CAMILLA ORGAN
A/R Denials Supervisor
Pilot Point,TX
Summary
Accomplished Supervisor focused on meeting client expectations and achieving company goals. Drives success by directing high-producing teams while developing lasting employee rapport. Highly effective and knowledgeable in process improvement and inventory control. Known for reliability, strong communication, and fostering productive work environment.
Overview
17
17
years of professional experience
Work History
A/R Denials Supervisor
R1 RCM
Remote, USA , TX
08.2018 - Current
- Oversee daily operations of a denials management team ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Ensures staff meet or exceed all productivity and quality standards by setting clear expectations, holding regular team meetings to foster a positive work environment and provide continuous feedback.
- Mentored junior staff members in their career development.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.
- Evaluated staff performance to identify and implement coaching and/or performance plans.
- Cultivated positive relationships with clients.
- Manage and audit inventory to include reconciliations, client reporting, and reporting workflow processes. Maintain KPI protocols, monitor and report on inflow met and potential revenue; while ensuring monthly revenue goals are met.
- Experience with high dollar/ complex claims; to include IP, OP, LTC, and Workers Comp.
- Demonstrated commitment to the organization's core values, leading by example and fostering a culture of excellence.
- Currently supervising a team of 11, with all staff meeting quality and productivity expectations. My primary client has met or exceeded revenue budget every month so far this year.
Senior Reimbursement Counselor
AmerisourceBergen
Frisco, TX
07.2012 - 12.2017
- Developed strong relationships with payers, resolving complex reimbursement issues associated with newly FDA approved specialty drugs.
- Assessed patient financial eligibility accurately, resulting in appropriate allocation of financial assistance resources.
- Established a Payer Research Team dedicated to establishing payer guidelines, such as prior authorization requirements to have new medications added to pharmacy formularies.
- Site Coordinator - Served as the primary liaison for high priority clients.
- Conducted regular audits on claim/ appeal submissions to maintain accuracy standards and reduce denials.
- Improved team productivity by providing comprehensive training and ongoing support to junior reimbursement counselors.
- Managed multiple high-priority projects simultaneously while maintaining attention to detail and meeting strict deadlines.
- Provided exceptional customer service to patients, addressing their concerns promptly and professionally throughout the reimbursement process.
- Contributed to the development of departmental policies and procedures, ensuring consistency in best practices among reimbursement counselors.
- Prepared insurance claim forms, authorizations, appeals and reviewed for completeness.
- Assured timely verification of insurance benefits prior to procedures or appointments, and that the required prior authorization had been obtained.
- Audited daily reconciliation report, specialty pharmacy report, and team productivity.
Paramedical Examiner
Portamedic
Tacoma, Washington
05.2008 - 06.2012
- Conducted comprehensive medical histories, vital sign measurements, and specimen collections for accurate insurance assessments.
- Assisted in training new examiners, sharing best practices for successful paramedical examinations.
- Performed EKG tests on clients based on health status and medical history.
- Developed strong rapport with patients through empathetic listening and clear communication skills.
- Collected blood samples from clients following safety and biohazard handling procedures.
- Collaborated with underwriters to ensure proper risk assessment and policy issuance.
- Interviewed customers to record medical history, financial records, and lifestyle information.
- Managed inventory of medical supplies, ensuring adequate stock levels for uninterrupted service delivery.
- Handled challenging situations calmly, resolving conflicts or concerns promptly and professionally when they arose during examinations or scheduling processes.
- Enhanced patient satisfaction by providing thorough and accurate paramedical examinations.
- Maintained up-to-date knowledge of paramedical examination protocols, ensuring compliance with industry standards.
- Verified proper storage and transportation of specimens to laboratories.
- Protected patients by following infection control, sharps disposal, and biohazardous waste disposal procedures.
Education
Associate of Applied Science - Medical Administration/ Billing And Coding
Fayetteville Technical Community College
Fayetteville, NC 05.2001 -
Licensed Practical Nurse - LPN
Central Carolina Community College
Sanford, NC 05.2001 -
Skills
Team leadership
Workflow optimization
Goal-oriented
Problem - Solving skills
Coaching and Mentoring
Analytical skills
Clear communication
Effective organizational skills
Expertise in Revenue Cycle Management
Timeline
A/R Denials Supervisor
R1 RCM
08.2018 - Current
Senior Reimbursement Counselor
AmerisourceBergen
07.2012 - 12.2017
Paramedical Examiner
Portamedic
05.2008 - 06.2012
Associate of Applied Science - Medical Administration/ Billing And Coding
Fayetteville Technical Community College
05.2001 -
Licensed Practical Nurse - LPN
Central Carolina Community College
05.2001 -
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