Teri Sutton Email & Phone Number

Meridian, Idaho, United States

Interact with attorneys and third party insurance professionals to explore where there may be liability and negotiate and coordinate claim payments. Identify, investigate, and collect recoveries from thirds parties who are legally responsible for medical expenditures. Prepare, research, and analyze claims reports to identify potential recoveries. Respond to subrogation inquiries and develop and follow up on cases. Responsible to understand contractural obligations regarding OPL cases and assist enrollees. Review and process drafts and checks and ensure accurate record keeping and reporting of activities. Testify at court hearings and represent the company in mediations.

Provide full support across all Payment Integrity teams including Special Investigations Unit, Vendor Appeals, High Dollar Clinical Audit, Third Party Liability, Concept Development & Clinical Editing. Assist in project management. Communicate and coordinate with internal and external stakeholders. Special projects pertaining to growth & optimization, talent & development, succession planning, process improvements, system redesigns, and medical records.

Eagle, Id, United States

Offered high level support remotely in the administration of the companies Operations and Human Resources programs. Provided guidance on sensitive case scenarios. Performed all aspects of recruiting and hiring for multiple offices. Conducted internal investigations, facilitated meetings with support staff, Administrator and Physicians. Provided expert advice on operations, team building and employee retention.

Boise, Idaho

Provided ready now talent for the companies most critical talent needs. Effectively increased and sustained employee retention. Shortened ramp up time in promoting employees to new roles. Increased cross functional collaboration between departments and multi-state locations. Attracted higher level potential talent through promotion. Built a career library to facilitate training and development. Provided employees a long term vision with Paylocity.

Orange County, California, United States

Provided leadership in developing, planning and implementing the practice's mission, financial and business plans. Established and oversaw operating policies and procedures. Enhanced operational effectiveness and profitability, emphasizing cost containment without jeopardizing quality of care. Responsible for HR administration and compliance. Lead efforts for recruitment, hiring, training, development, performance evaluation and retention of staff. Resolved any medical-administrative problems and kept lines of communication open with staff to ensure high employee morale and a professional, healthful practice atmosphere. Processing of payroll and administration of payroll and benefit programs. Continually monitored operations and physical properties to ensure patient safety. Informed Physician partners about current trends to facilitate policy making. Served as liaison to ensure practice compliance with all regulatory agencies, hospitals and health plans. Responsible for managing and executing marketing activities.

Newport Beach, Ca

Supervised centralized Scheduling, Insurance and Medical Records departments. Mammography Tracking Coordinator assisting Radiologist in reading high volume breast imaging. Newport RadioSurgery Center Cyberknife Department Coordinator. Efficiently assisted high caliber Radiation Oncologists and Neurologists. Obtained high dollar treatment authorizations in a time sensitive manner. Coordinated weekly Tumor Board meetings. Effectively scheduled treatment planning for Physicist and surgeries for all treating Physicians. Patient Navigator for patients and their families.

Mission Imaging

Supervised high volume centralized Scheduling and Insurance departments for Radiology group at Mission Hospital. Held staff accountable for exceptional patient service, accurate and timely insurance verification, authorizations for treatment, thorough medical screening and productivity. Supported front desk registration, high volume patient check-in and multiple phone lines, communicating detailed and specific messaging to Technologists and Physicians. Patient Navigator for Women's Imaging.