Fentress Wise
Charlotte,NC
Summary
Precise Accounts Receivable Manager offering strength in account reconciliation and invoice collections. Superb communicator addresses delinquent payments with tact and diplomacy. Successful in managing staff of employees processing average of $1.3M monthly.
Overview
15
15
years of professional experience
Work History
Accounts Receivable Manager
Covenant Case Management Services
02.2022 - Current
- Prepared bills receivable, invoices, and bank deposits.
- Reconciled daily AR ledger and verified proper posting.
- Verified discrepancies and resolved clients' billing issues
- Analyze current and potential contracts in terms of costing, volume, and reimbursement rates and use findings to drive contract strategies.
- Ensure ongoing knowledge and compliance with all contracts beyond initial implementation and throughout full revenue cycle
- Monitor, respond to, and communicate changes in billing requirements, regulations, and reimbursement rates, and maintain provider enrollments with payers.
- Create ad hoc operational efficiency projects.
- Provide monthly, quarterly, annual accounts receivable budgeting information, monitoring expenditures; identifying variances; implementing corrective actions.
- Support financial planning by forecasting
- Familiarize with financial, accounting, and bookkeeping software, spreadsheets, and statement of Financial Accounting Standards
- Delivered monthly reviews to finance leadership to explain performance.
- Work in conjunction with the Health Information & Technology department Manager, RD’s, Program Managers, and On Target Specialist to create and maintain a structured process for billing strategies.
- Identify any informational changes with MCO’s and provide corrective action and resolution.
- Develop and coordinate best practice for department to ensure KPI’s are met along with month end closing.
- Review work of billing staff to ensure accuracy, resolving inconsistencies as needed.
- Plan, implement, evaluate, and administer all Revenue Cycle strategies and processes, including reviewing authorization, eligibility and benefits verification, claims submission, payment posting for ERA’s, denial management, accounts receivable follow-up, reporting and aged claims.
- Provide reimbursement analysis/reports to CFO monthly.
Billing Project Manager
Essential Billing Solutions LLC
09.2019 - 01.2022
- Archived quality documentation and participated in internal and external CARF quality audits
- Partner Facing billing trainings and webinars
- Conducted monthly billing revenue cycle close for serval partners
- Quality review and auditing billing claims and billing configuration
- Successfully led key projects which resulted in 98% accuracy
- Evaluated effectiveness of training by surveying trainees and managers and collecting before-and after- data showing training impact
- Addressed problems with accounting, billing and service delivery to maintain and enhance client satisfaction
- Educated key personnel on appropriate production methods to achieve expectations and meet quality control standards
- Produced high-quality documents, spreadsheets, and presentations for internal and customer-facing needs
- Monitored project performance to identify areas of improvement and make adjustments.
- Planned, designed, and scheduled phases for large projects.
Credible Behavioral Health Inc
09.2018 - 07.2020
- Conducted billing workshop for 150 attendees
- Collaborate with other member on team and National Billing Manger to improve internal process and to ensure quality of work
- Produced ad hoc reports and documents for senior team members
- Authored maximizing revenue training documents
- Managed daily revenue cycle operations from point of registration through claim submission and denial management
- Identified efficiencies and develop new processes to maximize both productivity of staff and overall performance of revenue cycle as identified in monthly performance indicators
- Billing Configuration for enterprise partners with 7million revenue
- Resolved 95% average in billing task tickets
Billing Operations Manager
Synergy Surgicalist
06.2017 - 09.2018
- Ran weekly A/R aging report; decreased accounts in A/R of 120+days from 15% to 5%
- Accurately bill and, posted surgeries, hospital visits and payments for assigned carriers
- Printed and reviewed monthly patient aging report and solicited overdue payments
- Audit CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy
- Examined patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
- Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party requirements regarding billing
- Coordinated and manage team of 30 staff performance to maximize customer satisfaction, operational efficiency, and business profits
- Verified accuracy of accounts payable payments, resulting in 95% reduction in payment errors and check reissues
- Provide training to staff on policy and procedures designed for medical billing industry, which includes variety of insurance companies including Medicare, Medicaid, BCBS, AARP
Billing Operations Manager
DR. C. Lee Ginsburgh
06.2016 - 12.2017
- Generate revenue growth by negotiating increase contract rates
- Collection of 95% outstanding AR
- Implement Continuous Quality Improvement to measure performance of business operations
- Prepare monthly financial reports; and manage internal credential verification procedures
- Serves as a primary point of contact for, liaisons between, patients, staff, physicians, to facilitate proper lines of communication
- Coordinate multiple office functions that focus on computerized scheduling, electronic billing, reimbursements, collections accounts payable/receivable, patients records, data management and payment plans with a demonstrative knowledge of insurance carriers, medical terminology, CPT /ICD 9&10
- As Human Resources Administrator, Oversee Staff recruitment, training, and supervising; develop job descriptions; advertise open position announcements and address employees with confidentiality
- Manage implementation for EMR system
- Performed billing, collection and reporting functions for office generating over $1.5M annually
- Enrolled providers and Medicaid, Medicare and private insurance plans
Billing Analyst
DR. C. Lee Ginsburgh
10.2014 - 06.2016
- Provide effective leadership in, accounts receivable, accounts payable and collections by directing and coordinating activities consistent with established goals, objectives and policies
- Proactively seek opportunities to evolve day-to-day finance operations to improve speed, efficiency, and accuracy, developing procedures to enable growth without creating additional overhead
- Developed and implemented improvements to billing system to maximize efficiency, reduce delinquency and increase accuracy
- Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts
- Improved accounts payable processes and achieved 90% reduction in late fees
- Investigated CPT and payer denial patterns, reducing denials by 15
Billing Director
Essential Care
01.2012 - 01.2016
- Devised, deployed and monitored processes to boost long-term business success and increase profit levels 85%
- Guided client teams by proactively mentoring and developing staff in intellectual and professional development
- Supervised budgets and timelines by carefully reviewing project scope and providing support to billing specialist
- Tracked expiration dates on documents and communicates with appropriate staff to ensure that files were received before expiration
- Generated financial statements and reports detailing accounts receivable status
- Verified accuracy of accounts payable payments, resulting in 95% reduction in payment errors and check reissues
- Generated accounts payable reports for management review to aid in financial and business decision making
- Trained new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance
Accounts Receivable Representative
Riverside Health System
12.2008 - 10.2014
- Contacted insurance companies regarding unpaid claims or denials
- Insurance Verification & health information management skills
- Track progress of outstanding claims & patient balance
- Research insurance retractions, discrepancies, & reconciliations
- Submitted electronic and CMS 1500/UB 04 to insurance companies including Medicare and Medicaid to collect medical payments
- Orchestrated day-to-day operations of billing department, including medical coding, payment posting, accounts receivables and collections
- Translated and interpreted medical billing codes with strong accuracy to ensure swift payment from insurance agencies
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement
- Oversaw all billing for Medicaid PCA, waiver and skilled claims, commercial insurance and private pay clients
Education
Bachelor of Arts - Business Administration
Strayer University
Washington, DCAssociate - Medical Billing and Coding Specialist
Centura College
Newport News, VA01.2010
Skills
- 95M Reconciliations
- Full cycle Billing & Implementation
- Credentialing & Compliance
- Configuration Management
- Utilization management
- Certified Professional Coder
- Knowledge of EHR data, associated privacy regulations, and best practices for EHR use
- Delinquent Accounts Monitoring
- Billing Automation
- Statement Preparation
Timeline
Accounts Receivable Manager
Covenant Case Management Services
02.2022 - Current
Billing Project Manager
Essential Billing Solutions LLC
09.2019 - 01.2022
Credible Behavioral Health Inc
09.2018 - 07.2020
Billing Operations Manager
Synergy Surgicalist
06.2017 - 09.2018
Billing Operations Manager
DR. C. Lee Ginsburgh
06.2016 - 12.2017
Billing Analyst
DR. C. Lee Ginsburgh
10.2014 - 06.2016
Billing Director
Essential Care
01.2012 - 01.2016
Accounts Receivable Representative
Riverside Health System
12.2008 - 10.2014
Bachelor of Arts - Business Administration
Strayer University
Associate - Medical Billing and Coding Specialist
Centura College
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