Jane Fagan
Pharr
Summary
Seasoned Reimbursement Manager with background in healthcare and insurance industries. Experienced in managing reimbursement policies, ensuring all regulations are met while liaising with different departments to ensure smooth workflows. Strengths lie in strategic planning, problem-solving, leadership and communication skills. Previous roles have demonstrated significant positive impacts on company revenue through efficient process management and policy implementation.
Overview
27
27
years of professional experience
Work History
Reimbursement Manager/Executive Lead
Gulf Coast Eye Institute
McAllen
02.2021 - Current
- Oversaw account receivables, claims processing, and insurance authorizations across ten locations.
- Managed over 20 staff members, contributing to leadership team in policy implementation and daily operations oversight.
- Trained staff and collaborated with patients to enhance customer experience.
- Coordinated all company travel arrangements for visiting providers and staff conferences.
- Developed strategies that streamlined reimbursement processes, increasing efficiency.
- Researched medical procedures to ensure accurate understanding of medical terminology.
- Reviewed uninsured accounts, verifying eligibility for assistance programs and charity care.
Reimbursement Director/Office Manager
Aspen Orthopaedic Associates
Basalt
11.2007 - 12.2020
- Directed reimbursement processes for Aspen Orthopaedics, Midvalley Ambulatory Surgery Center, and Midvalley Imaging Center.
- Supervised a team of 13 staff members, ensuring understanding of job duties and responsibilities.
- Managed staff schedules, training programs, and annual performance reviews.
- Oversaw insurance contracts, physician credentialing, and facility accreditation.
- Maintained clinic schedules and monitored expense management.
- Redesigned billing office operations to automate processes, reducing overhead and maintaining AR below MGMA benchmarks.
- Implemented electronic remittance programs and prepared for ICD-10 compliance.
- Collaborated with management to develop policies and procedures for enhanced operational efficiency.
Office Manager/Reimbursment Director
Medical Eye Center
Medford
01.1998 - 11.2007
- Supervised policy manual drafting for Medical Eye Center, enhancing procedural clarity.
- Evaluated and implemented GE Centricity practice management software to improve operations.
- Trained staff as super user of Medflow electronic medical record program.
- Managed revenue cycle operations, including insurance coding and billing for four divisions.
- Coordinated schedules for seven doctors in clinic and surgery center, optimizing workflow.
- Reviewed insurance contracts as part of licensing and credentialing process for all physicians.
- Conducted compliance audits to ensure adherence to regulations and standards.
- Led customer service initiatives, addressing client inquiries and resolving billing disputes.
Education
Business major -
Many hours of continuing education covering all aspects of administrative duties
Skills
- Claims processing and insurance authorizations
- Revenue cycle management
- Policy implementation and compliance
- Team leadership and staff training
- Process improvement strategies
- Customer service excellence
- Insurance contract negotiation
- Multitasking and organizational skills
- Reimbursement strategies and denial management
- Medical billing expertise
- Analytical thinking and problem-solving
- Software proficiency in relevant applications
References
- Marcie Kissell, St. Mary’s Hospital, Grand Junction, CO, (970) 298-3169, former Co-worker, Aspen Ortho
- Connie Long, Aspen Orthopaedic Associates, (970) 462-8528, Accountant
- William Scott Timothy MD, Peak Physiatry LLC, (970) 456-6938, Owner
- Eric LaRochelle, Computer Concepts, Inc., EricL@computerci.com, (303) 756-9401
References
References available upon request.
Timeline
Reimbursement Manager/Executive Lead - Gulf Coast Eye Institute
02.2021 - Current
Reimbursement Director/Office Manager - Aspen Orthopaedic Associates
11.2007 - 12.2020
Office Manager/Reimbursment Director - Medical Eye Center
01.1998 - 11.2007
University of California at Sacramento - Business major,
Similar Profiles
Jennifer C. BarajasJennifer C. Barajas
Front Desk Supervisor at Gulf Coast Eye InstituteFront Desk Supervisor at Gulf Coast Eye Institute
Kassandra MelendezKassandra Melendez
Ophthalmic Medical Technician at Gulf Coast Eye InstituteOphthalmic Medical Technician at Gulf Coast Eye Institute
Eloisa RamosEloisa Ramos
Front Office Supervisor at Gulf Coast Eye InstituteFront Office Supervisor at Gulf Coast Eye Institute
Jose A BandaJose A Banda
Pipefitter Journeyman at BetchelPipefitter Journeyman at Betchel
Crystal RamirezCrystal Ramirez
Sales Associate at The Shack Supplements and ShakesSales Associate at The Shack Supplements and Shakes