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Customer Service Manager

Location:
Reading, Massachusetts, United States
Posted:
December 02, 2018

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Resume:

Kellyann L. Reed

** ****** ******

Dorchester, Ma 02121 ac7ur3@r.postjobfree.com

Cell: 857-***-**** ac7ur3@r.postjobfree.com

Seasoned healthcare revenue manager motivated by challenge and rewarded through seamless implementation of key corporate initiative that aid profitability, productivity, and quality. Recognized for strategically managing projects, applying standards and rallying cross-functional team participation that serves to elevate financial gains, enhanced efficiency, and increase effectiveness.

Summary of Qualifications

Result-oriented, high energy, hands-on professional, with a successful record of accomplishments in revenue management training, developing strategic processes, documenting and creating manuals, and communication of revenue enhancement policies. Experience in building internal and external relationships, conflict resolution, compliant healthcare billing, quality assurance, and customer service with focus on providing clients with exceptional revenue cycle management.

Major strengths include strong leadership, excellent communication skills, competent team player, detail oriented, and a dutiful respect for compliance in all regulated environments.

Operational management:

5+ years of experience in healthcare working for a non-profit organization. 2+ years of experience in supervising operations and personnel at Boston Medical Center. 15+ years of professional billing experience. Day to day problem solving with administrative staff, clinical staff, and patients. Solid leadership skills, a hands-on manager, and a creative problem solver.

Fiscal Management:

7+ years of experience managing revenue cycles, of multispecialty practices. 10+ years of experience in financial analysis, reporting and presenting Key Performance Indicator (KPIs) to clinical and non-clinical senior-level management. Proven record of revenue enhancement and growth.

Quality Improvement:

Experience implementing IT solutions, process reengineering and service improvement to increase staff productivity and clients’ satisfaction.

Human Resources Management:

2+ years of experience recruiting, hiring, training, evaluating, and developing administrative staff in an ancillary department setting. 6+ years of experience in training and developing financial-billing personnel. A mentor and coach to staff.

Accomplishments

Managed and lead a registration pilot for the department of Endocrinology to help minimize rejections for no referral/authorization.

Managed setting up new Copayment reconciliation and deposit workflow all Department of Medicine clinics, post Epic go live.

Successfully oversee $38 million in charges for the Department of Medicine which represent 13 Multispecialty clinics.

WORK EXPERIENCE:

Boston Medical Center Boston, Ma

12/2016 – Present

Oversee and streamline billing and collections processes

Oversees the operation of the billing department, encompassing medical, coding, charge entry, claim submission, payment posting, account receivables follow-up, and reimbursement management

Serves as the practice expert and go to the person for all coding and billing processes

Plan and directs patient insurance documentation, billing and collections and data processing to ensure accurate billing and efficient account collection.

Analyze billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.

Follow up on claims using various systems

Month-end closing of the billing group information

Prepares and analyzes accounts receivables reports, weekly and monthly financial reports, and insurance contracts in concert with the practice administrator. Collects and compiles accurate statistical reports.

Audits current procedures to monitor and improve efficiency of billing and collection operations.

Ensures that the activities of the billing operations are conducted in a manner that consistent with the overall department protocol, and are in compliance with Federal, State and payer regulations, guideline, and requirements

Analyzes trends impacting charges, coding, collection, and accounts receivables and take appropriate action to realign staff and revise policies and procedures.

Keep up to date with carrier rule changes and distribute the information with the practice.

Maintain a working knowledge of all health information management issues such as HIPAA and all health regulations/

Maintain a library of information/tool related to documentation guidelines and coding

Plan and implement quality assurance for all processes

Special program/billing planning and implementation

Personnel development; staff meetings

Staffing discussions and planning/interviews; Team building

Field Operators’ problem escalation and customer service

Assist with the implementation of a new billing system

Proven ability to perform strategic planning and priority setting for a billing department

Proven track record for improving process efficiencies and solving problems

Strong leadership skills with an ability to motivate direct reports

Excellent communication skills both written and verbal, and internal personal skills

Excellent analytical and problem solving skills

Ability to manage multiple projects concurrently

Mass General Hospital Charlestown, Ma

3/12- 11/30/2016

Assistant Billing Manager

Analyze trends in billing data by reviewing payer payments and denials, follow up with customer service inquiries about billing complaints or disputes regarding billing statements and EOB, review account receivables for unpaid claims and utilize the A/R reports for payer trends in claim denials.

Extensive experience supporting provider offices with all patient billing related issues. Supporting providers and staff for General Surgery, Weight Center and Oral Maxillary dental practices with all billing issues.

Manage and maintain constant communication via email with internal staff and practices about all patient billing related issues to help resolve problems in a timely manner.

Run monthly reports from Cognos/IPORT for monthly meeting with the providers Administrative Directors and Practice Manager, analyzing financial information on reports to report irregularities in data to Billing Manager.

Prepare email interoffice mail monthly revenue reporting packets for providers to review for payments.

Maintain information regarding coding and billing requirements to stay updated on payer policy changes on CPT/CDT payments and denials.

Maintain and operate and additional databases to support my practices with custom reports, after Partners upgrade to a new billing system by managing, tracking and resolving Epic charge review and claim edits in assigned work queue’s.

Register and update patient’s guarantor registration accounts for dental insurance. I regularly enter dental information to allow claims to process quickly and efficiently with this needed information.

Work and pivot spreadsheets of raw patient billing and receivable data, and turn this information to understandable statistical or analyzed format to present to my providers, billing manager.

Perform research to follow up on inquiries from Customer Service, fellow Assistant Billing Managers, Practice-specific questions, and team Leads. Maintain the patient information for all future follow ups until a resolution is concluded. Pushing back on payers if there are discrepancies or inconsistencies on claim.

Review rejections monthly for practices and provide strategies with rejections to resolve errors or corrections to re-bill a claim, request appeals to payer with referrals and authorizations obtained from the practices or admitting.

Work closely with third party department in resolving claim denials and appeal of all claims.

Resolve daily charge entry, Charge review and claim edits from systems IDX and EPIC.

5/04- 3/12 Mass General Hospital Sr. Billing Specialist Boston, Ma

I served as a liaison between the practice staff and coding/billing management staff to billing patient procedure visits and office services.

Prepared and managed daily provider encounter forms for billing to insurance companies, ordered and maintained stock of Intrauterine devices (IUD) office nurses and medical assistant for patients after validating insurance coverage.

Reconciled encounter form with provider documentation for procedures and CPT’s billed. Billed for all deliveries for the professional piece of the patient care daily. Responsible for selecting the appropriate diagnosis and CPT coding when global billing deliveries and assuring that documentation requirements are within compliance.

Working closely with internal and external staff daily about billing issues and inquiries and obtain patient authorizations and referral for services.

Time management to meet month end deadlines to assure as many charges have been submitted, follow up with all office provider about missing encounter forms and assist with research of procedure coverage’s

Regularly assisted patients with billing complaints and inquiries about bills or explanation of benefits assistance to resolve billing issues and question independently.

Contact person for all to collect payments from all international and self-pay patients, who required assistance with explanation of payment coverage. And maintain an organized file for record keeping.

SKILLS:

Customer Service

Basic Accounting

Excel

MS PowerPoint

Microsoft Word

Telephone Procedures

CPT-4/ICD-9 coding Medisoft

Office Procedures

Patient Charting

Data Entry

Appointment Scheduling Medical Terminology

File Management

Triaging

ICM-MD

ICM proper

First Aid

CAS/EMR

Patcom

Typing Proficient

Romexis

Medical Insurance Billing

Collections

Analytic skills

OSHA Guidelines

Patient Tracking System

Microsoft outlook

Reporting management

Peer support management

IDX/PCIS

LMR

Payer websites

IDX/RAD

KRONOS

GE

SDK

EPIC Clinical/Revenue cycle

Bilingual in Spanish

EDUCATION:

Boston University Human Resources Choose to Manage Program Boston, Ma

Employment enhancement skills 3 month course

2018-Graduation October 2018

Cambridge College

2013- Graduation June 2016 Cambridge, MA

Bachelor Management studies (Medical concentration)

Boston Career Institute Brookline, MA

6/2004-7/2004

Medical Coding Specialist

Bryman Institute Brighton, MA

2002-2003

Medical Administrative Assistant Program

Externship: Chiropractic Healthcare Services Brockton, MA

Dr. Robert Lapuck's Office:

Greeted patients at front desk, answered phone calls, took messages, scheduled and confirmed appointments, accepted co-payments, handled insurance referrals, worker's comp paperwork, filled out daily encounter forms, prepared patient charts and posted entries. Also I serve as a translator for Spanish-speaking patients. Communicated with legal representatives, Observed and assisted with coding procedures.



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