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EMAIL AVAILABLEPHONE NUMBER AVAILABLE - Okemos, MI Street Address
Work History:Forta Health Collections Manager - Remote- CAStreet Address /2024 - CurrentManage Collections team of five, to research and resolve outstanding claims submitted to insurance for all Forta locations throughout the US. Responsible for the collection, tracking, recording, and monitoring of data for accounting purposes.Physicians Health Plan of Michigan Credentialing Coordinator Lansing, MI06/2023 01/2024Responsible for the confidential collection, tracking, recording, and monitoring of data required in the credentialing/recredentialing process and for accurate provider information. Processes include -Conduct primary source verification such as State License Verification, Controlled Substance Verification, Drug Enforcement Administrations (DEA). Verify providers Hospital affiliations, collaborative agreements, attestation forms and other sources of truth documents. Communication daily with providers regarding missing or outdated credentialing documents within their CAQH application.Residential Options, Inc. ABA Billing Manager - Okemos, MI06/2014 06/2023Manage practice ABA services and a team of billing professionals.Executing and ensuring policies and procedures are adhered to, as well as fine tuning effective billing/intake processes for improvement.Managing all medical coding tasks, creating, and processing customer bills. Oversee the account collections process and manage the performance of billing staff members.Collaborate directly with clients and families to collect daily/weekly patient responsibility.Ensuring all clients maintain proper pre-authorization for services. Assist as necessary in the credentialing process of BCBAs and technicians as needed.Medical Management Systems Medical Coding Specialist/Account Representative - Lansing, MI06/2007 06/2014Account representative for Audiology, Surgery, Family Practice, Ambulance, Physical and Occupational Therapy. Responsible for full claim cycle; including collections, as necessary. Responsible for ensuring that our clients/healthcare providers receive proper reimbursement for services, as well as maintaining accurate patient records.Skills:Experienced in all Microsoft products; word, excel, outlook, teams, and PowerPoint, Central Reach, and other billing software.Medical Billing/Coding claims per CPT and HCPCS Guidelines. Maintaining CEUs.Apply knowledge of Anatomy and treatment of patient care utilizing ICD-10, HCPS and CPT guidelines to claims for insurance processing.Experience with Cactus/FACETS and navigating CAQH applications.Education:Lansing Community College, associate degree in Business Administration.AAPC Certifications; CPC, CPB and CCS.Certified Professional Coder, Certified Professional Biller, and Certified Credentialing Specialist |