Jodi DeRosa
Clearwater,FL
Summary
With a proven track record at Optum Insight, I excel in operations management and problem-solving, enhancing client relationships through effective cross-functional communication. Spearheaded revenue cycle improvements, significantly boosting team performance by integrating SOPs and KPIs, showcasing my ability to lead with both strategic vision and meticulous attention to detail.
Overview
24
24
years of professional experience
Work History
Revenue Cycle Operations Manager
Optum Insight
Clearwater, USA
01.2021 - 09.2024
- Revenue cycle management services for anesthesiology and pain management practices in multiple states
- Responsible for the overall performance of a very large client group with direct management of back-end accounts receivable processes
- Collaborated with Electronic Data Interchange, Provider Enrollment, Coding, Data Entry, Refunds, and Patient Service Center departments
- Worked closely with Client Manager regarding trends and issues that affect reimbursement metrics
- Addressed customer concerns with suitable solutions.
- Built strong operational teams to meet process and production demands.
- Guided employees on understanding and meeting changing customer needs and expectations.
- Produced SOPs to document workplace procedures and optimize productivity through standardization.
- Motivated and evaluated personnel for performance improvement and goal achievement.
- Delegated work to staff, setting priorities and goals.
- Assessed employee development needs and provided feedback on their progress towards meeting goals.
- Directed operations staff by providing guidance, training, and support in order to meet company objectives.
- Responded to information requests from superiors, providing specific documentation.
- Coordinated with other departments including sales, marketing, finance, human resources. to ensure efficient operations.
- Resolved customer complaints in a timely manner while ensuring customer satisfaction remains at optimal levels.
- Supervised day-to-day workflow of employees in order to maximize productivity and maintain quality standards.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Measured and reviewed performance via KPIs and metrics.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
Accounts Receivable Supervisor
Optum Insight (formerly Change Healthcare)
Clearwater, USA
01.2020 - 01.2022
- Accounts receivable team supervision including recognizing and resolving payer trends and errors
- Assisting staff with account inquiries, conducting quarterly performance reviews, approving timecards and PTO requests
- Training of new hires, processing account adjustment requests, resolving credit balances, daily electronic claim edit rejections, addressing client requests
- Coordinated with the sales and customer service departments to resolve billing disputes.
- Recommended solutions related to staffing issues and proposed procedural changes to managers.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Interacted with external auditors during year-end audit process when needed.
- Managed entire accounts receivable process, ensuring timely invoicing and collection activities.
- Delegated work to staff, setting priorities and goals.
- Implemented effective billing procedures, reducing errors and improving customer satisfaction.
- Reviewed employees' work to check adherence to quality standards and proper procedures.
- Reviewed reports on employee attendance, productivity and effectiveness to evaluate performance.
- Initiated legal or collection agency intervention for severely overdue accounts.
- Coordinated with the accounting department to post payments and adjustments accurately.
- Recruited, interviewed and selected employees to fill vacant roles.
- Led a team of accounts receivable specialists, providing training and performance evaluations.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Guided employees in handling difficult or complex problems.
- Performed periodic reviews of unapplied cash items on the general ledger accounts.
- Negotiated payment plans and arrangements.
- Resolved customer queries related to billing issues or payment discrepancies in a timely manner.
- Researched and prepared reports required by management or governmental agencies.
- Prepared month-end closing entries related to Accounts Receivable transactions.
- Supervised and monitored the daily operations of Accounts Receivable department to ensure accuracy, completeness, and timeliness of customer payments.
- Generated monthly aging reports for review by management team.
- Prepared detailed reports on accounts receivable status for senior management review.
- Created monthly aging report for review by management team.
- Discussed job performance problems with employees, identifying causes and issues to find solutions.
Payment Posting Lead
Optum Insight (Formerly McKesson/Change)
Clearwater, USA
01.2014 - 01.2020
- Posting and balancing of all insurance and patient payments utilizing ERA and manual posting of non-electronic items
- Coordination with EDI department to convert payers to EFT/ERA for optimal automation
- Processing of virtual credit card vendor payments
- Reconciliation of monthly reporting to balance with client banking records
- Identifying payment errors, locating missing remittances, routing of payment batches to appropriate work queues (both local and global partners), posting both manual and electronic payments, reporting payments received to collection agency
- Maintained detailed records of all payments posted in the system.
- Performed monthly reconciliations of cash receipts against bank statements.
- Conducted research on customer accounts as needed to ensure correct postings.
- Enforced compliance with organizational policies and federal requirements regarding confidentiality.
- Collected, posted and managed patient account payments.
- Provided support to customers regarding payment inquiries.
- Prepared and posted weekly payments to vendors and suppliers.
- Worked with team members to identify and develop process improvements.
- Reviewed and processed credit card transactions in a timely manner.
- Ensured accurate data entry into the accounting system for payment postings.
- Assisted accounting staff with month-end closing processes.
- Processed electronic payments from insurance companies, patients and other sources.
- Monitored account balances and made adjustments when necessary.
- Analyzed billing reports for errors or discrepancies in payment postings.
- Generated daily, weekly, monthly reports on payment activity.
- Developed strong professional rapport with vendors and clients.
- Researched and resolved payment posting discrepancies.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Worked with cross-functional teams to achieve goals.
Sr. Accounts Receivable Specialist
Optum Insight (formerly McKesson)
Clearwater, USA
01.2012 - 01.2014
- Processing payer correspondence, handling attorney requests/subpoenas, working accounts receivable for all insurance payers, handling incoming telephone calls
- Prepared aging reports to identify past due accounts.
- Processed credit memos and adjustments according to company policy.
- Provided detailed reports and analyses to management regarding receivables status.
- Coordinated with sales and customer service departments to resolve billing issues.
- Monitored customer account details to minimize or rectify non-payments, delayed payments and other irregularities.
- Enhanced customer satisfaction through prompt and courteous handling of all inquiries and complaints.
- Coordinated with internal departments to resolve disputes quickly and efficiently.
- Responded promptly to customer inquiries via phone or email.
- Negotiated payment plans with delinquent accounts.
- Researched customer inquiries regarding payment status or account balances.
- Reviewed and processed customer payments, credit memos, refunds, and adjustments.
Credentialing Coordinator/Accounts Receivable Representative
Riverdale Anesthesia Associates, PC
Riverdale, USA
05.2008 - 01.2012
- Anesthesiology group servicing hospitals and ambulatory surgery centers
- Responsible for preparation and submission of provider applications for facility privileges and participation in government and managed care insurance plans
- Tracking provider re-credentialing needs, accounts receivable for anesthesiology claims, with primary focus on Georgia Medicaid programs, payment posting
- Facilitated communication between departments to resolve credentialing issues efficiently.
- Kept close tabs on documentation expiration dates, communicating with correct personnel to submit files prior to expiration.
- Coordinated with departments within the organization to facilitate smooth completion of credentialing process.
- Set up NPI numbers for providers and facilities and updated current profile information.
- Confirmed facility and user credentials to initiate and maintain registration and enrollment processes.
- Prepared and submitted detailed reports on credentialing progress to management.
- Addressed and resolved discrepancies in provider documentation during credentialing.
- Checked applications for missing information and organized all paperwork.
- Liaised with insurance companies to complete provider enrollment and ensure billing capabilities.
- Coordinated with healthcare professionals to collect necessary documentation for credentialing.
- Monitored and tracked progress of credentialing applications to ensure timely completion.
- Collaborated with physicians to ensure timely completion of hospital applications.
- Monitored expiration of licenses and certifications, notifying providers of renewal requirements.
- Responded to verification inquiries from other healthcare organizations and insurance companies.
- Responded to inquiries from internal and external sources regarding credentialing status.
- Ensured strict confidentiality of provider information in accordance with HIPAA regulations.
- Managed end-to-end provider credentialing process, ensuring compliance with industry standards.
- Completed enrollments into Medicaid, Medicare and private insurance plans.
- Analyzed financial data related to accounts receivable transactions.
- Conducted periodic reviews of Accounts Receivable Aging report for accuracy.
- Identified delinquent accounts requiring collection action.
- Provided detailed reports and analyses to management regarding receivables status.
- Investigated reasons for non-payment by customers and take appropriate action.
- Collaborated with other departments to resolve any issues related to billing.
Client Manager/Credentialing Coordinator
Group Practice Management, Inc
Marietta, USA
01.2001 - 05.2008
- Anesthesiology billing company servicing multiple group practices
- Responsible for preparation and submission of provider applications for participation in government and managed care insurance plans
- Accounts receivable for anesthesiology claims for all insurance plans
- Responsible for demographic entry, charge entry, payment posting, preparation and processing of overpayment refund requests, appeals, daily submission of electronic claims and statements, preparation and balancing of monthly revenue reports for clients
- Implemented best practices for addressing customer inquiries efficiently across various channels like email, phone, social media.
- Provided timely and accurate delivery of client communications.
- Maintained accurate records of all customer interactions and transactions.
- Resolved customer complaints regarding sales and service.
- Developed and tracked key performance indicators within client services department.
- Recognized by management for providing exceptional customer service.
- Coordinated with healthcare professionals to collect necessary documentation for credentialing.
- Addressed and resolved discrepancies in provider documentation during credentialing.
- Completed enrollments into Medicaid, Medicare and private insurance plans.
- Monitored and tracked progress of credentialing applications to ensure timely completion.
- Set up NPI numbers for providers and facilities and updated current profile information.
- Reviewed and processed applications to verify accuracy of credentialing information.
Education
Associate degree - Accounting
Wisconsin Indianhead Technical College
Rice Lake, WI01-1987
Skills
- Performance monitoring
- Operations management
- Client relationships
- Problem-solving
- Cross-functional communication
References
References available upon request.
Timeline
Revenue Cycle Operations Manager
Optum Insight
01.2021 - 09.2024
Accounts Receivable Supervisor
Optum Insight (formerly Change Healthcare)
01.2020 - 01.2022
Payment Posting Lead
Optum Insight (Formerly McKesson/Change)
01.2014 - 01.2020
Sr. Accounts Receivable Specialist
Optum Insight (formerly McKesson)
01.2012 - 01.2014
Credentialing Coordinator/Accounts Receivable Representative
Riverdale Anesthesia Associates, PC
05.2008 - 01.2012
Client Manager/Credentialing Coordinator
Group Practice Management, Inc
01.2001 - 05.2008
Associate degree - Accounting
Wisconsin Indianhead Technical College
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