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Office Insurance

Location:
Dallas, Texas, United States
Salary:
open
Posted:
October 24, 2016

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Resume:

Cathy Mitchell

**** ****** *** ** #***

Lewisville, TX 75067

P214-235-8982

Email: acw7hw@r.postjobfree.com

US Anesthesia-Addison Group 2016- Present

Billing Analyst-Contract position

•Analyze A/R trends, collection trends and RCM performance issues and review reports

•Review patient insurance benefit options

•Validate prior authorization requirements

•Review appropriate billing and coding

•Assist with resolving reimbursement issues

•Denials Management process of working accounts that have been previously billed and denied and/or on hold due to missing information, appeals processing, insurance follow up to resolution, review denials for prior authorizations and medical necessity

CHOICE LABORTORY SERVICES, Dallas, TX 2014-2016

Revenue Analytics Manager

•Leads the analytical process of financial opportunity assessments for all insurance payers to identify opportunities to improve revenue cycle performance as a out of network, out of state provider

•Analyze A/R trends, collection trends and RCM performance issues and review reports

•Review patient insurance benefit options

•Validate prior authorization requirements

•Review appropriate billing and coding

•Assist with resolving reimbursement issues

•Denials Management process of working accounts that have been previously billed and denied and/or on hold due to missing information, appeals processing, insurance follow up to resolution, review denials for prior authorizations and medical necessity

•Resubmission of denials for Worker’s Comp, Commercial, Managed Care, Managed Medicaid and Managed Medicare

•Research insurance payers to obtain possible contracts

•Responsible for generating various recurring and ad-hoc reports daily, weekly, monthly or annually as

necessary to research and analyze cash collections, disputed and denied claims, suspended, held or pended

claims, and under and overpaid claims.

•Recommend changes as appropriate, relevant feedback to the President/CEO

MEDMARK SERVICES, INC., Lewisville, TX 2011 – 2014

Billing/Collections Manager

•Management of central business office operations for 15 behavioral health clinics

•Managed billing, collections, payment posting, adjustment posting, denials, appeals processing and authorizations

•Implementation of policies and procedures

•Recommend changes as appropriate, relevant feedback to the Chief Financial Officer

•Staff recruitment, training and development

•Billing compliance and significant involvement in the front end admissions process

NORTH TEXAS HOSPITAL, Denton, TX 2009 – 2011

Business Office Director

•Management of business office operations

•Managed admitting, patient billing, payment posting, insurance verifications, collections, prices and discounts

•Directly supervised a staff of 14 assigning work and monitoring productivity

•Staff recruitment, training and development

•Billing compliance, monitored productivity of the collection agencies and other contracted vendors and developed flat rate cash

•Key accomplishment of a $700,000.00 deficit to meet year-end cash goal

HICKORY TRAIL HOSPITAL, Desoto, TX 2008 – 2009

Business Office Director

•Management of business office operations for a behavioral health hospital

•Managed billing, collections, payment applications and insurance verifications

•Negotiated discounts, eligibility funding resources and charity care program

•Monitor contracted reimbursement levels, staff recruitment, training and development, bi-weekly reviews of employees’ work and monitors productivity and billing compliance

•Monitored productivity of the collection agencies and other contracted vendors and bad debt recovery

•Key accomplishments included meeting and exceeding monthly collection cash goals and reduction of AR days

PEROT SYSTEMS, Nashville, TN 2006 – 2008

Project Director

•Responsible for leading a team of Hospital Billing Analysts at a client hospital facility in accomplishing the revenue reimbursement goals set out in the contract which included billing, collections, cash posting and adjustments

•Established, implemented and enforced the operational processes needed to successfully accomplish project and company objectives

•Provided leadership, organization and support to the project staff, acting as the primary contact for the client and monitoring staff performance

•Conducted presentations to management and client concerning issues, programs or projects

•Ensured that all cash is accurately accounted for with supportive documentation, reporting it on a timely basis

•Ensured that all corporate reporting is accurately completed and forwarded to the corporate office within the mandated timeframe

•Key accomplishment of exceeding the $13,000,000 monthly cash goal

TENET HEALTH SYSTEMS – RBO, Frisco, Texas 2003 – 2006

Director of Patient Services

•On-site Business Office Director and liaison between the Admitting Department, the National Medicare Center and the Regional Business Office to manage patient accounts

•Implemented policies and procedures and recommended changes as appropriate

•Provided relevant feedback to the Chief Financial Officer and the Regional Business Office

•In charge of oversight and coordination of all front-end patient services, scheduling, pre-registration, registration areas, billing compliance, as well as the Emergency Department and financial clearance functions

•Developed and implemented initial and ongoing training programs and monitored performance

•Instrumental in the implementation of hospital patient accounting system by training staff at various facilities

EDUCATION

UNIVERSITY OF PHOENIX, Dallas, TX

Master of Arts, Business Management

TEXAS A&M UNIVERSITY –Commerce, Texas

Bachelor of Social Work



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