Youlae Smith
Savannah,GA
Summary
Collections Manager with over 20 years of experience in the Mental Health, Substance Abuse, & Eating Disorders Industry reporting to top executives. Provides versatile and professional support developed through experience as Collections Manager, Lead Auditor, Office Manager, Regional Manager and Claims Examiner Experience with accounts receivable. Supervise follow-up on missing documentation necessary for collection of accounts. i.e. EOB, Authorization, AOB etc. Supervise research unapplied payments when payer indicates claim paid and check date and number given. Project organizer and weekly meeting host. Supervise review AR aging against assigned accounts to ensure all have current follow-up.
Overview
17
17
years of professional experience
Work History
AR Manager
CSI Caregiver Services/ Home Care
12.2016 - Current
- Ensure all these listed functions are completed daily by my staff
- Supervise follow-up of any outstanding claims greater than 45 days from invoice date and resolution of same in timely manner
- Supervise work accounts via telephone, email, and websites or in person
- Supervise follow-up on missing documentation necessary for collection of accounts
- I.e
- EOB, Authorization, AOB etc
- Supervise research unapplied payments when payer indicates claim paid and check date and number given
- Supervise review AR aging against assigned accounts to ensure all have current follow-up
- Supervise document all calls both incoming and outgoing within the memo section of the client’s account; i.e
- Name and telephone of the contact; check number, invoice number, status of account and check amount
- Supervise communicate delinquent accounts to immediate supervisor and appropriate office administrator
- Supervise re-issue invoices as necessary to payer for all unpaid portions of account
- Supervise work with other internal departments to resolve unpaid invoices – give information to Collection Manager
- Supervise process client credit cards as necessary
- Supervise file appeals in a timely manner on denied insurance claims
- All appeals must be reviewed by the Collection Manager or designee
- Identify adjustments needed while reviewing accounts
- Identify and document for the Upper Management/ director accounts being considered for collection agency action or legal placement
- Review detail on unpaid invoices/ HCFA 1500’s to ensure accuracy of billed information
- Ensure contract information is correctly entered and reviewed for billing guidelines and timely filing limits
- Cross train on other functions within the department
- All other related duties as assigned.
Collection Manager
Behavioral Health/ Medivance Billing Services
04.2014 - 04.2016
- Based on the Monthly Aging, Supervise collections team to ensure balances less than 10% or less in the 120 + aging buckets
- Ensure claims are worked timely and in order to ensure clients satisfaction
- Placing phone calls and E-mails to Client Relations to ensure communication with Facilities on current or past issues
- Works closely with the Billing and Posting Department to implement processes and policies that contribute to accurate invoicing and billing
- Monitor Aging in a timely manner and provide percentages to the collection team
- Report ongoing issues to upper management in order to obtain accurate and timely turn around
- Maintain reports and spreadsheets to provide to the facilities
- Oversees and assists with the cleanup of AR reports
- Addressing ongoing client complaints concerning collections or service rendered and works on complaints of service failures with designated departments.
Lead Analyst/ Auditor
Healthcare Financial Systems
02.2013 - 04.2015
- Audit and monitor Physician Billing accounts and claims for several different specialties
- Responsible for the follow-up on all denied or rejected claims and or correspondence from insurance carriers
- Follow-up with insurance carriers in a timely manner on unpaid/incorrectly paid claims
- Process billing calls and questions from patients, clients and/or third-party carriers
- Identify root-causes on reported issues and bring fourth resolution
- Prepare and present monthly AR activity trends to Project Manager and/ or Supervisor
- Knowledge of Manage care contracts
- Utilize payer requirements and make corrections or adjustments towards adjudication of claims
- Identify trends and report to management for proper resolutions
- Analyze codes billed CPT, ICD-9 and HCPCS
- Analyze and recommend correct modifiers to increase reimbursement and/or overturn denials
- Remain current on commonly used concepts, practices and procedures within the field of healthcare insurance billing
- Participate in cross functional departmental planning sessions
- Perform all other related duties and projects as assigned by Manager, Supervisor, or Director
- Work with system such as, IDX, Epic/Apex, ETM, Medical Manager and other medical billing systems
Office Manager
Allergy and Asthma Center
03.2008 - 07.2012
- Managed staff of 15 employees in private practice
- Supervisor A/R monthly for provider meetings
- Greet and provide insurance benefit/ review to patient
- Customer care services to resolve issues and insurance concerns
- Work with claim through Medical Billing Manager, Practice Fusion, Zoom, and Ingenix
- Update patients’ demographics and new insurance verification
- Work with Modifiers, and CPT codes and HCPCS
- Front desk finalizing/ closing accounts for end of night
Claim examiner
HAA Preferred Partners
03.2007 - 03.2008
- Provide production and satisfaction to our customers, clients and providers
- Process over 100 clean claims a day
- Provide quality assurance and follow HIPAA and ISO guidelines
- Third party billing through all carriers
- Participate in educational activities and attends weekly staff meetings
Regional Manager
ADPI Staffing
07.2004 - 02.2007
- Managed staff of 20 employees for EMS billing
- Customer care and client service for 100% satisfaction
- Identify and resolve patient complaints
- Prepare, review and send patient statements
- Evaluate patient’s financial status and establishes budget payment plans
- Follow and report status of delinquent accounts
- Review accounts for possible assignment and make recommendations to the Billing Supervisor
- Perform daily backups on office computer system
- Perform various collection actions including contacting patients by phone
- Process payments from insurance companies and prepare a daily deposit
- Conduct self in accordance with HIPAA’s employee manual
- Train and instruct of new hire
Education
Bachelor - Science
Florida Memorial University
2006
Skills
- Strategic planning
- Policies and procedures
- Staff Management
- Schedule optimization
Timeline
AR Manager
CSI Caregiver Services/ Home Care
12.2016 - Current
Collection Manager
Behavioral Health/ Medivance Billing Services
04.2014 - 04.2016
Lead Analyst/ Auditor
Healthcare Financial Systems
02.2013 - 04.2015
Office Manager
Allergy and Asthma Center
03.2008 - 07.2012
Claim examiner
HAA Preferred Partners
03.2007 - 03.2008
Regional Manager
ADPI Staffing
07.2004 - 02.2007
Bachelor - Science
Florida Memorial University