Erin Roy
Aubrey
Summary
Dynamic Contracting and Credentialing Supervisor at Behavioral Innovations with expertise in contract negotiation and team training. Proven track record in streamlining credentialing operations and enhancing compliance. Adept at developing policies that improve efficiency while ensuring quality standards. Strong communicator committed to fostering collaborative relationships with insurance providers.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Contracting and Credentialing Supervisor
Behavioral Innovations
09.2020 - Current
- Initiate contract review and negotiations with new insurance payers.
- Connect with and maintain open discussions with insurance representatives on contracts.
- Track steps for completing contracts with management and insurance companies.
- Conduct credentialing reviews for new therapists.
- Developed and monitored policies and procedures related to the Credentialing process.
- Performed audits of credentialing files to ensure accuracy and completeness of documentation.
- Developed strategies for streamlining Credentialing operations while maintaining quality standards.
- Trained new employees on Credentialing processes and procedures.
- Research new state insurance companies and percentages of population served.
- Conduct and complete any special projects from management.
- Create and monitor projects for issues or concerns with insurance providers.
Billing and Credentialing Specialist
Origins Behavioral Healthcare
02.2019 - 08.2020
- Complete all new insurance enrollment for new facilities/providers.
- Ensure all claims have been received by the insurance by the fifteen day mark.
- Report all refund analyses to the department director for review.
- Responsible for collaborating with superiors on all negotiation offers.
- Maintain and send out all medical records requests to corresponding insurances.
- Assist director with all special projects.
- Credentialing all new clinicians and updating licenses with all insurance carriers.
Payment Collections Team Supervisor
Texas Pain Physicians
10.2017 - 02.2019
- Ensuring all insurance and patient payments are reported in the system properly.
- Contacting insurance providers for stop loss payment replacements.
- Verifying all bank deposits are reported and accounted for in the payment system.
- Trainer and supervisor of all payment posting team members.
- Reporting to executives monthly productivity of individual team members.
- Responsible for collaborating with executives on daily operations in the department.
- Completing all third party insurance payment negotiations.
- Gathering necessary documentation for direct deposit of all insurance payments.
- Schedules and runs all meetings with the payment collections team.
- Assists executives with special projects as needed.
- Proficient with the most up to date PrognoCIS system.
- Creating and reporting all anesthesia claims to all corresponding insurance providers for payment.
- Oversees the daily workflow and productivity of all team members.
- Built posting and refund procedures.
Medical Billing Specialist
Majors Medical Service
Dallas
12.2013 - 10.2017
- Responsible for all Medicaid AR.
- Head of claims timely processing and appeals.
- Department lead of training Medicaid's rules and regulations company wide.
- Accountable for the timely return, payment, or recertification of all company equipment.
- Schedule delivery routes for technicians.
- Expert in Medicaid coding and billing.
- Manager, trainer, and quality assurances officer of Medicaid billing staff.
- Resolved patient disputes over account balances.
- Overseeing Medicaid claims audits.
- Built and maintained an exceptional understanding of Medicare coding and billing.
- Became team lead of high end Power and Complex Mobility, and created the most efficient process in high risk complicated power mobility orders.
- Oversee quality maintenance and repairs of all durable medical equipment.
- Collaborating with outside legal representation with regards to Medicaid.
- Proficient with the current Brightree System.
Education
Bachelors - Science of Business with Project Management Certificate
University of Phoenix
Dallas, TX02.2023
Associates - Liberal Arts
Collin County Community College District
McKinney, TX12.2013
Skills
- Team Training
- Project Management
- Customer Service
- Credentialing
- Insurance Terminology
- Microsoft Office
- Payment Posting
- Payment Collections
- Medical Coding
- Team Building
- Account Analysis
- Medicare & Medicaid Reimbursements
- Strong communication skills
- Contract negotiation
- Policy development
- Team leadership
- HIPAA compliance
- Evaluate performance
Certification
- CPR/First Aid/AED
Timeline
Contracting and Credentialing Supervisor
Behavioral Innovations
09.2020 - Current
Billing and Credentialing Specialist
Origins Behavioral Healthcare
02.2019 - 08.2020
Payment Collections Team Supervisor
Texas Pain Physicians
10.2017 - 02.2019
Medical Billing Specialist
Majors Medical Service
12.2013 - 10.2017
Bachelors - Science of Business with Project Management Certificate
University of Phoenix
Associates - Liberal Arts
Collin County Community College District
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