Lead Patient Accounts Auditor A/R
Current• Pursued and received payment of $300,000.00 in old A/R dating back to 2018• Maintains audit percentage of 99%;• Disseminate changes in laws, policies and guidelines to all NELC departments;• Facilitates meetings with Provider Representatives to resolve trending payment issues;• Meet with auditors to answer claim questions and resolve ongoing issues;• Coach billers and auditors on payment policies;• Educate A/R, Auth and Insurance departments of changes and process improvements that can beimplemented to decrease A/R days;• Assigned problem payers to create a billing process and ensure proper billing and timely accuratepayments;• NELC Work output - 66,000 patient notes, 30,500 write-off notes, 16,000 posted adjustments, 4,000new claims created, and 3600 formal appeals submitted;Senior A/R Specialist/Auditor• Train new auditors on Medicaid payers;• Collections and recovery of problematic accounts due from all Federal Medicare and Medicaid payersin NH, VT, ME and MA.• Evaluate documentation and activity on patient accounts to determine appropriate follow-up andensure accurate billing, coding, authorizations, and insurance information;• Reduce outstanding A/R balances with timely evaluation of all denied, underpaid, and overpaid claims;• Create new processes and strategies for tracking delinquent accounts to bill and collect more efficiently.
