Carol Hartford

Managed all aspects of billing, including Medicare A and B, Managed Medicaid, and Private Pay. Claim follow up on all payers within 2 weeks of billing. Cash posting to ensure accuracy including proper posting of any co-insurance/co-pays

Obtained Managed Medicaid authorizations within established time limits to ensure timely patient care and compliance with plan requirements.

Facilitated discussions with families regarding potential out-of-pocket expenses, promoting financial transparency and informed decision-making.

Assessed qualifications through Medicaid Pending interviews and coordinated application appointments to streamline the enrollment process.

Oversee 2 assistants and 3 concierge/receptionists.

Participated in daily PDPM meetings to evaluate patient management and engaged in weekly UR conferences for utilization review.

Processed daily census data for the center and maintained accurate payer and responsible party records.

• Analyzed Medicaid claims to ensure compliance with regulatory requirements and organizational policies.
• Guided clients through enrollment processes, clarifying eligibility criteria and required documentation.
• Resolved billing discrepancies with healthcare providers, enhancing service delivery and client satisfaction.
• Provided ongoing training to ensure compliance across 20 facilities
• Developed training materials for new staff, enhancing understanding of Medicaid processes and best practices.
• Communicated with facilities via weekly reports and calls, visiting those with high pending case volumes to address issues directly.
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Executed job functions aligned with standards at facility

Managed daily operations to ensure compliance with healthcare regulations and standards.

Coordinated billing processes, improving accuracy and reducing discrepancies in patient accounts.

Streamlined office procedures, enhancing workflow efficiency across administrative functions.

Managed daily operations to ensure compliance with healthcare regulations and standards.

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