Accounts Payable Quality Assurance

NANCY KOCH

*****.*****@******.*** 678-***-**** Rome, GA 30161

Summary

Dynamic Medical and Health Services Director with extensive experience in healthcare operations management, adept at leading interdisciplinary teams, optimizing patient care processes, and ensuring compliance with regulations to enhance healthcare delivery and operational efficiency.

Skills

• Policy and program development

• Project management development and lifecycle

• Sales and Marketing

• Systems implementation

• Accounts payable/receivable

• Quality assurance and control

• Workflow Management

• Denials Management

Experience

Parsons Medical Group Waco, TX

Director of RCM Service

4/2024-12/2024

• Managed onshore and offshore billing teams

• Oversaw daily team productivity

• Conducted weekly client meetings to review KPI and account status

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Advantum Health Louisville, KY

Regional Director of Operations

08/2022 – 04/2024

• Led and managed both onshore and offshore RCM Operations teams to enhance client experience and outcomes.

• Established key performance metrics, analyzed results, and implemented corrective actions for performance improvement.

• Oversaw daily operations and workload for RCM Operations Team.

• Collaborated cross functionally to ensure consistent and high-quality client service.

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Floyd Medical Center Rome, Georgia

Denials Coordinator

08/2017 - 01/2023

• Analyzed inquiries and drafted appeal letters for insurance denials.

• Performed post payment reviews and RAC audits.

• Kept current on insurance benefit levels, eligibility, and verification processes.

• Identified denial causes to develop resolution plans.

• Communicated reimbursement and coverage discrepancies with payer representatives.

• Reviewed insurance policies to assess coverage and claims approval. NW Georgia Medical Clinic

Rome,Georgia

Practice Manager

12/2016 - 07/2017

• Led a dynamic Family Practice and OB GYN clinic with ten physicians, five mid-level providers and 40 staff

• Supervised daily operations, ensuring compliance with policies and guidelines.

• Managed accounting, budgeting, and financial reporting.

• Resolved patient and team member concerns effectively. Floyd Medical Center Rome, Georgia

Business Office Mgr/Program Lead OP PT

02/2016 - 11/2016

• Evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed

• Managed daily activities of claims billing, claims corrections, and insurance case management.

• Attended weekly hospital central billing office meetings to ensure departmental compliance with current hospital billing requirements.

• Performed tasks as member of line staff to reduce wait time.

• Supervised employees at multiple sites to maintain consistent practices across company.

Self Employed Contractor Rome, Georgia

Credentialing and Billing Consultant

12/2014 - 01/2016

• Performed all aspects of credentialing for physical and occupational therapists with individual clinics

• Enrolled newly licensed therapists with CAQH and NPPES participation

• Renewed existing and obtained new insurance contracts for clinical staff Advance Rehabilitation/Source Medical

Rome, Georgia

Implementation Project Manager/Billing

Operations Manager

11/2001 - 12/2014

• Managed onboarding of 120+ clients to TherapySource, overseeing five departments.

• Delivered software training, ensuring smooth billing transitions.

• Reviewed productivity and client interaction to determine client transition from implementation to general workflow and offshore billing partners

• Served on key groups to test software upgrades prior to updates being published to clients

• Managed 50 person team for billing operations.

• Billed daily and monthly charges to carriers via paper and electronic format

• Maintained client databases by adding and updating fee schedules, insurances, CPT and ICD codes

• Developed business policies to improve processes.

• Attended tradeshows to help market billing services.

• Created reports to show key performance indicators and developed action plans to address deficiencies and enhance strengths.

• Monitored contracts and service level agreements to identify potential risks and implement mitigation actions to protect development process from unforeseen delays and costs.

Education and Training

Chattahoochee Technical College Dallas, Georgia

Medical Coding Certification

2001

Georgia Highlands College Rome, Georgia

Pepperell High School Lindale, Georgia

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