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Click here or scroll down to respond to this candidateCandidate's Name
Street Address 27th Street SMoorhead, MN Street Address
Phone: PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLESUMMARYHighly resourceful, accomplished professional with more than 25 years of experience directing business and health care operations. Excellent problem solving and communication skills. More than 12 years experience with job fairs and trade shows; recruiting, interviewing, demonstrating and selling services. Extremely knowledgeable about the need for confidentiality and compliance.CAREER OBJECTIVETo obtain a position with a growth-oriented and progressive companyKEY SKILLS Experience building and maintaining strong relationships with internal and external professionals Provide updates on policy changes and training/materials to those impacted whenever necessary Responsible for troubleshooting software issues and work with company to make necessary improvements Excellent customer service and communication skills RELATED WORKEXPERIENCE01/01/2019 present. Consulting & Credentialing Contracts with practices to fill needs. Reviews claims for proper coding and documentation. A/R clean-up and staff training. 24 months Coding/documentation review for Internal Medicine provider. 18 months assisted with set-up of ABA practice and billings. 8 months cleanup, billing staff training, and credentialing for behavioral health center. 10 months cleanup A/R and billing staff training for Audiology practice. 12 months implementing new EHR/PCM system; troubleshooting issues with outbound and inbound EDI files.04/2022 07/2022 Payer Contract Specialist; The Village Family Service Center; Fargo, ND Credentials and contracts with 3rd party payers for clinic and individual therapists. Reviews contracts to ensue reimbursement is correct. Reviews claims for proper coding and documentation. Assists with written policies and procedures for compliance. Provides feedback to upper management on procedure violations. Work with violators to follow proper procedures and regulations.08/2016 04/2022 Director of Revenue Cycle/Compliance Officer; CORE Professional Services; Brainerd, MN Credentials and contracts with 3rd party payers for clinic and individual therapists. Responsible for taking lead and initiating implementation of EMR and billing software. Oversee claims filing and denial management to ensure prompt payment; works with billing software to correct any programming needs. Provide monthly, quarterly and other reports as requested. Responsible for staff training on EMR/RCM system and is available to answer any ongoing questions. Maintain knowledge of 3rd party payer rules and updates; keep teams informed of changes. Responsible for developing and updating Policy and Procedure/Compliance Manuals. Provide feedback to staff on a regular basis, discussing progress and the ever-changing needs of our business. Monitor Eligibility Verification Team to make sure that process is working effectively and efficiently, leaving no gaps in payment of services.12/2014 08/2016 Team Leader; Siege Enterprises, LLC; Fargo, ND Supervision of 43 staff within all areas of the CMS Intermediary employer was subcontracted with. Initiated use of job fairs and trade shows; booking, set up and booth attendance to promote company. Responsible for marketing, recruiting, interviews, hiring and training of new staff members. Instrumental in recruitment and hiring process for 28 staff in 10 days to fulfill a new contract with CMS. Worked directly with call center staff we had throughout Noridian. Process monthly evaluation reports for employees regarding production and quality measurements set forth by CMS12/2004 12/2014 Vice President of Client Relations; Advantage Billing Concepts, Inc.; Hibbing, MN Responsible for maintaining open communication with all insurance companies for contracting, claims payment, provider enrollment, prior authorization, authorization appeals and any other needs. Worked with Practice Management System and staff to ensure claims were filed per ANSI standards, corrected rejections, and provided staff training on proper submission for future claims. Assisted providers with implementation and establishing processes for starting new practices. Performed routine audits to ensure providers were being paid according to contract. Oversaw processes to ensure continued compliance with policies and regulations. Educated posters on importance of monitoring EOBs for proper reimbursement to avoid unnecessary issues. Served as resource to 15 staff and over 60 practices; consulting and training as requested. Active in interview, hiring, performance reviews, corrective action, and discipline process if needed. Instrumental in initiating trade show participation for our company which resulted in enrolling new clients with PCM system and billing services. Responsible for ongoing communication to ensure client satisfaction and positive growth.CERTIFICATION AND EDUCATION1998-Present Certified Revenue Cycle Executive-CRCE- Highest level of certification through the American Association of Healthcare Administrative Management(AAHAM)VOLUNTEER EXPERIENCEAmerican Association of Healthcare Administrative Management- Current Certification Chair of local MN Chapter coordinating with National AAHAM.- Served as Vice President for 6 years, President for 2 years, and Chair of Board of MN Chapter AAHAM.- Worked closely with Corporate Sponsor Program during this time to secure funds to help our Chapter operations for the year.Gigis Playhouse Down Syndrome Achievement Center, Fargo, ND Organized a fundraiser to help with their Rebuilding Fund after losing everything to a devastating fire. American Cancer Society- Served on the Relay for Life committee for planning annual walks. |
