Dari Grubbs
Adair,IA
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
12
12
years of professional experience
Work History
BILLING & A/R SUPERVISOR
CHILDSERVE
10.2023 - Current
- Responsible for revenue cycle management including verifying and validating the accuracy of charges for Skilled, Homes, Homecare, Community Options, and DME programs
- Coordinate collection of billing source information from program services and serves as primary backup for the billing specialists
- Prepare and submit CMS1500 or UB04 claims to proper payer for Skilled, ICF/ID and SCL Homes, and Homecare services
- Verify payments are applied correctly to charges and supervise collection efforts
- Develop and implement processes for revenue cycle management
- Participate in the design and implementation of new accounting procedures and processes for new and existing programs
- Prepare monthly summary of collection efforts on accounts over 60 days
- Evaluate and analyze reports to identify problems and trends in revenue management and staff productivity
- Implement and ensure compliance with revenue management policies, procedures, and best practices
- Ensure compliance with company policies and procedures as well as with federal, state, and local regulations
- Work with external auditors from private and government agencies to review sales and receivables activity
- Supervise Accounts Receivable functions between ChildServe and third-party payers and functions as lead in Accounts Receivable issues
- Issue final notice letters and recommends placement of past due accounts with collection agency
- Hire and train staff
- Evaluate staff performance and development and meet on quarterly, and yearly basis to review
- Review staff timecards and submit to payroll.
- Supervise month-end close processes, ensuring accuracy in financial reporting for accounts receivable activities.
- Reconcile daily AR ledger and verified proper posting.
MEDICAL BILLING SPECIALIST II
CHILDSERVE
04.2018 - 10.2023
- Assist with the review and updating of all DME processes and implementation of new processes
- Prepare and submit monthly/weekly billing within required timelines
- Prepare monthly invoices for families and other pay sources
- Record and apply insurance and private payments and/or adjustments in the billing system
- Reconcile batch totals
- Review and file appeals on unpaid claims and resolve payment discrepancies for DME, Homecare, and Day Programs
- Resource for patients, families, providers, and payers regarding patient accounts and applicable regulations
- Create and maintain training manuals
- Recommend revisions to existing accounting procedures to enhance quality and consistency of financial regulations
- Serve as back up and subject matter expert for other team members
- Confirm insurance listed in the billing system is accurate and up to date
- Work with supervisors and management to identify and resolve system issues in Carevoyant
- Submit prior authorizations for DME equipment and orthotics to insurance providers
- Trained Insurance and Authorization Department on orthotics and DME prior authorizations when duties transitioned.
Billing & A/R Coordinator
CHILDSERVE
05.2016 - 04.2018
- Verify insurance eligibility and complete medical prior authorization requests
- Verify charges, procedure codes, and diagnosis codes
- Prepare weekly and monthly billing and submit to proper payer within timelines
- Record and apply payments and/or adjustments in the billing system
- Reconcile batch totals
- Prepare monthly reports on AR over 90 days
- Review and file appeals on unpaid claims and resolve payment discrepancies for DME
- Resource for patients, families, providers, and payers regarding patient accounts and applicable regulations
- Prepare monthly invoices for families and other pay sources
- Submit uncollectible accounts to supervisor for collections or write off.
- Contributed to successful audits by maintaining comprehensive documentation of all A/R activities, transactions, and policies.
- Improved A/R collections by streamlining invoice processing and diligently following up on overdue payments.
Claims Specialist
Timberline Billing Service
07.2012 - 04.2016
- Compile, review, prepare and sort source documents while verifying accuracy of data to be entered
- Process account information, client information and other forms of documentation to resolve inconsistencies while reviewing data for errors using standard procedure
- Coordinate with management team to request further information for documents that are deemed incomplete
- Compare data entered with source documents, or reenters data in verification format on screen to detect errors
- Transmit entered information into the database
- Prep CMS 1500 forms for Claims Coordinator
- Track claims in the queue and document issues on the issue log spreadsheet to ensure claims are processed in a timely manner.
Education
B. S. SOCIAL SCIENCE -
UPPER IOWA UNIVERSITY
03.2024
MEDICAL BILLING AND CODING -
SOUTHWESTERN COMMUNITY COLLEGE
01.2011
Skills
- Detailed oriented
- Expert organizational skills with developed problem-solving skills
- Ability to prioritize multiple demands
- Proficient in Microsoft Office, Carevoyant, Kronos
- Experience with Medicare, Medicaid and Commercial Insurance
- Ability to work independently
- Deep understanding of medical billing with complex claims in varied services
- Maintain positive working relationships
- Ability to interpret and follow applicable policies, procedures and regulations
- Staff Training and Development
Community Leadership
05/01/18- Current
Boys and Girls Club Of Central Southwest Iowa, Board Member
- Serves as Chair of the Safety Committee
- Serves on the Internal Committee overseeing Programming, Technology, Staff and Human Resources, and Safety.
- Contributes to the formulation and realization of the organization’s strategic plan and vision, actively supporting its objectives and aspirations.
Timeline
BILLING & A/R SUPERVISOR
CHILDSERVE
10.2023 - Current
MEDICAL BILLING SPECIALIST II
CHILDSERVE
04.2018 - 10.2023
Billing & A/R Coordinator
CHILDSERVE
05.2016 - 04.2018
Claims Specialist
Timberline Billing Service
07.2012 - 04.2016
B. S. SOCIAL SCIENCE -
UPPER IOWA UNIVERSITY
MEDICAL BILLING AND CODING -
SOUTHWESTERN COMMUNITY COLLEGE