Colleen Clark

• Managed charge description master, ensuring accurate coding, pricing, and compliance with regulations.
• Processed and validated updates to maintain billing integrity across all transactions.
• Collaborated with revenue integrity leadership to develop educational programs on charge capture and billing compliance.
• Ensured adherence to payer requirements for procedures, patient visits, and ancillary services.
• Analyzed statistical data on late charges and billing trends, identifying operational improvements.
• Supported implementation of new services, ensuring proper setup and compliance with coding and pricing.
• Collaborated with clinical departments to review documentation and identify compliant billing opportunities, enhancing revenue capture.
• Conducted bill form testing to validate accurate billing output following CDM changes.

• Manage the performance and productivity of the AR follow up team
• Monitor AR follow up, denials management, recoupments and credit balance resolution
• Observe workflow prioritization to confirm AR metrics and benchmarks are achieved
• Implement strategies to improve processing efficiency
• Maintain up to date knowledge of regulatory & compliance changes
• Ensure employees & vendor staff are performing functions complying with company policies & procedures
• Completed monthly performance monitoring and implemented corrective actions.

Establish training sessions for staff when processes are modified, or education is needed

• Coordinate with insurance companies to resolve account issues
• Perform research for appeals and take required actions for proper reimbursement
• Monitor delinquent accounts to maximize opportunities to limit financial risk
• Performs re-bill and post-bill exception corrections for accurate reimbursement
• Manage all overdraft situations and submit credit balance reports in allotted time frame

• Accurately applied payments to patient accounts to maintain financial integrity.
• Facilitated timely submission of claims, adhering to insurance filing restrictions to optimize payment processing.
• Posted and reconciled insurance payments, resolving discrepancies to uphold account accuracy.
• Investigated incorrect payments, EOB rejections, and outstanding account issues to enhance resolution efficiency.
• Retrieved electronic remittance advice for efficient payment processing.
• Sent secondary claims following primary insurance processing.

• Applied appropriate CPT codes aligned with ICD-10 codes for surgical procedures.
• Leveraged in-depth knowledge of coding concepts and principles to enhance accuracy.
• Maintained thorough understanding of major insurance companies and claims adjustments to support accurate billing.
• Prioritized and modified coding functions to align with operational demands, ensuring timely processing.
• Analyzed and translated medical diagnoses for a high-volume medical office.