Erin Roy
Aubrey,TX
Summary
Dynamic leader with a proven track record at Behavioral Innovations, enhancing regulatory compliance and streamlining provider enrollment processes. Expert in HIPAA compliance and credentialing oversight, I've successfully developed staff training programs, boosting team efficiency. Skilled in fostering provider relations and implementing accreditation standards, my approach significantly minimizes regulatory risks.
Overview
11
11
years of professional experience
Work History
Contracting & Credentialing Supervisor
Behavioral Innovations
2020.09 - Current
- Conducted primary source verifications such as background checks and board certifications.
- Hired, managed, developed and trained staff, established and monitored goals.
- Developed internal requirements and standards to minimize regulatory risks and liability across programs.
- Initiated new payer contracts, reviewed fee schedule for negotiations, and established payer representative relationships.
- Maintained timelines and processes for payer enrollment with the team.
- Built and implemented staff training processes and procedures.
Billing & Credentialing Specialist
Origins Behavioral Healthcare LLC
2019.02 - 2020.09
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Ensured timely filing for all submitted claims.
- Conducted reviews for patient refund analyses.
- Monitored all claims for payment and accurate patient responsibility.
- Completed all compliance and medical record audits.
Payment Collections Team Lead
Texas Pain Physicians
2017.10 - 2019.02
- Responsible for all payment reconciliations with bank statements.
- Conducted all new hire on boarding and training.
- Monitoring productivity of individual team members.
- Created and implemented payment and refund policies and procedures.
- Weekly and monthly reporting with executive teams.
Billing Specialist
Majors Medical Service
2013.12 - 2017.10
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Researched and resolved billing discrepancies to enable accurate billing.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Worked with multiple departments to check proper billing information.
- Responded to customer concerns and questions on daily basis.
- Audited and corrected billing and posting documents for accuracy.
- Maintained accurate records of customer payments.
Education
Bachelor of Science - Business Administration And Management
University of Phoenix
Tempe, AZ02.2023
Skills
- Provider enrollment
- Accreditation standards
- HIPAA Compliance
- Audit preparation
- Employee Onboarding & Training
- Background Checks
- Credentialing oversight
- Regulatory Compliance
- Provider Relations
- Insurance procedures
- Medical Terminology
Timeline
Contracting & Credentialing Supervisor
Behavioral Innovations
2020.09 - Current
Billing & Credentialing Specialist
Origins Behavioral Healthcare LLC
2019.02 - 2020.09
Payment Collections Team Lead
Texas Pain Physicians
2017.10 - 2019.02
Billing Specialist
Majors Medical Service
2013.12 - 2017.10
Bachelor of Science - Business Administration And Management
University of Phoenix
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