Allison Mortley
Riverview,FL
Summary
Adept and versatile professional with exceptional background in healthcare revenue cycle, managed care plans, and customer service. Skilled in training employees, while promoting individual and organizational growth. Successful at engaging with team members and maintaining accountability. Methodical and well-organized in optimizing daily operations and managing high caseloads in fast-paced environments. Proven history of analyzing and resolving issues to exceed organizational standards.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Appeals & Grievances Non-Clinical Specialist
Healthfirst
10.2020 - Current
- Analyze claim denials and render determinations on appeals in accordance with organization, state, and CMS guidelines
- Conduct in-depth investigations and leverage advanced problem-solving skills to address grievances to member satisfaction.
- Collaborate with teams across Healthfirst to address complex cases, resulting in successful resolutions.
- Contribute to the development of new procedures aimed at further enhancing the effectiveness of work processes.
- Provide guidance to team members on best practices for handling challenging cases, resulting in improved overall performance metrics.
- Serve as subject matter expert within A&G and assist with projects such as Category Validation and OE Ratio reports and Article 44/49 Audits.
Patient Financial Counselor, Team Lead/Educator
Orlando Health
07.2018 - 06.2020
- Managed a team of 30+ across two sites and directed day-to-day operations with responsibility for productivity, quality, and collections management.
- Maintained up-to-date knowledge on evolving healthcare regulations and assisted in the development of new policies procedures to improve patient financial experience.
- Enhanced team performance by designing and implementing comprehensive trainings on best practices in revenue cycle and patient financial counseling.
- Conducted thorough audits of patient accounts to identify discrepancies and prevent potential revenue loss, simultaneously coaching team members on areas of opportunity.
- Improved cash flow by proactively monitoring aging accounts receivables and implementing effective collection strategies.
- Created detailed reports on departmental performance metrics for presentation to senior management, highlighting areas for improvement and recommending strategic changes when necessary.
Patient Financial Counselor
Orlando Health
02.2016 - 07.2018
- Conducted revenue cycle functions within several areas including Patient Access, Admissions, Scheduling, Insurance Verification, Authorizations, and Patient Accounts
- Enhanced patient satisfaction by providing clear explanations of insurance benefits and coverage limitations.
- Collaborated with medical staff to ensure accurate billing codes and minimize claim denials.
- Negotiated payment plans with patients, maintaining a high rate of successful payments and educated patients on available financial assistance programs.
- Reduced hospital bad debt through proactive communication with patients about their financial responsibilities.
Patient Experience Intern
AdventHealth
08.2015 - 12.2015
- Collaborated with interdisciplinary teams to identify areas for improvement in the patient experience process.
- Analyzed patient feedback data to identify areas for improvement and implemented targeted interventions for better outcomes.
- Led regular team meetings to review performance metrics, discuss challenges, and develop strategies for continuous improvement in the patient experience domain.
Education
Master of Health Administration -
Louisiana State University At Shreveport
Shreveport, LA05.2020
Bachelor of Science - Healthcare Administration
University of Central Florida
Orlando, FL12.2015
Skills
- Leadership
- Training & Development
- Healthcare Revenue Cycle
- Medical Terminology
- HIPAA knowledge
- Root Cause Analysis
- Analytical Thinking
- Clear and concise communication
Certification
- Certified Specialist Managed Care (CSMC), HFMA - 2020
- Certified Revenue Cycle Representative (CRCR), HFMA - 2019
Timeline
Appeals & Grievances Non-Clinical Specialist
Healthfirst
10.2020 - Current
Patient Financial Counselor, Team Lead/Educator
Orlando Health
07.2018 - 06.2020
Patient Financial Counselor
Orlando Health
02.2016 - 07.2018
Patient Experience Intern
AdventHealth
08.2015 - 12.2015
Master of Health Administration -
Louisiana State University At Shreveport
Bachelor of Science - Healthcare Administration
University of Central Florida