Jennifer Thomas
McKinney, TX 75070
Phone: 214-***-****
***********@*****.***
OBJECTIVE:
Healthcare Manager with several years experience. Special leadership strengths in managing departments as well as client
relationships in the radiology, EMS and infusion drug business. Excellent oral and written communication skills. Enjoy being a
trusted advisor to continuously achieve a high level of satisfaction, retention and positive referrals.
EXPERIENCE / JOB HISTORY:
Intermedix Corporation, Mansfield TX
April 2013 December 2013
Client Services Manager
• Serve as the primary point of contact for a set of clients and promptly respond to all client inquiries.
• Interfaces with the operation’s processing team as necessary to address client needs and monitor client transaction
processing.
• Constantly monitors and analyzes assigned client accounts in order to assure accurate and successful processing.
• Identifies potential problems with client accounts before they occur and works to eliminate future.
• Works to correct problems that do occur and to prevent them from recurring in the future.
• Develops collaborative relationships across multiple departments and with external clients in order to accomplish client
goals.
• Develop and maintain knowledge of client credentialing and fee schedules.
• Coordinate and perform visits to current client locations to assess the needs of the client account and works collaboratively
with Intermedix management team in acquiring new accounts, including such things as site audits and visits.
• Review and if necessary correct all client month end reports prior to delivery to the client.
• Generate client ad hoc reports upon request.
• Work with clients during their budget setting process to ensure aggressive and realistic targets are being set.
• Create client collection forecast models.
• Create and deliver client performance presentations.
• Establish client hospital connections for the receipt of patient insurance and demographic information.
• Assist with the marketing of Intermedix’s service lines.
• Uphold company compliance policies.
Zotec Partners, Rockwall TX June 2009 – May 2012
Client Service Manager
Proactively evaluate revenue cycle processes and performance for assigned clients on an ongoing basis, interacting with
•
Operations Management to ensure timely workflow and optimized collection performance.
Regularly conduct client meetings to review accounts receivable performance, practice trends, payor performance and
•
advise practice on business/ industry issues impacting the practice.
Oversees and or conducts regular audits of the practice to ensure appropriate charge capture, charge flow, report dictation,
•
contract management, electronic claims filing etc.
Schedules and oversees coding audits for the practice and provides feedback to provide practice with feedback to optimize
•
coding quality.
Schedule coding education meetings for the practice to provide feedback to optimize physician dictation.
•
Page 1
Jennifer Thomas
Establish Key Performance Indicators (KPIs) for clients and regularly review to ensure consistent performance;
•
communicating with Operations regarding any exceptions, inconsistencies, etc.
Interacts with Operations Management to communicate any changes in the practice and plan for appropriate operational
•
impacts (i.e. new sites, new physicians, managed care contracts, etc).
Deliver client reporting, assuring standard and specialty reports are delivered accurately and timely to client to evidence and
•
illustrate performance.
Serve as direct liaison between client and company to communicate process changes affecting the client in an effective and
•
timely manner.
Respond timely to client inquiries (including but not limited to) benchmark comparisons, reimbursement changes, internal
•
processes, patient issues, etc.
Serve as the intermediary between Operations and the client’s facilities to obtain charge, demographic and audit files.
•
Managed Care Contracting support for clients to analyze and provide information to clients and/or assist in contract
•
negotiations.
Gain a strong working knowledge of client needs and expectations and provide proactive recommendations to improve AR
•
management and collection performance.
Provide ongoing communication regarding client satisfaction and work collaboratively with Operations, support, etc. to
•
promptly address issues.
Routinely assess client satisfaction and complete the Client Management Subjective Assessment on a monthly basis to
•
report satisfaction levels.
Maintain current working knowledge of the local market trends, payor practices, state and national reimbursement trends
•
impact the practice specialty.
Knowledgeable and proficient in the company’s billing system and decision support.
•
Knowledgeable of medical coding and reimbursement.
•
Knowledgeable of Medical Billing Compliance.
•
Knowledgeable in third party reimbursement processes to include managed care contracting.
•
McKesson Corporation, Dallas TX February 2008 – March 2009
Account Manager
Serving as an Account Manager for clients of medium to large size, independently providing high level client management
•
services as well as ensuring client access and exposure to specialized financial reimbursement strategic and information
management services.
Develop and maintain positive customer relations and coordinates with various functions within the company to ensure
•
customer request are handled appropriately and in a timely manner.
Ensures that all appropriate resources are available and utilized to effectively and consistently provide clients with business
•
management and strategic planning services of the highest caliber.
Regularly conducts client meetings to review accounts receivable performance, payor issues and trends, client’s business
•
strategies, and physician compensation plans.
Maintains day to day relationships with existing clients, collecting and clarifying information with the client, communicating
•
project or program plans and progress, and answering client questions.
Performs periodic billing audits for assigned clients to ensure that utility files, billing parameters, electronic transmissions,
•
demographic interface tapes, and billing and payment tapes, insurance verification interfaces are utilized appropriately.
Ensures preparation, analysis and presentation of all Account Management deliverables (including A/R measurement
•
statistics and payor trends, fee schedules, ad hoc financial reports) ensuring their relevancy, accuracy and overall quality
while requiring interaction with operations management and third party payors.
Genezen Healthcare, Addison TX October 2004 February 2008
Accounts Receivable Manager
Responsible for managing up to 16 collectors at one time.
•
Implemented major collection project for $4.5 million in old account receivables.
•
Page 2
Jennifer Thomas
Created collection policies and procedures.
•
Act as an independent lead on all collection projects.
•
Audit and monitor all collectors for productivity and quality of work.
•
Monitor and report payment trends to the Insurance Verification Department and Finance Department from commercial and
•
government payors.
Identify and report overpayments from physicians and insurance carriers for the physician’s retention reports.
•
Stay abreast of all Lash Groups’ reimbursement updates and policies.
•
Assist and train the Payment and Collection Department regarding policies and procedures for auditing super bills,
•
reconciling, posting payments and adjustment procedures.
Coordinate patient payment plans.
•
Reconcile end of month reports as well as old accounts for reporting purposes to the physicians and Finance Department.
•
Monitor all uncollectible, high balances and aging reports to track industry trends.
•
Responsible for end of month posting of all adjustments and payments.
•
Identify high and low adjustment reports.
•
Negotiate settlement offers with the physician offices.
•
Insurance Specialist
• Trained new employees in all aspects/functions of collections.
• Implemented electronic claim filing for all physicians.
• Collected, reconciled, transferred and posted insurance payments made to physicians in various states.
• Identified and appealed denied claims.
• Identified and applied adjustments.
• Maintained and disseminated weekly collection reports to Finance Department.
• Researched formatting errors and claim form requirements for commercial and government carriers while coordinating with
internal billing company to ensure that such errors were resolved.
• Identified and processed refunds to patients, providers and all insurance carriers.
• Credentialed physicians with Medicare and Medicaid carriers while maintaining company reports of provider updates.
• Performed customer service duties and special projects as needed.
TrailBlazer Health Enterprises, Dallas TX September 2000 October 2004
Technical Specialist
• Assisted customer service representatives regarding benefit information, review processes and Medicare requirements.
• Monitored and audited Customer Service Representatives to assure quality while maintaining CMS requirements.
• Reported all changes in Medicare guidelines and requirements in weekly QC meetings.
Appeals Representative II
• Served as Lead Auditor for the Appeals Department which consisted of 16 auditors.
• Supervised and monitored auditors with problems or questions to ensure process was
completed in a timely manner.
• Tracked and monitored audit interactions and provided feedback with other Customer Service Departments.
• Processed telephone appeals for the providers and beneficiaries pertaining to all denials including utililization review.
• Researched and acquired planning and data gathering skills.
• Worked closely with external and internal departments including the processing and recording of overpayments and
recoupments.
• Gathered data to record and compile monthly audit reports.
Blue Cross Blue Shield of Texas, Bonham TX 1989 1997
Customer Service Representative II
• Processed written and incoming telephone appeals for the providers and beneficiaries.
Page 3
Jennifer Thomas
• Assisted providers and beneficiaries with claim status, claim denials, claim form requirements, provider enrollment
requirements, eligibility information and updates, benefit information, coverage issues and general questions.
• Kept abreast of Medicare rules and guidelines mandated by CMS.
Senior Claims Examiner
• Processed Medicare claims including all specialties such as anesthesiology and physical therapy while
maintaining a high level of production and accuracy.
• Participated in extensive training for CPT, ICD 9 coding and HCFA 1500 requirements.
• Performed special projects as needed.
PROFESSIONAL DEVELOPMENT:
• Dean Vaughn Medical Terminology and attends RBMA yearly conferences.
EDUCATION:
• Grayson County College 1993 1994
• Completed pre requisite nursing courses in Psychology, Child Psychology, Sociology, Microbiology and Anatomy and
Physiology I and II.
REFERENCES:
• Available upon request
Page 4
Jennifer Thomas