Cindy White

• Maintain Ballad Physician Contracts strives to load contract rate updates and new builds in less than 25 days and contract precision @ 90%.

• Bi monthly meetings with Ballad Payor Relations to insure contracts are loaded correctly.
• Audit contracts when rates are updated and break fixes are performed on the contract to ensure all lines are testing. Also check to make sure expected amounts are populating to ensure claims are valuing correctly.
• Maintain a working relationship with Revenue Recovery Department which includes answering questions about contracts and make sure contracts are loaded correctly.
• Training new employees are the processes for Contract Management and using Clients system in order to update contracts and make updates to contracts and to do rates updates.
• Maintain Ballad PB Contract Sign off each month.
• Review contracts to ensure correct rates are loaded.
• Review reports to ensure correct expected amounts are loaded on the contract.

Started MPV Appeals Analyst for Wellmont Physicians Billing this was a new program that I started in order to capture money that insurance was not paying. I was responsible for obtaining the contracts and sending this information to MPV to load the contracts into the system. I was responsible for filing appeals to the insurance companies for the underpayments. We started this program with our top 10 payors. After the program was deemed a success additional payors were added. I would work with provider reps to do bulk appeals in order to get larger volume of claims reprocessed. I communicated with upper management reports with the amount of money that was brought in due to the appeals I was filing. After seeing the amount of money being recovered I was able to add 3 additional employees to this department. Once additional employees were added I was responsible for training all new employees. I performed audit checks to make sure employees were working accounts correctly. I worked with Highland Wellmont to get copies of contracts and updated contracts as well as fee schedules. This information was then forward to MPV and they loaded this information into the MPV system. I was able to pull reports and work underpayments along with the practice management system to file appeals.

Reviewed contracts in order to build contracts into Epic for go live in June 2020. Created contracts, components,components groups, and fee schedules for all aspects of the PB contract build. Meet deadlines to ensure built progress is on target for the go live June 2020. Worked with Ballad IT to ensure task were completed to go live. Maintained relationship with Ballad payor relations to ensure all contracts were built in Epic prior to go live. Worked with Ballad Payor Relations to get clarification on contracts to ensure we have correct information to build contracts. Worked with Ballad Payor relations to obtain copies of contracts and get fee schedules needed for builds.

Worked with Ballad Payor Relations to get contracts mapped to correct payor and plans to make sure claims will map to correct contract.

Created test patients in TST in order to do testing and created claims in TST in order to make sure contracts lines are testing correctly.

Maintained Contract Build Tracker to keep with items used for the build.

Maintained Contract Testing Tracker to keep up with testing patients used for the build.

Maintained relationship with Epic TS to ensure build on target for go live in June 2020.

Gathered all information from MPV/Experian old system we used to track underpayments.

• I was responsible for reviewing charges before claims were filed to make diagnosis were correct. I performed follow up on claims. I worked denials and filed appeals. I reviewed medical records on denied claims making sure correct CPT code was billed as well as correct diagnosis. Performed collections on patients unpaid balances by making phone calls and sending letters and if accounts remained unpaid sent account to collections. I worked with physicians offices and developed protocol for seeing patients that have accounts placed with collections to collect payment before continuing to see patients. I worked with office staff to set up payments plans for patient's with large balances. I worked with office to answer questions and research new procedures before office started billing new CPT codes.
• As a Team leader I was responsible for running reports and distributing reports each day. I was responsible for training new employees. I was responsible for doing Supervisor duty when she was out of the office. I was responsible for helping Supervisor with special projects. I was responsible for doing batch checks for Team members as part of their review. I was responsible for batch checks for new employees to make sure new employees are working items correctly.