Billing Representative Manager
Resume:
DOREEN LYNCH
Sicklerville, NJ *****
**********@*****.***
SUMMARY
Conscientious, detail-oriented manager who leads by example, enjoys challenges, and relates well to all areas of the business. Dedicated and motivated Billing Manager with more than 25 years of operational experience in healthcare. Strong collaborator with clinical and operational colleagues to drive improvement.
EXPERIENCE
SAMARITAN HOSPICE
Marlton, NJ
May 2019 to July 5, 2022
REVENUE CYCLE MANAGER
●Managed revenue cycle/billing department, collections, AR follow up and denial management for Samaritan Hospice, Palliative Medical Partners and Homevisit Physicians.
●Managed and created workflows for a team of 8-10 billers, for two different tax ids, two practice management and EMR systems. Managed team for claim submissions, insurance and patient payment posting and AR Follow up for all three practices.
●Implemented and trained employees on a new EMR/PM system, Netsmart/My Unity for Hospice billing over the course of a year, while working down AR for Cerner system.
●Worked to outsource credentialing department.
●Implemented and trained on a new contracting software for all business contracts for the company.
●Worked closely with clinical team to maintain billing and coding rules and timeliness of claims submission.
●Improved and maintained days in AR of 30 days with strategic processes with managed Medicaid, Commercial and Medicare payers.
●Scheduled monthly team meetings to discuss payer issues, updated workflows, and overall employee engagement in their daily tasks.
AXIA WOMEN'S HEALTH
(formerly Known as Regional Women’s Health Management)
Voorhees, NJ
June 1998 to May 2019
BILLING MANAGER
●Managed billing department, collections, AR follow-up and denial management for a 250-physician practice generating over 200 million dollars in revenue with a team of 60.
●Improved and maintained days in AR of 28 days with strategic processes.
●Worked closely with office managers and billing staff at the practice level regarding billing issues with insurances, patients, and providers. Managed all claims, payment, and insurance issues.
●Continuous training of office billing staff on issues like payment plans, correct ICD-10 coding, review of daily charges for billing errors before claims submission to insurance.
●Maintained a worklist for the credentialing department notifying them of payment issues related to credentialing. Maintained oversight of the credentialing process.
●Created, maintained, and regularly tested practice management software including all rule engines in claims management software eClinical Works, payment and adjustment types, explosion codes and specific insurance carrier rules required for correct submission and payment.
●Developed new rules for compliance and practice changes/needs to ensure payers will process claims in-network.
●Managed all relationships with insurance carrier provider reps. Scheduled regular calls for the carriers to review and correct issues. Identified resolutions and oversaw implementation.
●Reviewed reports for CPT procedure analysis to ensure contract compliance. Reviewed monthly trending analysis reports, working closely with Director of Analytics to focus on changes in days in AR. Identified areas of change and managed solutions for improvement.
●Extensively involved in the reorganization of the company, merging 25 new practices into current company.
●Ongoing monitoring and process improvement of revenue cycle.
HAHNEMANN UNIVERSITY
Philadelphia, PA
1988 - 1998
BILLING REPRESENTATIVE
●Worked as Billing Representative for large Hematology/Oncology Physician group, I Brodsky Associates.
●Duties included posting all charges for outpatient chemo drugs, patient visits and hospital charges for inpatient Bone Marrow Transplants and other surgical procedures. Transmission of claims electronically or on paper HCFA forms to insurance, posting all insurance payments, working all AR follow up with insurance companies.
●Processed and sent patient statements monthly, posted all patient payments, worked closely with patients in reference to bills and payment plans.
EDUCATION
LaSalle University 1986-1988
Philadelphia, PA
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