Amanda Kerley

Stabilize Business Office Operations of Skilled Nursing Facilities Entering Receivership

• Serve as the primary liaison for the revenue department, providing training and support to Business Office Managers (BOMs).
• Manage receivership transitions in collaboration with cross-functional teams to streamline financial and administrative processes.
• Train and mentor BOMs on Medicaid applications, redeterminations, appeals, private collections, and revenue management.
• Identify operational gaps, and implement corrective actions to improve financial and operational performance.
• Ensure compliance with company policies, state Medicaid regulations, and industry best practices.
• Travel to facilities within the region to provide on-site guidance and support.

Revenue Cycle Strategies and Process Improvement

• Pioneered the first hybrid Revenue Cycle Team, designing training programs for staff on IL Medicaid policies, CMS regulations, billing guidelines, and appeals strategies.
• Managed the development and review of training materials, ensuring alignment with policies and procedures.
• Provided continuous training, mentorship, and troubleshooting, collaborating with Managed Care, Billing, and Collections teams to resolve policy/system issues.

Field Support and Operational Efficiency

• Delivered real-time training and troubleshooting to staff on documentation, policies, and systems, like PointClickCare.
• Acted as a key contact for resolving billing discrepancies, ensuring smooth billing, and insurance verification.
• Collected and analyzed field data to identify challenges and drive process improvements.

Revenue Cycle Collaboration and Issue Resolution

• Led complex Medicaid case support, advising on next steps to maximize recoupment, and ensure accurate payments.
• Developed technical solutions, communication tools, system updates to streamline operations and address operational challenges, like DHS policy changes.
• Directed Medicaid appeals and resolved issues such as wrongful claim rejections, facilitating the recoupment of $50,000 from a wrongful rejection.
• Collaborated with HFS and DHS to resolve policy errors, while ensuring a quick resolution of issues impacting revenue cycle performance.

Cross-Departmental Collaboration and Stakeholder Engagement

• Maintained communication with DHS and HFS to clarify policies and resolve issues.
• Coordinated with external partners on initiatives like MMAI and MLTSS.
• Worked with Billing, Collections, and Regional Directors to streamline processes and address operational challenges.
• Advised leadership on policy updates, and ensured timely communication across teams.

Maximizing Revenue Recoupment and Special Projects

• Led initiatives to recover revenue by resolving Medicaid payment issues, and wrongful rejections.
• Directed special projects to optimize revenue cycle efficiency and implement process improvements.
• Supported the collections team in resolving Medicaid-related issues, and ensuring accurate billing.

Leadership and Problem Solving

• Led the Revenue Cycle Team, providing strategic guidance, implementing process changes, and training solutions.
• Facilitated roundtable training sessions to ensure consistency, and monitor team success.

• Managed 80+ long-term care Medicaid cases and 80+ managed care plans.
• Delivered training on new software systems and web applications to staff and senior leadership.
• Provided training to facilities and staff to enhance strategies, programs, and initiatives.
• Recommended process improvements to reduce costs and increase productivity.
• Collaborated across departments to coordinate project efforts and ensure alignment.
• Worked closely with facilities, residents, families, staff, and state/federal organizations to meet or exceed expectations.

• Served as an ABE-registered community partner, with a specialization in Medicaid applications, redeterminations, appeal support, and providing general community resources related to ABE online applications.
• Advised residents and families on Medicaid planning, applications, appeals, and redeterminations.

• Designed and implemented a wide range of wholesome, enriching, and interactive activity programs tailored to meet the diverse, multicultural needs of nursing home residents.
• Managed a team of staff members and volunteers, providing guidance, training, and direction to ensure the successful completion of projects and tasks.