commercial/government payers and patients. Communicates and worked effectively with colleagues from other departments.

United States

Cardiovascular & Arrhythmia Institute (CAI) - Mesa, AZResponsible for coordinating the schedules of physicians, facilities, anesthesiologists, lab work, required testing and any other required items/staff in accordance with a physician's recommendation for patient care. Receives orders for procedures determines the appropriate diagnostic and procedure codes for procedures and authorizations. Documents eligibility, benefit and authorization information in accordance with established guidelines. Research patient accounts due to invalid and/or missing authorization information and correspond with clients, insurance companies, patients, sales representatives to obtain the necessary information. Verifies prior authorizations and/or pre-service requirements are met. Proactively manages and maintains all outstanding authorization accounts to increase billing of clean claims. Provides outstanding customer service to patients and developed and maintain positive working relationships with internal and other external customers. Documents all account activity and corresponded to inquires in a timely manner. Reviews accounts on a daily basis while meeting or exceeding all daily, weekly and monthly production goals. Performs daily activities of billing and auditing of accounts to ensure accurate claims submissions and to optimize reimbursement for patient treatment from clients, commercial/government.

Mesa, Arizona, United States

United States

Documents eligibility, benefit and authorization information in accordance with established guidelines. Research patient accounts due to invalid and/or missing authorization information and correspond with clients, insurance companies, patients, sales representatives to obtain the necessary information. Verifies prior authorizations and/or pre-service requirements are met. Proactively manages and maintains all outstanding authorization accounts to increase billing of clean claims. Provides outstanding customer service to patients and developed and maintain positive working relationships with internal and other external customers. Documents all account activity and corresponded to inquires in a timely manner. Reviews accounts on a daily basis while meeting or exceeding all daily, weekly and monthly production goals of billing and auditing of accounts to ensure accurate claims submissions. Communicates and worked effectively with colleagues from other departments.

Greets all patients and visitors upon entering ED with culture sensitivity. Interviews new patients and reviews returning patient information to determine eligibility, updates and/or changes in demographics/insurance/guardianship/guarantor; adds to data base as appropriate to build patient health record. Determine primary visit purpose; routes Worker's Compensation patients to appropriate service area. Verifies insurance information, eligibility and benefit coverage to ensure understanding of requirements and/or constraints effecting treatment. Reviews patient registration information for updates and/or changes to primary and secondary insurance coverage to ensure accuracy of billing. Requests tribal enrollment verification to ensure coverage; screens income eligibility requirement and refers to Eligibility Coordinator as needed. Completes prior authorization and referrals for patients for outside care, MRI, CT, and Inpatient Admissions. Advises and counsels patients on their insurance benefits. Trains new employees for Patient Registration procedures, rules and regulations.

Mesa, Arizona

Performs pre-registration/registration processes, insurance verification and authorizations, notifications and benefit coordination. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Obtains all necessary signatures and documentation requires by the patient's insurance plan. Calculates patient liability according to insurance benefits, collects deposits and co-payments. Provides financial counseling to patients and their families. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients and their families in completing financial assistance paperwork when appropriate. Acts as a liaison between the patient, the billing department and the payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence. As assigned, conducts patient visits for bedside registration to expedite the completion of the patient registration. Communicates with physicians, clinical and hospital staff, nursing and Health Information Management Services to resolve outstanding issues and/or patient concerns. Works to meet the patients' needs in financial services. Meets or exceeds productivity standards. Completes daily assignments and maintains accurate production logs and records. Identifies opportunities to improve work processes and practices good work group dynamics. Provides a variety of patient services and financial services tasks. May be assigned to functions such as transporting patients, provide training for new staff, collecting and releases patient valuables in accordance with company policies, posting daily deposits, or conducting other work assignments of the Patient Financial Services team.

Casa Grande, Arizona

United States

Prepare patient account information for billing third party payers. Expeditiously collect from third party payers while adhering to existing policies and procedures. Worked cooperatively with coworkers and clients with minimal supervision and frequent interruptions. Actively and willingly worked on a Welfare Billing Team and Customer Service to do everything necessary to make the office run smoothly. Obtained, prepared and submitted claims to all third-party payers and client accounts. Reviewed remittance advice for cost share, allowances, deductibles, co- insurance, and non-covered adjustments. Recorded on the computer system all calls, correspondence, interviews, and activities related to each patient account. Review aging reports to determine status of accounts. Entered data into computer system with accuracy and speed. Respond to billing inquires by contacting appropriate departments for charge entry questions, preparation on Quality Assurance Forms and maintained billing inquiry logs.

Answer phones and greet clients, assist medical records with admissions, discharges, deaths and revocations. Complete file intake and set up in EHR for all hospice patients in both the medical and the prescription drug program data base. Assist Revenue Agent with insurance verification, receipt of referrals, billing, and prior authorizations for patients entering into end of life care and for Hospice Medication and Supplies. Verify patient demographics and insurance information with regard to end of life care applicable medical benefits. Completes monthly compliance audits of patient charts for Medicare Compliance. Assists in stockroom operations, orders supplies, and complete inventory. Maintain donor database for donor contribution, completes deposits, sort and distribute mail and filing of medical records. Complete intake of referrals, determine medication coverage to related hospice diagnoses. Refer patients and families to local resources. Provide information about the hospice mission to incoming inquiries.

Associate Legal/Medical Office Mngmt- Aas, Office Systems Technology

Certification, Outpatient Coding, Complete November 2021