Bethany Smoot

a. Perform quality monitors of work processes and procedures in accordance with established QA guidelines. Completes ad hoc reporting requests as directed by the QA Manager.

b. Identify and report compliance/non‐compliance with policies and procedures in conjunction with review activities and established Directives.

c. Analyze and monitor data, perform trend and root cause analysis, and report findings per established reporting deadlines. Communicates findings orally in appropriate and professional manner. Quarterly review results are completed and ready for manager’s review and signature no later than the 5th calendar day of the following month following the reporting quarter. Quality Improvement Plans (QIPs) will be reported to respective managers and logged no later than the 10th calendar day of the month following the reporting quarter.

d. Prepares quarterly reviews requiring minimal corrections or change by Quality Assurance Manager. ∙ All review data/findings are accurate, complete, and succinctly defines the outcomes. ∙ Summary is free of spelling errors and grammatically correct. ∙ Recommendations are relevant and offer tailored references for improvement.

e. Ensures information, including requests for data and special projects, is provided within established deadlines. Meets all mandatory employee obligations such as required training, care and protection of government issued equipment, proper handling and protection of confidential, sensitive, and personally identifiable information

f. Is self‐accountable for role in team/organization goals and outcomes.

g. Alternate Privacy officer duties include logging reported breaches, performing monthly privacy rounds in the building in order to identify potential breaches, monthly reporting of breaches/findings, and presenting privacy expectations and requirements to all new employees.

• Responsible for the collection functions of the Revenue program third party insurance reimbursements, and other account receivables.
• Through aggressive follow-up performs analysis on outstanding third-party receivables and other accounts receivables to determine the best course of action to affect maximum recovery.
• Initiates or performs all follow-up action based on a variant number of criteria (age of receivable, type of receivable, amount of receivable).
• Analyzes, plans initiates, coordinates and implements actions required to maximize collections of receivables.
• Receives and responds to a variety of communications generated by third party payers.
• Audits, analyzes, and reviews information regarding the established third party receivable to discuss the status of the account when inquiry is made on follow-up.
• Actively contacts and pursues insurance companies and other third party payers to expedite collections.
• Determines when referral to Regional Counsel or other departments is appropriate for further progression of the collections.
• Analyzes claims to ensure expected payments are consistent and in accordance with the specific policy and or regulatory rules.
• Identifies and follows up on ways to expedite collections through contacts in the public and or private sector.
• Selected as February 2015 Employee of the Month for my contribution in a significant reduction of aged claims and increase in collections for VISN 1 facility White River Junction, as well as assisting in other work lists with the ability to multitask and work other accounts in the Huron tool while on hold with insurance carriers.
• Attended LSS Yellow Belt training in August 2014
• Successfully completed participation on the Lean Six Sigma Black Belt Project "Entered Not Reviewed Status" and aided in generating Power Point presentations as well as charts and graphs for review and analysis to present findings to Executive Leadership.
• Attended Building Better Teams training which aided in building upon my skills of communication and teamwork needed for problem solving

• Responsible for verifying veterans’ insurance coverage for inpatient, outpatient, mental health, and pharmacy services and entering updated information into the database.
• Verifying veterans’ benefits, policy numbers, pre-certification requirements, insurance company contact information, and effective dates of coverage
• Adjust day to day workflow in accordance with established priorities to ensure timely completion
• Provide accurate and timely information to other departments via inter-office communication
• Expert in insurance plans for all VISNs 1-4 and shared this information with all co-workers and new employees.
• Served as a VISN 2 liaison for urgent matters from the facility regarding veteran insurance issues and Office of Regional Counsel entries.
• Very proficient in researching and resolving problems with claims that are rejected.

• Completing the daily functions for the station I am assigned to as the Point of Contact by determining proper application of insurance payments to veteran copayments
• Efficiently refunding veteran payments when applicable by obtaining proper Fund and Resource Code
• Review any First Party debt related to the Debt Management Program (DMC) and the Treasury Offset Program (TOP)
• Processing veteran pre-payment accounts into Refund Review and Public Voucher (PV) prepared to balance account.

• Promotion to Billing/Collections (Jan 2012-Dec 2012):
• Verify patient insurance policies for correct billing and collections
• Counsel patients on their physical therapy benefits
• PatientChart assembly
• Posting insurance and patient payments to accounts
• Charge entry in database for billing purposes
• Daily deposit including documenting and distributing money to other Drayer Physical Therapy clinics
• Troubleshooting and solving account errors
• Processing reports from multiple databases and analyzing of daily, weekly, monthly, and year-to-date reports for auditing purposes in order to identify billing/collection errors and trends
• Adhere to all policies and procedures to ensure that compliance standards are met
• Follow-up with insurance companies and patients in regards to outstanding balances
• Receiving medical record requests and releasing of medical records according to HIPAA guidelines
• Submitting treatment plans to insurance companies for authorization.
• Duties also included working the accounts receivable report including processing write-offs, mailing of collections letters, and establishing patient payment plans.
• In addition to the duties as a Billing and Collections specialist, I was also the team leader responsible for organizing fundraisers and charity events that Drayer Physical Therapy participated with and donated to. Occasionally I was also asked to participate in marketing events that were geared towards local physicians' offices. In this role I was expected to serve as a resource to any and all referral sources if they had any questions in regards to the referral process.
• This position required a large amount of organization, strong communication skills, self-motivation as well as encouraging team members, and the ability to multi-task to meet deadlines.
• Receptionist (Sep 2009-Jan 2012):
• Responsible for answering all incoming calls and coordinating scheduling of appointments
• Managing multiple therapists' daily schedules
• Collect copayments and process receipts for cash, checks, or credit card transactions
• File and maintain medical charts according to policy standards
• Assist clinical staff with patient care as needed.
• This position required skilled usage of Microsoft Office and Excel, as well as computer systems Misys Tiger and Raintree.
• This position also required the ability to multi-task while maintaining quality customer service to uphold the company's mission statement.

• 3.78 GPA
• Graduated magna cum laude