Manager Insurance
Resume:
Suzanne Nogle
Encino, California 91316
************@*****.***
OBJECTIVE
To obtain a challenging and rewarding position within a thriving healthcare company that will utilize and build upon 20+ years of revenue cycle experience.
WORK EXPERIENCE
January 2015 – Present Healthcare Partners (via Robert Half) Torrance, CA
Medical Billing Manager (Consultant)
Responsible for billing & insurance follow-up activities for a large Multi-Specialty Medical Practice
Identify errors, train staff on insurance guidelines
Write Policy and Procedures
Meet with Insurance Carriers on bulk claims resubmission and denial errors
Review and approve all adjustments over $500.00
October 2011 – September 2014 PIH Health Physicians Whittier, CA
Revenue Cycle Account Follow Up Manager
Responsible for all Billing & Collection activities for a large Multi-Specialty Medical Practice.
Managed a Staff of 16 Insurance Follow Up Collectors and 4 Self Pay Follow up Collectors
Maintain AR day at 75 or below
Increase Collections by 15% in 90 days
Resolve and approve all credit balance within 60 days
Prepare and Present Monthly Report to Senior Leadership
Assisted in the Implementation of a new Practice Management System and Electronic Health Record System
Prepare and Present Monthly Reports to Clinic Managers and Staff on Denials
Managed and Monitored Collection Vendors
Worked with IPA to Decrease Denials
Meet with Insurance Carriers to Resolve Outstanding Claims issues
Bulk Settlements with Insurance Carriers on old Outstanding Accounts
Employee Performance Evaluations
Reviewed patient charts for charges against the charge master
Would have compliance audits for Medicare to make sure they were not over- or under-charging
April 2009 – January 2011 California Spine Center Newbury Park, CA
Billing & Collections Manager
Responsible for all Billing & Collection activities for a large Spine Center and Ambulatory Surgery Center
Maintain AR day at 85 or below
Attend WCAB and settle on Work Comp cases
Settlement Negotiations on all Third Party cases
Prepare and Present Monthly Reports to Senior Leadership
Increase Cash Collections by 18% in 3 months
Assisted with the Implantation of Electronic Billing System
Managed and Monitored Collection Vendors
Employee performance evaluations.
Reviewed patient charts for charges against the charge master
Would have compliance audits for Medicare to make sure they were not over- or under-charging
October 2008 - April 2009 Pediatric Management Group Los Angeles, Ca
Collections Manager
Responsible for all collection activities for a large Pediatric Physicians Practice
Managed 27 employees 1 Supervisor 2 Leads
Weekly meeting with Insurance Carriers to resolve all outstanding accounts.
Worked with Contracting on existing and new Managed Care Contracts.
Maintain A/R day at 95 or below
Reduce AR days by 25 in 45 days
Prepare and present monthly Presentations on Collections to Senior Leadership
Monitored unit Operations and Actively Provide Directions as Required using Standard Policies, Procedures & Guidelines
Implement a Write new Policy & Procedures
January 2003 - October 2008 Kaiser Permanente Pasadena, CA
Collections & Denial Management Manager
Responsibility for collections activities for Southern California Workers Compensation
Denial Management for Northern & Southern California
Adjustment processing unit for Northern & Southern California
Managed 32 employees 3 Supervisors and 4 Analyst
Employee performance evaluation
Settlement Negotiations on Work Comp Lien Cases
Worked with Kaiser Permanente Claims Department on Work Comp Late discovery
Prepare and present presentation on collections to Senior Leadership & Physicians at facilities
Prepare and present denials to Senior Leadership
Maintain a 5 day turnaround time on denials
Maintain a 48 hr. turnaround time on posting of adjustments
Meet on a regular basis with Insurance Carriers
Monitored unit operations and actively provide directions as required using standard policies, procedures & guidelines
Managed 4 external Collection Vendors
Assisted with the implementation and training of a new computer system
Worked in a Labor Management Partnership
Reviewed patient charts for charges against the charge master
Would have compliance audits for Medicare to make sure they were not over- or under-charging
November 1997 - January 2003 Synergistic Systems Chatsworth, CA
Client Service Director
Manager and operate all billing and collection activities for Three emergency Room Physician Groups
Maintain AR days at 80 or below
Managed 21 employees
Performance evaluation
Meet with physicians and Hospital Administration staff on a regular basis
Presentation at Physicians Board meetings
Meet with Insurance Carriers to resolve outstanding claims
Start up of new Physician Groups
Hire and train off site employees
Monitored all collection activities with outside collection agency
August 1982 - November 1997 West Hills Hospital West Hills, CA
Cashier & Admitting Manager
Manage the daily operations of the Cashier, Admitting & Emergency Admitting departments
Daily deposit
Managed 38 employees and 2 Supervisors
Employee performance evaluations
Increased up front collections by 80% in 2 months
Decreased wait time for registration by 60% in 30 days
Worked unbilled report and maintained at a 5 day turnaround
Unapplied cash 30 days or below
Refunds
Assisted with the training and implementation of a new computer system for Billing, Collections & Admitting
Office Manager of Medical Group the Hospital operated
Assisted with the adjudication of claims that the hospital had a capitation agreement with
EDUCATION
Valley College Van Nuys, CA
Valley Medical & Dental School Van Nuys, CA
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