Assisting client with setup of new software systems (EHR/Claims Management/Clearinghouse), claims management and authorizations

Complete RCM services for valued clients

• Responsible solely for generating $100k+ estimated revenue for 2000+ clients on a Weekly basis; $12-14 million estimated annually • Maintained all Certipay America Enterprise Client Accounts to ensure accuracy of billing for all administrative services; including receiving and responding to all Billing inquiries for division and fulfilling requests for both internal and external customers• Processed Monthly and Quarterly Enterprise and PEO Sales Person and Broker commission calculations for Sales Ops team• Utilized research and analytical skills for Collections purposes including Payroll, Tax and Billing Returns via Bank Portals daily; assisted in reviewing the SAGE Accounting System for errors in payment posting and credit balances due• Protected revenue through the development of tools for tracking and identifying potential areas of lost revenue

• Responsible solely for generating $100k+ estimated revenue for 2000+ clients on a Weekly basis; $12-14 million estimated annually • Maintained all Certipay America Enterprise Client Accounts to ensure accuracy of billing for all administrative services• Tasked with receiving and responding to all Billing inquiries for division and fulfilling requests for both internal and external customers• Processed Monthly and Quarterly Enterprise and PEO Sales Person and Broker commission calculations for Sales Ops team, maintaining positive business relationships, while serving as the sole point of contact for all inquiries• Conducted scheduled and periodic audits and reviews, aggregating the results of data analysis for company leadership• Protected revenue through the development of tools for tracking and identifying potential areas of lost revenue• Lead Project Liaison for process automation and data migration projects, overseeing the migration of 40M+ rows of data from a series of Microsoft Access Databases to SQL Server.• Utilized research skills for Collection purposes including Payroll, Tax and Billing Returns via Bank Portals daily and reviewing the SAGE Accounting System for errors in payment posting and invoicing• Protected revenue through the development of tools for tracking and identifying potential areas of lost revenue

• Ensured Revenue Integrity through diligent maintenance of receivables for three main offices and providers• Posted all dental insurance payments for Commercial, Medicare and Medicaid payors• Worked all Remittance Advice for all locations to ensure payment from all payors• Worked with all payors to dispute or correct any claims submission errors• Led all collections activities for outstanding balances due for all offices

• Call Center Environment with emphasis of providing excellent telephone customer service for calls related to Mortgage payments, Escrow analysis, Tax statements and Amortization schedules• Completed Fast Pay Payments, ensuring customer accounts remained current• Reviewed accounts to ensure accuracy of on-time payment and corrections for collections activity on clients account• Utilized Problem Solving and de-escalation skills to properly communicate with all clients and work with Team Lead to resolve any issues

• Oversaw all Medicare, Medicaid and MACSIS claims submission, account reconciliation and payment operations; ensuring revenue integrity through diligent oversight for both Substance Abuse Rehabilitative and Mental Health services• Responsible for all County Board Enrollments for ADAMH Grant Funding• Reported all OHBH data to the ADAMH Board to ensure all statistics were properly captured from Intake to Discharge status; assisted reducing discharge clients to 7%• Entered daily staff schedules, answered all client calls/inquiries regarding outstanding balances, verified insurance benefits and pre-certification across multiple payors• Provided Excellent Customer Service to all Internal and External customers• Assisted in credentialing facility as a Medicare – Part B provider, including all individual providers within facility• Credentialing and renewals for all providers for commercial insurance payors• Reported monthly data to both the CIO and CFO to identify any discrepancies or issues

• Responsible for leading a team of 10 employees across 8 separate off-site locations, charged with data entry of all Intake paperwork for patient profiles and data entry of provider schedules within both the Epic and MyAvatar Electronic Medical Record systems (EMR/EHR) to streamline accuracy and efficiency of all claims billing to Commercial Insurance, Medicare, Medicaid and ADAMH Board funding payors• Responsible for Crisis Intervention, School Base and Home Base programs, which included data entry of all Intake paperwork for patient profiles, schedules/treatment notes; including General Ledger work to ensure accuracy of all services entered and correction of any critical errors for MACSIS claim file submissions• Partnered with department leadership in the development of programs, initiatives, and workflows, which provide alignment with education for internal customers to support regulatory guidelines• Developed and maintained process documents, training materials, and conducted training sessions for new hires• Worked closely with NetSmart while developing the HIPAA 5010 template for department per new Medicare/Medicaid standards, while serving as an Interim Department supervisor • Tasked with Month End Accounting Period closures and operations• Responsible for End of Year Grant Funding reconciliation to ensure all funds were met to 95%• Provided Excellent Customer Service to all Internal and External customers• Partnered in the development of Crisis Intervention Team• EPIC SuperUser

• Responsible for ensuring all payment for claims submission for multiple patients and locations• Reviewed Critical Error reports to ensure all services were submitted to all payors in a timely manner, per claims guidelines• Provided Excellent Customer Service to all patients to ensure patient satisfaction and compliance regarding invoicing and payment• Posted all payments, credits and adjustments to Client Ledger and submitted claims to secondary payors• Reported daily for all payment posting activity and reconciliation• Created inter-company payments/remittance advice to Patient Accounts that did not belong to the Behavioral Health Department• Trained Supervisor on Billing system and Billing processes for Department upon hire• Assisted in patient invoicing and collections• Assisted Precertification Department in obtaining Retro-Authorizations and continued authorizations for services rendered

• Responsible for ensuring all Intake paperwork was compiled for all New Patients daily• Reviewed and completed Intake paperwork with patient families daily and assisted in explaining Precertification details for services rendered• Collection of patient payments• Responsible for submitting all New Intake information to the Billing Department for billing purposes• Maintained and Implemented new chart organization to ensure JCHAO compliance and ease of access for clinical providers• Provided Excellent Customer Service to all patients and their families regarding services rendered, patient documentation updates and scheduling appointments• Assisted Psychiatry Department with Patient Calls and Refills for prescriptions, scheduling follow up appointments• Collection and submission of OHBH and Ohio Scales information to the ADAMH Board• Worked Part-time at Urgent Care facilities in the evenings and weekends; responsible for registering patients and charging/discharging patient charts