Licensing Specialist Call Center

SHERRI HACKNEY WISE

*** ***** ***** ****

DILLWYN, VA 23936

434-***-**** – cell

adw18r@r.postjobfree.com

Education:

Master of Science, Community and College Counseling, Longwood College, December 1993 Bachelor of Science, Business/Office Administration, Cum Laude, Longwood College, December 1986 Business Education, Virginia Tech, attended 1980-82 Professional Experience:

Family Insight, PC, Richmond, VA 23230

December 2020 – present

--Quality Assurance Coordinator (December 2022-May 2023) Conducted qualitative and quantitative reviews of medical records and supporting documents to ensure accuracy and efficiency. Identified billing irregularities, overpayments, potential problems with regulatory compliance, and responded to external audits and/or investigations by regulatory agencies. Reported trends that reflected on the quality of care and file documentation. Compiled and sent client medical records for medical records requests.

--Agency Administrator (December 2020-December 2022) Provided complete oversight of the CSA programming and contacts for the company. Procured additional CSA contracts from differing Virginia counties. Kept in contact with CSA Coordinators regarding quality assurance, service provisions, and any issues that arose. Provided support to the ABA program by constructing, submitting, and tracking authorization approvals. Supported the credentialing activities for the company as it related to licensed staff. Acted as the main contact with Virginia licensing (DBHDS) for the company, including submitting necessary paperwork to add locations and services. Gathered and reviewed HR files for audit. National Counseling Group, Inc., Richmond, VA 23230 August 2011-November 2020

--Director of Operational Support – January 2018-November 2020 Provided hiring, training, supervision, direction, guidance, and oversight of operational support personnel for NCG, including NCG’s customer care call center and regional administrative support staff. Ensured that operations submit clean claims to billing, securing necessary authorizations and ensuring correct insurance in client charts. Developed mechanism for and provided oversight of staff submitting non-medicaid (CSA documentation) to finance for complete billing. Responsible for overseeing credentialing of licensed staff to MCOs. Interfaced with various MCO provider credentialing contacts to establish good working relationships Ensured company was in compliance regarding required documentation being present in client files. Completed necessary documentation and coordinated with site leadership, including interfacing with licensing (DBHDS) and Magellan, to get locations added to organization’s license and obtain necessary MIS numbers. Active in and supportive of all tasks my supervisees performed, including providing coverage and assisting in getting tasks completed on time and in the absence of others. Assisted and oversaw checking of monthly eligibility, entered client insurance, and pulled authorizations from various MCO portals. Secured client insurance numbers from various MCO portals. Provided MCO portal training to supervisors and directors within the company. QMHP registration process for NCG that was instituted in 2018. Assisted with opening a site office in Farmville for National Counseling Group, Inc. Starting January 2020, began being responsible for compiling, submitting, and collecting CSA and other funder billing/invoicing by required deadlines. Built relationships with all CSA coordinators throughout the State of Virginia who were contracted with NCG. Continued to provide support and assistance to others on the team. Member of the company’s Virginia State Leadership Team from 2015-2019. Recruited staff for employment from historical networking in the field.

--Director of Health Records and Service Access – September 2015-December 2017 Served as overseer of client electronic mental health records for the entire agency to ensure compliance with regulatory body requirements and local funder requirements. Supervised 10 support staff who provided assistance to direct services staff and administrative directors in 21 sites. Oversaw compliance and numerous operations functions in other NCG acquired partners. Managed and oversaw staff who processed pre-billing reports and identified trends to assist the company with financial success. Oversaw the company’s call (care) center where all incoming calls to the agency originated and all referrals were received. Reviewed resumes to screen for qualifying QMHPs for hire.

--Quality Improvement Team Coordinator & Quality Improvement Manager–August 2011–August 2015 Provided lead in developing teams to improve quality of various company functions and areas needing improvement. Reviewed clinical documentation, including SIRs and assessments, to ensure quality and completeness and provided feedback to sites. Provided support to The Institute as needed on various projects (implementation of EHR, researching accreditation, etc.). Conducted investigations due to client complaints. Prepared necessary reports and made recommendations. League of Therapists, Charlottesville, VA 22901

January 2011-July 2011

--Director of Quality Assurance

Provided leadership, direction, and supervision to a team of Quality Assurance Coordinators. Responsibilities included oversight of clinical practice as it related to records management and quality control in ensuring all clinical charts met DMAS, DBHDS, CSA, and other funding source regulations. Served as a support and trainer to staff on clinical documentation to ensure optimum quality of client charting, including regular paperwork training/consultation at each location. Provided structure for continual quality improvement and initiated implementing tracking system. Visited all company sites and met regularly with QA Coordinators and Directors regarding quality assurance compliance.

--Director, South Central League of Therapists, Dillwyn, VA 23936 (Branch of League of Therapists) March 2011-July 2011

Founded site and recruited staff to provide outpatient therapy, intensive in-home services, home-based counseling, and parent support coaching services. Served as direct marketer and advertiser for site, presented to agencies regarding services, took referrals, secured funding, coordinated intakes, start up and continuation of services, maintained clinical charts/files, and interviewed, hired and supervised staff. Family Preservation Services, Inc., Farmville, VA 23901 December, 1994-July, 2010

--Regional Director – June, 1995-July, 2010

Worked with various departments within NCG, to include finance, development, and HR. Oversaw the Performed all administrative duties as director of this community-based counseling agency, serving Farmville, VA and the surrounding counties. Primary duties included recruiting, hiring, training, and supervision of up to 50+ staff members. Responsible for budget management, marketing, records management and maintenance, and clinical services. Served as chief operations manager in growing and expanding the agency and adhering to state licensure and payment regulations. Responsible for successful networking with community and state agencies. Served six county area. Provided clinical supervision to staff, as well as continued providing services to children and families. Regularly met requirements for quarterly bonus based on exceeding expectations on records managements (including both clinical and personnel records), community involvement, and revenue margins (including minimal write offs and exceeding revenue targets).

--Counselor – December 1994-December 1996

Provided home-based counseling services to at-risk youth and families. Provided counseling to clients who have been diagnosed with a mental health, mental retardation, or substance abuse disorder. Responsible for conducting initial intake assessments, creating individual service treatment plans for clients, and submitting client progress note documentation. Longwood College, Farmville, VA 23901

--Director of Community Programs – May, 1989-June, 1992 Served as program developer for adults, children, and senior citizens in the community; worked with community agencies to assess and meet needs of community; coordinated and held community events; solely responsible for programming decisions; oversaw regularly held community meetings of senior citizens; managed and balanced program budget; served as institution’s rental agent; wrote, edited, and published the college’s quarterly bulletin; and served as academic advisor to adult students. Shackelford & Honenberger, Attorneys at Law, Orange, VA 22960

--Legal Secretary – September 1983-January 1985

Served as paralegal to several attorneys; prepared legal documents for civil, estate, domestic relations, real estate, and criminal law; accompanied attorneys to court and on investigations regarding criminal prosecutions; and served as receptionist in greeting clients and answering phones. Performed general office duties consisting of filing, typing, copying, report preparation, etc. References:

Andrea Carter, Licensing Specialist, Commonwealth of Virginia, Richmond, VA 276-***-****; email: adw18r@r.postjobfree.com

Spencer Ferguson, LCSW, Richmond, VA 434-***-****; email : adw18r@r.postjobfree.com Sarah C. Honenberger, Attorney at Law, 300 North Ridge Road, Richmond, VA 23239 540-***-****; email: editmore2@ hotmail.com

John Salay, Chief Compliance Officer, Family Insight, 2820 Waterford Lake Dr., Midlothian, VA 23112; adw18r@r.postjobfree.com; 804-***-****

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