Reimbursement Manager Customer Service

Tina Padden, CPCO,CDME

Roselle Park, NJ *****

********@*****.***

Cell: 908-***-****

● Dedicated senior manager with 23+ years of experience in durable medical equipment and home infusion operations. Consistently achieve record-high customer satisfaction rankings, improvements to the bottom line and turnaround of underperforming operations.

● Respected builder and leader of customer-focused teams; instill a shared, enthusiastic commitment to customer service as a key driver of company goal attainment. Lead by example and ensure the execution of all safety, security, quality and company operations policies. Areas of Expertise

Customer Service Management

Complaint Handling & Resolution

Retail Operations Management

Customer Satisfaction Enhancement

Front-End Supervision

Sales & Margin Improvement

Teambuilding & Training

Cost-Reduction Strategies

Order Fulfillment

Professional Experience

Community Surgical Supply of Toms River, Inc./Adapthealth — Kenilworth, NJ

Director of RCM 12/31/2021 to 12/2022

Community Surgical was acquired by Adapthealth December 31, 2021. My title was changed to Director of RCM. In addition to my day to day responsibilities detailed below, I was part of the transition team. I collaborated with senior management at Adapt to plan for data transfer to their software. We had several meetings per day to review capped rental items, payer contracts and fee schedules. I was tasked with organizing projects focused on collecting as much aged AR as possible, reduce held revenue and clean up open orders. The goal was to move clean, collectable data to their software. I also attended Adapt’s national sales meetings and RCM leader meetings in New York and Las Vegas. I added to our off-shore RCM teams and assigned them specific work flows to alleviate tasks that are more repetitive and ancillary in nature so my in house team could focus on more difficult tasks. I continued to support my staff and get them excited about this new chapter. Community Surgical; Governmental Reimbursement Manager, 8/09 to 12/31/2021 Promoted to director of reimbursement to recruit, train and supervise a team of 80+ billers, collectors and team leaders for 14 governmental payers in addition to 40+ third party commercial payers, private pay, cash application and VA. Foster an environment in which patients receive high levels of service and employees are motivated to deliver top performance. Manage reimbursement operations to ensure minimum DSO & minimum denials, as well as maximum cash flow and collections.

● Reduced governmental payer aging by 35% between 2009 and 2012, benchmarking a record-setting DSO and 120+ aging of 14% or less.

● Trained CSRs and managers at regional branches to achieve significant improvements in patient satisfaction and ensuring equipment delivered meets or exceeds payer qualifications for coverage.

● Maintained all license and revalidations, adding sites for Medicare and Medicaid.

● Serves as HIPAA Officer and is a liaison for corporate compliance.

● December 2021 Community Surgical sold to Adapt Health. My title changed, but still had the same responsibilities. I was in charge of coordinating fee schedules, active rentals and reducing hold and aging over 120 so we have a clean as possible data transfer to Brightree.

● I remained in my current position but also had to take on the transition to Adapt’s computer system, Brightree.

● After the sale, I continued my current role but also traveled to national sales meetings and RCM meetings.

● I was tasked with making sure payer contracts were current and loaded correctly. The Promptcare Companies — Clark, NJ

I

Reimbursement Manager

Directed staff of 27 employees, including 5 supervisors to bill and collect Medicare claims for Infusion, Enteral and TPN service lines, in addition to high-dollar and aged commercial payer accounts.

● Managed team to consistently meet or exceed collections goals set by the VP of Reimbursement. Introduced training programs that enhanced employee performance and helped build a motivated workforce.

● Maintained high standards of compliance with regulatory guidelines through ongoing training and coaching of the team.

● Ensured profitability and maximum reimbursement through monthly review of COGs reports and billing reports against multiple payer contracts.

Arcadian Healthcare— Cranford, NJ 5/04 to 5/05

Director of Reimbursement

Direct department manager for Customer Service and Reimbursement departments. Ensured adherence to regulatory compliance guidelines at 6 branch locations. Selected Contributions:

● Supervised intake procedures and set monthly goals in an effort to improve staff’s accuracy and to ensure compliance of payer regulations were met.

● Attended monthly board of directors meetings to review financial statements and goals.

● Responsible for month-end close, maintaining payer files in Dezine system and reviewing COGs reports and investigating and reporting variances and anomalies to Operations Manager. The Promptcare Companies — Clark, NJ 2/94 to 5/04

Reimbursement Manager, 2/04 to 5/04

Customer Service / Qualification Manager, 5/99 to 2/04 Reimbursement Supervisor, 9/97 to 5/99

Patient Account Representative, Medicaid, 7/95 to 9/97 Qualification Coordinator, 2/94 to 7/95

Advanced to increasingly responsible positions, culminating in management role with oversight for the reimbursement activities. Directed 10-18 employees throughout multiple positions. Selected Contributions:

● Directed Horizon BC/BS collection team & worked closely with director of managed care to ensure prompt resolution of payer issues through off-site and on-site projects with Horizon team. Maintained and reviewed contract files to ensure maximum reimbursement per payer contract.

● Direct customer service team and oversee intake process to ensure qualification and compliance with payer guidelines. Create monthly goals and monitor progress of documentation and qualification coordinators to minimize unbilled revenue.

● Managed reimbursement team to collect from all payer groups. Approve A/R adjustments, weekly payroll & personally work high-dollar and difficult accounts to maintain better than industry-standard DSO.

● Maintained unbilled revenue at or below $300k per month. Obtained authorizations and CMNs to bill for DME & IV services.

Education and Training

AAPC- CPCO Certification 2018

UNION COUNTY COLLEGE — Cranford, NJ 1997

Earned certification of Medical Office Manager

CDME Certification- 10/2021

UNION HIGH SCHOOL — Union, NJ 1988

Earned high school diploma

. Former Secretary for JAMES

. Member of AAHomecare Grassroots Team

. Member of OAMES

. Member of PAMS

. Member of NEMEP

. Member of HOMES

References Available Upon Request

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