Celeste Stauffer
Valrico,FL
Summary
Revenue cycle and provider relations professional with experience in claims resolution, A/R follow-up, and network onboarding. Supports provider education, billing issue research, and clear communication across internal teams to resolve concerns and improve satisfaction.
Overview
22
22
years of professional experience
Work History
Provider Relations Manager
CareCentrix
Remote, FL
08.2022 - 10.2026
- Supported provider relations across CareCentrix home health and post-acute networks.
- Strengthened provider partnerships through effective communication and timely issue resolution.
- Facilitated initiatives to enhance provider satisfaction and engagement.
- Assisted with provider onboarding, enrollment, and policy education.
- Reviewed provider concerns and escalated service issues to internal teams for resolution.
- Researched provider inquiries and responded promptly in a professional manner.
- Answered provider questions regarding billing issues and claims processing.
- Resolved customer inquiries and complaints requiring management-level escalation.
Technical Coach
CareCentrix
05.2016 - 08.2022
- Coached operations staff to enhance quality, timeliness, customer service, and staff development outcomes.
- Provided first-level support to operations staff, resolving complex issues and concerns effectively. Worked with operations leaders on issue review and root cause analysis, and partnered with other organizational areas to identify and document process improvements.
- Supported rollout of new processes and procedures, researched system issues, assisted user acceptance testing, and trained new and existing team members on changes.
- Trained CareCentrix staff on healthcare workflows and system navigation.
- Delivered classroom and virtual sessions for CareCentrix employees.
- Developed onboarding materials for CareCentrix technical training programs.
Billing Analyst
CareCentrix
04.2013 - 09.2014
- Ensured timely daily EDI transmissions to maintain billing accuracy and compliance.
- Reviewing system reports for billing errors, identify, and escalate issues to appropriate department for resolution, and communicate to all business lines accordingly.
- Utilizes HIPAA compliant billing software to ensure EDI and payer requirements are met. Reconciles daily EDI transactions through payer confirmation reports and uplines variances to clearing house/payer for resolution.
- Reviewed weekly paper invoicing, resolved discrepancies, and ensured timely submission to enhance cash flow. Managed manual billing for several small contracts in accordance with payer guidelines to support consistent revenue collection.
- Analyzed CareCentrix billing records to ensure accuracy and compliance with regulations.
- Matched invoices against payer and provider billing data for accuracy.
- Addressed billing discrepancies by collaborating with internal teams and clients for resolution.
Collection Specialist
CareCentrix
03.2012 - 04.2013
- Coordination of invoice activities leading to timely reimbursement of receivables by using available resources including databases, internet, and telephone.
- Resolved daily denials from payer edits, enabling timely preparation for appeals of denied services.
- Determined and initiated actions to resolve rejected invoices, preparing corrections and payer appeals through electronic and paper processes.
- Subsequently resolving appeals rejected or returned from payer. Support and guidance to internal and external customers related to insurance and government payers claims processing protocols; Identifying concerns which may result in education concerning the importance of clean claims; Utilizes various resources to determine patients' eligibility, benefits, and health plan confirmation. This includes online payer databases, CareCentrix Eligibility platforms, and medical records that may trigger provider or payer recoup/rejection activity. Managed approximately $600-$900K in accounts receivable.
- Facilitated the collection process for patient accounts, aiming to recover overdue payments efficiently. for CareCentrix healthcare billing workflows.
- Evaluated claims for accuracy and compliance within the billing system., balances, and account history in collections systems.
- Contacted patients and payers about outstanding payment arrangements.
Billing Specialist
Greystone Home Health
02.2011 - 09.2011
- Managed Commercial/Medicare/Medicaid accounts receivable by contacting providers to verify payment timelines for claims, ensuring timely revenue collection.
- Processed patient billing for healthcare navigation services and insurance claims.
- Resolved billing questions with patients, providers, and insurance representatives.
- Reviewed account balances using billing software and patient records.
Billing Analyst
Gentiva Health Services
03.2007 - 12.2010
- Coordinated implementation of new contracts, ensuring alignment across departments. Liaised between billing, contracts, data management, and I/S staff to fulfill payer billing requirements. Establish & maintain Account IDs within the AS400 Payroll/Billing system; Trained FSU staff on new payer systems and format modifications to enhance operational understanding. Assist in work distribution and completion of special projects. (Parent company to CareCentrix)
- Reviewed billing discrepancies for CareCentrix client accounts and corrected invoice errors.
- Executed claims processing tasks and payment records using billing systems and account documentation.
- Analyzed denied charges and prepared follow-up actions for resubmission.
SR Collector
Gentiva Health Services
05.2004 - 03.2007
- Managed Commercial/Medicare/Medicaid A/R for 90+ branches by contacting payers to assess payment timelines on claims; analyzed and resolved issues leading to claim pendings or denials by providers.
- Managed Gentiva Health Services patient accounts and collection calls.
- Contacted insurers regarding denied home health claims and account balances.
- Reviewed hospice claims and payment discrepancies for Gentiva billing teams.
Skills
- Provider relations
- Payer relations
- Claims resolution
- Payer billing
- Network onboarding
- Policy education
- Revenue cycle management
- Problem-solving abilities
- Communication skills
- Customer service orientation
Timeline
Provider Relations Manager
CareCentrix
08.2022 - 10.2026
Technical Coach
CareCentrix
05.2016 - 08.2022
Billing Analyst
CareCentrix
04.2013 - 09.2014
Collection Specialist
CareCentrix
03.2012 - 04.2013
Billing Specialist
Greystone Home Health
02.2011 - 09.2011
Billing Analyst
Gentiva Health Services
03.2007 - 12.2010
SR Collector
Gentiva Health Services
05.2004 - 03.2007