Dorothy Berrian
Augusta,USA
Summary
Dynamic leader with extensive experience in revenue cycle management and team supervision, notably at Virtual Business Office Associates. Excelled in implementing training programs and process improvements, achieving a 95% increase in productivity. Skilled in HIPAA compliance and medical billing, coupled with strong leadership and communication abilities, ensuring optimal team performance and client satisfaction.
Overview
21
21
years of professional experience
Work History
Team Leader/Supervisor
Virtual Business Office Associates
Columbia, SC
03.2024 - 11.2024
- Developed and implemented training programs for new team members, resulting in a 95% reduction in onboarding time.
- Led a team of 50 onshore employees and 60 offshore employees, providing guidance and support to ensure the successful completion of projects.
- Demonstrate servant leadership, lead daily huddles, and conduct weekly 1:1s to ensure team members' needs are being met, and that opportunities are addressed timely.
- Ensured compliance with HIPAA regulations by implementing privacy policies and procedures for handling patient information.
- Created performance metrics and tracked key indicators to evaluate individual and team performance.
- Conducted regular meetings with staff members to provide feedback, address concerns, and identify areas for improvement.
- Identified skill gaps within the team and coordinated training sessions to enhance overall capabilities.
- Served as a liaison between upper management and the team, effectively communicating goals, objectives, and expectations.
- Identified opportunities for process improvement and implemented changes, resulting in a 95% increase in productivity.
- Established clear expectations for individual roles within the team, promoting accountability, and ownership of tasks.
- Identifying and developing future leaders.
- Providing timely, meaningful written and verbal feedback to follow up with representatives and Account Analysts as it relates to their daily work assignment progress and issues in a timely manner to appropriate leadership.
- Conducted regular audits to identify coding errors or discrepancies, leading to a 95% reduction in claim rejections.
- Implemented a new performance evaluation system that provided more accurate feedback for employee development.
- Following project policies and procedures, consistent with payer guidelines and client expectations.
- Reduced accounts receivable backlog by 95% through effective follow-up on unpaid claims.
- Maintained up-to-date knowledge of medical coding updates, payer policies, and industry trends to ensure accurate billing practices.
- Analyzed financial reports related to collections, aging accounts receivable, denial rates, and reimbursement trends for performance evaluation purposes.
- Managed the revenue cycle process from charge entry to payment posting, ensuring accurate and timely claims submission.
- Served as a subject matter expert on medical coding systems, such as CPT-4, ICD-10-CM/PCS, and HCPCS Level II codes.
- Participated in continuous improvement initiatives to streamline billing processes, and reduce errors.
Supervisor of Operations Hospital and Physician Billing
EnableComp LLC
Franklin, TN
11.2021 - 03.2024
- Reporting to the Manager, the Revenue Cycle Supervisor has daily oversight of one of the teams assigned to the following accounts receivable inventories: Pre-Billing, Billing, Follow-Up, Denials, and Appeals.
- The supervisor will bring experience leading a team to achieve results, and demonstrate the ability to facilitate change.
- The supervisor supports new client onboarding and transitions within the VA Service Line of EnableComp, monitors key performance indicators daily, and ensures targeted goals are met or exceeded.
- Manage staff within the VA Service Line Operation, i.e., Pre-Billing, Billing, Follow-up, Denials, and Appeals, to ensure that the team's daily work activities are prioritized and aligned with the strategy.
- Maintain a positive environment for team members that leads to high performance and retention.
- Engage, energize, and motivate others.
- Coach team members to manage client expectations, and maximize revenue.
- Manage and drive A/R to meet V.A. Service Line goals and metrics.
- Demonstrate servant leadership, lead daily huddles, and conduct weekly 1:1s to ensure team members' needs are being met, and that opportunities are addressed timely.
- Review client project objectives with the team, guide A/R management, provide strategies to maximize revenue collection, and monitor the ongoing progress of projects.
- Presents insights to leadership on the state of the Client(s) A/R, and how EC is helping to bridge the gap of collecting 100% of cash due.
- Communicate effectively with all levels in and outside of Enable Company.
- Ensures that the VA Service Line activities comply with federal, state, and local regulatory guidelines.
- Hire required talent to ensure smooth operations, execute client projects, establish and oversee training, and implement operations structure and operational policies as assigned by leadership.
- Daily monitoring of Key Performance Indicators.
- Analyze trends in accounts receivable, and take appropriate action, if necessary, to realign staff to meet the strategy.
- Participate in various revenue cycle improvement initiatives to maximize reimbursement and collection activities.
- Identify opportunities and root causes to identify trends.
- Work on enhancement initiatives with technology team members to improve the scalability of Enable Comp.
- Work all veterans, workers' compensation, Medicare, Medicaid, and commercial claims from the EPIC hospital and physician portal, and Salesforce.
- Adjust and reconcile payments, overpayments, and recoupment as received from the insurance companies.
- Creates a spreadsheet for the team to conduct a weekly payment search from the client system.
- Accurately entered and coded medical charges into the billing system for multiple healthcare providers.
Revenue Cycle Specialist (Assistant Manager)
Medac Anesthesia Business Partners
S.C
09.2019 - 11.2021
- Conduct weekly random measures cases audit of BPO AR Representatives work
- Responsible for Checking on Provider Enrollment status, refiling, updates and adjustments
- Escalated write-off approval based on established write-off policies
- Responsible for review and completion of 'Unpaid claims Request' in the Work AR requests module
- Manage and process Collection Agency insurance refiles
- Knowledge of billing practices and procedures
- Knowledge of coding operating policies
- Ability to management ability, mature judgement, and self-motivated
- Ability to manage multiple employees, clients and projects
- Knowledge of out of network vs in network payments, PPO, HMO
- Basic understanding of medical insurance benefits
- Microsoft Office experience
- Anesthesia payment posting experience
- Adjust and reconcile payments, overpayments, and recoupment as received by the insurance
- Demonstrated strong attention to detail by consistently identifying and correcting errors during the charge entry review process
- Maintained a high level of productivity by consistently meeting or exceeding daily charge entry targets
- Reviewed and verified patient demographic information, insurance details, and procedure codes to ensure accurate charge entry
- Successfully transitioned from in-office work to remote work, maintaining productivity and meeting all deadlines
Account Receivables
Medac Anesthesia Business Partners
North Augusta, SC
08.2016 - 09.2019
- Maintain the production of at least 45 claims daily for anesthesia claims.
- Maintain the accuracy of follow-up at 95% per audit guidelines.
- Perform balance and pending patient transfers, and other related tasks.
- Identify the root cause of claim denials and underpayments; process appeals in accordance with carrier policies.
- Apply check, credit card, EOB, EFT, and lock box payments.
- Adjust and reconcile payments, overpayments, and recoupment as received from the insurance companies.
- Identify denial, underpayment, or other unpaid claim trends or patterns; report appeals in accordance with carrier policies.
- Document notes in the billing system in accordance with protocols; ensure adequate detail and clarity of the notes.
- Maintaining flies for claims in order to document data, reserves, and payments.
- Oversaw Workers' Compensation claim processes.
- Answering questions from claimants and other parties, explaining the legal requirements and procedures that apply to Workers' Compensation claims.
- Reviews records to ensure required reports and signatures are included.
- Purges charts on a timely basis and follows the process for storage according to company policy.
- Copies and maintains medical records, logs for all urgent copy requests.
- Prepares and monitors all outside copy services.
- Maintains strict confidentiality of all information within the facility.
- Completes daily tasks to maintain medical record compliance.
Patient Service Representative
Medac Anesthesia Business Partners
North Augusta, SC
09.2013 - 08.2016
- Proficient skills in computer programs: KAM billing system, Microsoft Word, and Excel.
- Understanding of payment, Explanation of Benefits (EOB).
- Knowledge of HIPAA (legal and ethical considerations related to patient information).
- Process credit card payments and checks for patients.
- Ability to use office equipment, such as printers, faxes, telephones, and to calculate other office machinery; self-starter; ability to work independently.
- Willing to help others in any area, as needed.
- Verified insurance coverage and obtained necessary authorizations for medical services, minimizing billing errors.
- Maintained accurate patient records by updating personal information, medical history, and insurance details in the electronic database.
- Managed incoming and outgoing correspondence, such as emails, faxes, and mail, to ensure timely communication between patients and healthcare professionals.
- Handled a high volume of inbound customer calls, averaging 40 to 50 calls per day.
Customer Service Representative
Wal-Mart Super Center
Augusta, GA
07.2003 - 03.2013
- Ability to deal with large transaction volumes such as payroll checks, tax checks and personal checks
- Communicate with customers and vendors to exchange information regarding products, materials and services
- Maintain 100% of financial records, such as accounts of daily collections of billings, and records of receipts or cash receipt Journal/Log
- Answer customers' questions or concerns regarding procedures or policies
- Working efficiently under pressure
Education
High school diploma - Computer Program
Ashworth University
Norcross, GA05-2009
High school diploma -
Lucy Craft Laney
Augusta, GA06.1998
Some College (No Degree) - Computer Networking Specialist
Augusta Technical College
Augusta, GASkills
- HIPAA
- Telecommunications
- Leadership
- Revenue cycle management
- Key performance indicators
- Daily workflow improvement
- Client service
- SOP adherence
- Goal setting
- Work Planning and Prioritization
- Coaching and mentoring
- Medical billing
- Communication skills
- Organizational skills
- Customer service
- Hospital experience
- Patient Record Management
- Data entry
- Supervising experience
- SharePoint
- KAM Billing Management
- ResQ
- Cerner
- Epic
- Salesforce
- Enforcer 2 and 3 system
- SQL
- Anesthesia billing
- Workers' compensation
- Commercial Insurance Relations
- Medicaid government
- Medicare claims
- Typing
- Analysis skills
- Excel
- PowerPoint
- Microsoft Office
- Time management
- Overseeing daily activities
- Client communication
- Coaching
- Team supervision
- Meeting facilitation
- Trend tracking
Accomplishments
- T.O.P Award Team Outstanding Performance
Timeline
Team Leader/Supervisor
Virtual Business Office Associates
03.2024 - 11.2024
Supervisor of Operations Hospital and Physician Billing
EnableComp LLC
11.2021 - 03.2024
Revenue Cycle Specialist (Assistant Manager)
Medac Anesthesia Business Partners
09.2019 - 11.2021
Account Receivables
Medac Anesthesia Business Partners
08.2016 - 09.2019
Patient Service Representative
Medac Anesthesia Business Partners
09.2013 - 08.2016
Customer Service Representative
Wal-Mart Super Center
07.2003 - 03.2013
High school diploma - Computer Program
Ashworth University
High school diploma -
Lucy Craft Laney
Some College (No Degree) - Computer Networking Specialist
Augusta Technical College
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