Katherine Burke
Sykesville,MD
Summary
Results-driven billing manager with expertise in overseeing billing processes and optimizing revenue streams. Skilled in managing billing systems, resolving discrepancies, and ensuring compliance with billing regulations. Strong leadership, analytical, and communication skills, with a focus on driving efficiency and accuracy in billing operations.
Overview
26
26
years of professional experience
Work History
AR Billing Manager
AADermatology
Linthicum Heights, MD
08.2023 - Current
- Created daily worklist for 12 employees for Maryland, Virginia, and Pennsylvania locations
- Morning huddle to review payer issues, systems, issues, or training issues
- Resolved patient billing complaints
- Weekly review with RCM management team to review A/R
- Interview/hiring of new employees
- Reviewed AR for trending issues with payers - root causes and solutions
- Worked closely with Credentialing team to ensure all providers were up to date
- Weekly quality audits to ensure accuracy and best billing practices
- One Drive
- Modernizing Medicine software
Medical Billing Manager
Greater Maryland Pain Management
Odenton, MD
01.2023 - 07.2023
- Oversee day to day billing and follow up in a pain management practice of 7 employees
- Research problem accounts, spoke with all insurance carriers
- Resolve patient billing issues
- Make daily bank deposits
- Ensure timely and clean billing
- Account follow up on claims aged +120 for all payers-government and non-government
- Staff training
- Initiated SOP for billing department
- Collaborate MD billing software
- Contract position
RCM Consultant
Positive Determinations, LLC
Tampa, FL
11.2022 - 01.2023
- Staff training on Medicare guidelines for billing/follow up
- Account follow up on claims aged 45+ days
- Expert subject matter expert for traditional and managed Medicare billing collections
- Provided consultation and hands on assistance for billing denials and payment delays for four behavioral health hospital companies
- Review Behavioral Health Claims, submission/resubmission as needed
- Aura software
Sr. Billing Specialist
Clearway Pain Solutions
Annapolis, MD
11.2021 - 11.2022
- A/R follow up on high dollar claims company wide
- Account follow up claims 45+days
- Staff training on billing guidelines
- Administrator for payor site user set up/training for eligibility, claim status
- Achieving targets set forth by upper management
- Observe all trending issues – finding root cause and solution
- Athena software
RCM Consultant
Positive Determinations, LLC
Tampa, FL
02.2021 - 11.2021
- Expert subject matter expert for traditional and managed Medicare billing collections
- Provided consultation and hands on assistance for billing denials and payment delays for four behavioral health hospital companies
- Review Behavioral Health Claims, submission/resubmission as needed
- Staff training on Medicare guidelines for billing/follow up
- Account follow up on claims aged 45+ days
Billing Manager
Fidel Integrated Medical Solutions
Pikesville, MD
01.2020 - 07.2021
- Oversee daily A/R operation of two facilities owned by Fidel Chiropractic
- Lead on software conversion from Eclipse to Chirotouch – Updated EMR and billing
- Assist with staff training
- Review and work both aging’s to bring down outstanding A/R for both sites
- Observe trending issues with old software
- All cash posting and write offs
- Provider Credentialing
A/R Manager
Meridian Senior Living
Bethesda, MD
04.2017 - 10.2019
- Oversee daily A/R operation of 88 facilities managed by MSL
- Provide support and additional training for business office managers
- Assist staff accountants with audits as requested by investors
- Ongoing training for Business Office Managers on third party insurance, EOB interpretation
- Assist with month end close process for 13 facilities
- Review monthly aging with facilities
- Assist with contracting with new insurance carriers
- Assist with development of policy and procedures
- Set up billing specifications with billing software for HCFA 1500 form and/or UB 04
- Set up billing software My Ability
- Assist in transitioning all third-party billing to the Bethesda office
- Worked closely with treasury department to project cash flow
- PCC software
Corporate Medicare Coordinator
Lorien Health Systems
Ellicott City, MD
04.2012 - 08.2017
- Monitors claims submission process from host systems for nine facilities
- Managed Medicare Part A claims processing to include submission, follow-up, denials, appeals
- Assists in continually improving and maintaining the aging of receivables
- Provides training to key personnel on Medicare guidelines
- Coordinate with staff and medical records that claims requiring attachments or medical records
- Provides daily statistical report on all pending and adjudicated claims for management team
- Provides monthly scheduling to key personnel month end close schedule
- Spearheaded web-based software implementation for Managed care claims for nine facilities
- PCC software
Medicare Supervisor
Johns Hopkins Hospital
Baltimore, MD
11.2008 - 04.2012
- Monitored claims submission process from host systems
- Trained staff on improvement initiatives associated with Medicare productivity analysis
- Conducts quarterly data quality reviews to ensure compliance with payer specifications
- Ensured all accounts were reviewed for timely follow-up and prompt resolution of denials
- Assisted with continued aging improvements while minimizing 'controllable' losses
- Report preparation to summarize Medicare statistical information
- Reconciled JHHS accounts with claim improvements for reconciliation review with the payer
- Communicates timely feedback to the appropriate audience in a clear and concise manner
- HIPPA compliant
Collection Coordinator
IGG America
Linthicum, MD
02.2006 - 11.2008
- Managed client accounts to ensure proper claim adjudication
- Maintained claim follow-up on all rejected or partial payments
- Processed/Prepared all claim resubmissions, appeals, and account write-offs
- Communicated with insurance payers to resolve claim issues over 120+ days
- Acquired knowledge base on medical terminology and CPR+ software
Reimbursement Supervisor
Symphony Respiratory Services
Hunt Valley, MD
11.2002 - 02.2006
- Managed all billing and collection efforts on Medicare DME respiratory services
- Processed claim rejections
- Coordinated all SNF and hospital invoice billing
- Acquired knowledge base relating to Rehab Partner, Infinium, and Mestamed
Reimbursement Technician
Homewood Retirement Centers
Hagerstown, MD
03.2001 - 11.2002
- Provided specialized Medicare, DME and Medicaid billing services
- Communicated daily with insurance providers to ensure prompt payment
- Payment Posting
Collection Specialist
Phoenix Rehabilitation
Indiana, PA
07.2000 - 03.2001
- Managed all account receivables aged 120+
- Acquired extensive expertise with BCBS on claim follow-up surrounding denied and under-paid claims
Billing Specialist
Homewood Retirement Centers
Hagerstown, MD
11.1998 - 07.2000
- Assisted with implementation process of the Accerlate software for Medicare DME billing
- Trained key contact personnel on Medicare DME regulations
- Managed claims processing and follow up
Education
Medical Office Assistant - Healthcare
ICM School Business
Pittsburg, PA01.1985
High School Diploma - Academic
United high school
Armagh, PA01.1984
Skills
- Audit Support
- Collections experience
- Staff Training
- Claims Processing
- Payment posting
- Staff Training and Development
- HIPAA knowledge
- Workflow Planning
- Revenue Cycle Management
- Collections Management
- Collections understanding
- Insurance Verification
- Report Preparation
- Team direction
Timeline
AR Billing Manager
AADermatology
08.2023 - Current
Medical Billing Manager
Greater Maryland Pain Management
01.2023 - 07.2023
RCM Consultant
Positive Determinations, LLC
11.2022 - 01.2023
Sr. Billing Specialist
Clearway Pain Solutions
11.2021 - 11.2022
RCM Consultant
Positive Determinations, LLC
02.2021 - 11.2021
Billing Manager
Fidel Integrated Medical Solutions
01.2020 - 07.2021
A/R Manager
Meridian Senior Living
04.2017 - 10.2019
Corporate Medicare Coordinator
Lorien Health Systems
04.2012 - 08.2017
Medicare Supervisor
Johns Hopkins Hospital
11.2008 - 04.2012
Collection Coordinator
IGG America
02.2006 - 11.2008
Reimbursement Supervisor
Symphony Respiratory Services
11.2002 - 02.2006
Reimbursement Technician
Homewood Retirement Centers
03.2001 - 11.2002
Collection Specialist
Phoenix Rehabilitation
07.2000 - 03.2001
Billing Specialist
Homewood Retirement Centers
11.1998 - 07.2000
Medical Office Assistant - Healthcare
ICM School Business
High School Diploma - Academic
United high school
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