Patient Care Service Delivery

MICHELLE K. TORRI

Seymour, CT ***** 203-***-****

**************@*****.*** Bold Profile

PROFESSIONAL

SUMMARY

Healthcare management professional with a proven track record of driving operational excellence and enhancing patient care. Emphasis on fostering team collaboration and adapting to evolving needs. Skilled in optimizing processes, budget management, and elevating patient satisfaction levels. A reliable, results-driven leader with a strategic mindset and strong communication skills.

SKILLS • Collaborative leadership • Benefits Administration Spreadsheets & Accounting

Reports

• • Employment Law

• Office Relocation • Satellite office launch

• Training & Development • Staff Recruitment & Orientation

• Collaborative leadership

WORK HISTORY PRACTICE ADMINISTRATOR 08/2021 to 05/2025 ReFocus Eye Health Waterbury, CT

Oversaw daily practice operations to guarantee seamless service delivery for patients and providers alike.

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Boosted practice growth through the development of marketing initiatives and community outreach efforts.

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Fostered a positive work culture by promoting open communication, teamwork, and professional development opportunities among staff members.

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Collaborated with physicians to develop strategic plans for continued growth and expansion of the practice's service offerings.

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Coordinated facility maintenance to ensure a clean, comfortable environment for patients and staff members alike.

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Reduced wait times for patients, optimizing the flow of daily appointments and procedures.

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Enhanced employee morale through regular performance evaluations and professional development opportunities.

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Developed customized reporting tools that allowed for better tracking of key metrics affecting overall practice performance.

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Enhanced patient satisfaction with timely appointment scheduling and organized recordkeeping.

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Provided outstanding support to entire staff which helped improve process flow and boosted efficiency.

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• Addressed and remedied all patient or team member issues.

• Boosted staff morale through transparent leadership practices that M K

fostered trust between employees at all levels of the organization hierarchy.

Maintained strict adherence to HIPAA guidelines ensuring confidentiality of sensitive patient information throughout all aspects of practice administration duties.

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Facilitated seamless coordination between administrative tasks such as referrals processing or insurance pre-authorizations with clinical teams'' workflows for optimal efficiency.

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Coordinated efforts with marketing teams for targeted advertising campaigns that effectively increased patient base and overall brand visibility.

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Developed and maintained a high-performing team through effective recruitment, onboarding, training, and performance management.

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Optimized resource allocation by tracking staffing levels against patient volume trends to maintain service quality without incurring unnecessary labor expenses.

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• Key Points:

Oversaw the ReFocus Renovation Project without closing or reducing patient schedules

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• Increased Google reviews from 2.5 to 4.8

• Ensured staff receive performance evaluations

PRACTICE ADMINISTRATOR/OPERATIONS 01/2016 to 07/2021 New England Retina Associates, P.C. Hamden, CT

Develop positive working relationships and establish a foundation for trust and credibility

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• Establish and support the desired culture of the practice Oversee operations including business, financial, and human resources management

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Inform physicians about current trends, problems and activities to facilitate policy making

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Ensure practice compliance with regulatory agencies governing healthcare operations including HIPAA Privacy, HIPAA Security, and Billing Fraud and Abuse.

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• Credentialed, in part, two new physicians to the practice Implementation of new ventures, i.e. opening a new practice location and relocating an existing office including real estate search, lease negotiations, design, implementing network and communications infrastructure, coordinating and personally overseeing the move, and notification to all affected parties

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Certified Professional Coder with AAPC, allowing me to oversee billing operations and ensure correct coding guidelines are taught and adhered to

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Successfully achieved and transitioned practice from PQRS, to MU, to MIPS

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Recruited new Information Technology firm to support the practice and achieve HITECH compliance

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• Direct, supervise, and delegate authority and responsibility to a highly experienced management team, and consult with and advise managers on a regular basis to improve management techniques and practices

Meet with physician partners, office managers, and head technicians on a regular basis with the goal of achieving superior patient care and support

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Develop effective working relationships with affiliated professionals such as, legal, accounting, ACO, and other professionals

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BILLING MANAGER 03/2014 to 12/2015

New England Retina Associates Hamden, CT

Oversee all billing activities including payer contracted fee schedules to ensure proper payments are received

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Responsible for setting up and implementing new practice management software, coordinating with multiple offices and departments

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Financial reporting to administrator and physicians on a monthly, quarterly, and annual basis

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Track A/R benchmarks and take appropriate actions to keep the A/R at or below established targets

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Understand, interpret, and apply CMS rules and regulations and remain current on updates, deletions, and additions to CPT and ICD-10 codes and coding guidelines

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Conduct periodic in-service sessions for staff in conjunction with the patient services department managers to maximize workflow efficiency, maintain physician satisfaction, and achieve desired performance standards within the practice

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• Effectively supervise, train, evaluate, and mentor assigned staff FINANCE/BILLING MANAGER/HIPAA SECURITY OFFICER 04/2008 to 03/2014 Associated Neurologists of Southern Connecticut, P.C. Fairfield, CT Responsible to plan, organize, and carry out all financial activities including accounting, loan payments and renewals, monthly bank account reconciliations, monitor EFT payments, and accounts payable.

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Profit sharing contribution disbursements and maintain files and asset spreadsheet for the owner physicians' 401k investments.

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Fund and calculate owner and employee health insurance premiums and deductibles.

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Responsible for staff and physician payroll, owner equalization bonuses, quarterly production compensation calculations, and 1099 distributions.

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Financial reporting to administrator and physicians on a monthly, quarterly, and annual basis.

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Track A/R benchmarks and take appropriate actions to keep the A/R at or below established targets

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Liaison with accountants and TPAs for administration of Defined Contribution Plan and health, life, and long-term disability insurance benefits.

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• Oversee all billing activities including all payer contracted fee schedules to ensure proper payment.

Understand, interpret, and apply CMS rules and regulations and remain current on updates, deletions, and changes.

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Conduct periodic in-service sessions for staff in conjunction with the patient services department manager to maximize workflow efficiency, maintain physician satisfaction, and achieve desired performance standards within the practice overall.

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• Effectively supervise, train, evaluate, and mentor assigned staff. Employ positive internal and external customer service skills and relate to coworkers and supervisors in a collegial and professional manner.

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Set professional example for department, adhering to and enforcing Medicare and HIPAA compliance requirements in an ethical manner.

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• Attend work-related seminars and workshops

Work with outside IT consultants, PM/EHR vendor, and Telephone System vendor to ensure hardware, software, and internet connections function effectively on a daily basis and remains in safe functioning condition with appropriate back-up system in place.

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Order hardware and software required for the system's functionality and inventories same.

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• Key Points:

Researched, interviewed, and hired new IT service with practice administrator which ultimately resulted in the implementation of data backup and disaster recovery procedure.

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Replaced insurance broker for the practice who consolidated services to save the practice an average of $2600 monthly in insurance benefits.

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Worked with managing partner and practice administrator to develop and implement a production based compensation model for the physicians.

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Successfully registered and attested for Meaningful Use Stage 1 for all practice providers.

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BILLING SUPERVISOR/CODING CLAIMS ANALYST 06/2005 to 04/2008 Associated Neurologists of Southern Connecticut, P.C. Fairfield, CT Supervised daily activities of billing staff to ensure correct coding practices, timely filing of claims and CMS compliance.

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Daily verification of financials, charges and coded services and procedures or with accuracy and completeness; ran applicable reports.

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• Balanced financials and prepared daily deposits. In-service physicians and non-physician practitioners on documentation and coding.

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Performed periodic claim audits to determine documentation / level of service appropriateness.

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Lead role in the development of coding policies and procedures and fee slips

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Researched coding for new services, implement and train all affected parties.

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• Performed quarterly internal claim audits for physician profiling.

• Set daily/monthly/annual closings ensuring daily claim submissions and accurate financial reporting.

Remained current in neurological CPT and ICD-9 coding to ensure compliance with CMS regulations and proper reimbursement from all third parties.

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Attended seminars, workshops, and continuing education classes on coding, Medicare, other third party payers and issues that had an impact on ANSC, as directed by manager.

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• Key Points:

Acted as "super user" in interviewing medical software companies to aid in the decision-making and implementation process. Ensured that all workflow for the billing department was translated into the new system and all staff was properly trained.

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CMS CODING CLAIMS ANALYST 12/1998 to 06/2005

Associated Neurologists of Southern Connecticut, P.C. Fairfield, CT

• Daily insurance verification of patient eligibility and referral requirements. Daily verification of financials, charges and coded services and procedures with accuracy and completeness; ran applicable reports.

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• Tracked and maintained Medicare and Medicaid fee schedules. Posted Medicare/Medigap EOB's, posted allowable fees in accordance with contractual agreements and alerted manager of discrepancies in payments, transferred balances to co-insurance or patient, and queued for billing; contacted carriers regarding denials and proceeded to resubmit or appeal in accordance with carriers' policies.

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• Designed and developed spreadsheets to record and track data Monitored reimbursement of selected procedures, by payer, on a continuous basis to identify changes in reimbursement patterns.

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Ran open encounter report monthly to ensure all provided services are billed.

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Ran A/R reports monthly with insurance analysis reports to review with manager.

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• Assisted with internal/external audits as directed by manager. Read all insurance policy and procedure correspondence, advised manager and staff of important issues and updated insurance library and manuals with same.

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Remained current in neurological CPT and ICD-9 coding to ensure compliance with CMS regulations and proper reimbursement from all third parties.

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Attended seminars, workshops, and continuing education classes on coding, Medicare, other third party payers and issues that had an impact on ANSC, as directed by manager.

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• Key Points:

Participated in list serve discussion resulting in being published in a Part B News article by Carl Ayers.

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Managed to see an appeal through the 3rd level of Medicare's appeal process, the ALJ (Administrator Law Judge). The telephone hearing with the appointed attorney resulted in a favorable outcome for the practice.

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EDUCATION Accounting

Sacred Heart University, Fairfield, CT

GPA: GPA 3.8

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