Tracy Vandermerwe

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

East Kingston, NH 03827

603-***-****

Highlights

Experienced, diversified, hardworking Billing Manager proficient in overseeing team operations, implementing improvements, and reducing delinquency. Offering 23 + years of medical billing and management experience focused on team efficiency and producing high quality work. Exceptional abilities in conducting research, problem-solving and prioritizing simultaneous tasks. Resourcefulness, critical thinking skills and superior work ethic for top job performance. Successful track record handling complicated assignments. Able to work independently, prioritize work while being proactive. Ability to drive issues toward successful resolution. Highly experienced in reconciling insurance and patient payments and resolving account disputes. Proficient in a variety of practice management software applications. Dedicated to maintaining strict patient confidentiality.

Professional Skills

●23 + years medical billing experience

●Staff training

●Collection experience

●Insurance credentialing experience

●Audit procedures

●ICD-10, CPT Terminology

●Excellent Interpersonal Skills

●Excellent Phone Skills

●Good time management skills and self-directed

●Knowledge of contracting process, Medicare fee schedules

●Ability to analyze information and formulate effective plans for using information

●Established and maintained effective working relationships with multiple insurance companies

●Considerable skill in facilitating problem solving

●Various Practice Management Software

●Claim Entry & Payment Posting

●Records Organization & Management

●Insurance & Patient Aging

●HIPAA Compliance

●Online Claim Submission & ERA-

Professional Experience.

Commonwealth Diagnostics International - Billing Manager March 2021 to Current

●Oversee activities, performance, and productivity of 3 billing agents including planning, guiding, controlling, and training, as well as ensuring that performance standards are established, implemented, and maintained.

●Coordinate 1000 + claims per week

●Review all transactions

●Review and release accurate correspondence, daily/weekly/monthly reports

●Review audits for inaccuracies

●Perform billing, collections, receivables, and report for month to end

●Participate in all contract negotiations with different insurance companies.

●Schedule weekly meeting with billing staff to establish efficient workflow processes, targeting insurance denials and rejections

●Implement modifications to improve overall effectiveness of activities

●Report monthly to the Executive Team to discuss aging reports, goals, and strategies.

●Ensure Insurance A/R collections is achieved

●Review billing problems, research issues and resolve concerns Review and update policy and procedures, evaluate staff and make recommendations for status changes and promote teamwork and performance.

●Create new standard operating procedures improving billing accuracy and cash flow

●Train and mentor staff on procedures, compliance requirements and collections techniques

●Work with customers to develop payment plans and bring accounts current

Owner of VDM Management Services – Medical Billing and Office Management 2000 to Current

●Manage multiple Health Care Provider’s practices- billing and office management at one time

●Improve providers revenue over 30% with same patient load

●Improve provider’s office intake and management

●Experienced billing for Mental Health, Nursing Home, Opioid Addiction and Speech Therapy

●Ensure claims are entered and submitted with 48 hours of receipt

●Accurately apply payments to patient accounts

●Post and reconcile insurance and patient payments. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts

●Ensure accuracy of insurance claims. Verify correct ICD-10, and CPT codes for a variety of specialties

●Collaborate with primary social worker/case manager/other health care professionals involved in the patient's care

●Set up new patient accounts

●Insurance credentialing for new providers

●Check patient’s insurance benefits

●Assists in educating patients/families of their insurance benefits

●Assign ICD-10 to provider’s diagnosis and insure correct level of service and various other CPT codes

●Set-up practice management software for submission of electronic claims to clearinghouses. Work with clearinghouse to resolve file compatibility issues

●Retrieve Electronic Remittance Advice (ERA's)

●Send secondary claims upon processing of primary insurance

●Monthly processing of Patient statements. Answer and resolve patient billing inquiries

●Follow up on Insurance and patient aging. Re-submit insurance claims as necessary

●Knowledgeable in timely filing restrictions for insurance payers

●Ensure office practices are in compliance with HIPAA regulations

●Responsible for processing payments, adjustments and denials according to established guidelines (Payment Poster)

●Review medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed

●Ensure accurate entry of work into designated billing systems

●Assist with training materials and training staff members

●Communicates with the Clinics to provide or obtain corrected or additional data

●Performs corrections for patient registration information that includes, but is not limited to, patient demographics and insurance information

●Responsible for working EDI claim rejections in a timely manner

Technology Summary; Experienced in MS Office (Word, Excel, Outlook) Kareo EHR, Therapist Helper, Medisoft, Upload Advantage, Inbox Health, and QuickBooks.

Education; Bachelor of Science Salem State College 1990

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