Kelly Gorman-Forrest
Summary
Results-driven professional with a proven track record of delivering innovative solutions and driving operational excellence. Expertise in leveraging analytical skills to enhance processes and improve efficiency while fostering collaborative team environments. Committed to continuous learning and adapting to industry trends, ensuring alignment with organizational goals. Passionate about utilizing strategic thinking to contribute to business growth and success.
Overview
36
36
years of professional experience
Work History
Physician Services Lurie's Children's Level IV
Conifer Health Solutions
10.2012 - Current
- Pursued reimbursement on outstanding claims and accounts. Worked all denials & claim appeals for multiple payors and specialties. Contacted payors via phone, web portal and email to maximize reimbursement and resolve open AR.
- Proficient with complex reimbursement issues and denials as well as complicated registration issues.
- Extensive work with high dollar NICU receivables.
- Acted as a back-up/temporary AR rep in multiple additional WQ's as needed.
- Proven work history as a reliable & flexible team player able to adapt to the changing needs of the client. Successfully met or exceeded both QA and productivity standards as set forth by Conifer.
Billing & Collections Specialist
Home Med Care
09.2009 - Current
- Responsible for all DME billing & collection functions for 3 retail locations and a large long term rental equipment warehouse. I was also the Store Manager for the Chicago retail location from 12/10 thru 02/11.
- Performed as back up customer service/mastectomy and compression garment fitter role as needed.
- Responsible for the credentialing/contracting for various payor sources including Medicare, Medicaid, BCBS.
- Performed all cash application/posting functions for both paper and EFT transactions.
- Obtaining and submitting any additional information (ie. medical records, MD orders) for all payors to facilitate correct and full claim payment.
- Ensure that all payments received on claims are completely and accurately
- Work with all payors to resolve and correct any underpaid claims.
- Completed all claim adjustments and write offs.
- Responsible for generating and sending scheduled overdue notices on delinquent patient accounts.
Infusion Reimbursement & Collections
HHI Infusion Services
10.2003 - 06.2009
- Responsible for all infusion collection activity and follow up for all payor sources including Medicare, Medicaid, Managed Care and Commercial Insurance.
- Responsible along with 2 other collectors for achieving over $2,000,000.00 in collections per month.
- Met departmental collections goals required to qualify for bonus compensation each and every month for 6 years.
- Verify claim payments are consistent with current fee schedules.
- Assist inquiries for information from all payors.
- Obtaining and submitting any additional information (i.e. medical records, MD orders) from all payors to ensure that all payments received on claims are completely and accurately paid.
- Work with payors to resolve and correct any underpaid claims.
- Verify and process any valid overpayment refund requests to various payors.
- Clarify or verify any billing discrepancies with pharmacy.
- Assisted with billing functions as necessary.
- Responded to requests for specific collection activities as requested by upper management.
- Completed all claim adjustments and write offs.
- Transferred all eligible patient accounts to outside collection agency.
- Responsible for generating and sending scheduled overdue notices on delinquent patient accounts.
- Resolve with cash application personnel any payments posted incorrectly or in error.
Electronic Billing & Collection Specialist
Health Link Services - DME & Medical Supplies
12.1999 - 06.2003
- Responsible for bringing outsourced billing and collections back in-house as well as purchasing/installing/maintaining of electronic billing software for all payors including Medicare, Medicaid, Managed Care, Workers Compensation, Commercial and Private Pay.
- Processed all billing/claims for all payors.
- Completed ongoing billing follow up, problem resolution & collection activity for all payors.
- Assisted with order intake when necessary.
- Cash application/payment posting for all payors.
- Implemented and educated staff on HIPAA policy.
Care Team Coordinator
Olsten Health Services
04.1999 - 07.1999
- Responsible for the coordination of two separate field teams consisting of RN's, LPN's, CNA's, PT/OT/ST's & MSW's.
- Patient Census of approximately 150
- Data entry both clinical and administrative
- Payroll & Billing
- Medical Transcription
- Tracking of physician orders
- Coordination of daily conference calls for both field teams
- Maintain of all personnel records and patient clinical records
Data Entry and Medical Transcription
Olsten Health Services
12.1995 - 04.1999
- Verification and entry of all payroll/billing information processed by Client Care Coordinators prior to weekly upload to the corporate office
- PC/windows based data entry medical supply billing
- PC/Windows based data entry Plan of Treatment (POT/485 Forms), discharge summaries, physician interim orders
- PC/windows based data entry of Infusion Therapy billing
- PC/windows based data entry of all new employee information
- Responsible for data base integrity
- Assisted with all medical record functions as well as branch level billing/financial functions
Office Manager Display Advertising
Pulitzer Publishing
03.1990 - 07.1998
- Managed the display advertising/sales office consisting of 18 full time sales representatives.
- Performed all clerical duties
- Assisted art Department
- Functioned as administration assistant to the General Manager of Sales
- Maintained the "morgue" of previous newspaper issues for each individual zone/area of the newspapers circulation.
- Coordinated all ad copy for transfer to print
- Reserved space in the paper during the mark up phase prior to publication.
- Created display advertisements in conjunction with the Art Department using Apple Desktop Publishing.
Field Staff Supervisor
Olsten Health Services
04.1994 - 12.1995
- Supervised 2 schedulers and all field staff for placement in institutional staffing positions
- Processed all administrative and field staff payroll and subsequent billing/data entry for all facility based assignments.
- Responsible for all field staff employee files including all requirements for in-service hours, corporate/state regulation compliance and all annuals update of these documents.
Computer Systems Operator/Infusion Billing & Administrative Payroll Coordinator
Olsten Kimberly Quality Care Regional Billing Center
09.1992 - 04.1994
- Maintained, upgraded and installed AS400 computer hardware/software and related equipment for the Chicagoland Metro Market consisting of 9 local branch offices and a Regional Resource Center
- Weekly upload to the New York corporate office
- Processing of administrative payroll
- Processing of infusion billing
- DME billing
- Assisted with other billing/collection functions as required
- Assisted all branch personnel with AS400 related inquiries and technical support.
Payroll/Billing Coordinator
Kimberly Quality Care
03.1990 - 09.1992
- Responsible for all data entry functions
- Administrative and field staff payroll/billing
- Infusion and DME billing
- Medical Supply billing
- Tracked & monitored visit frequency compliance for all intermittent RN, LPN, CNA, PT, OT & ST visits
- Handled all information technology questions and issues related to IBM SYS36 including loading and updating of software, daily system backup
- Weekly upload to mainframe at corporate office.
Skills
- Experience with numerous medical billing software programs including Epic, CPR, Brightree, Dezine, Nterprise etc
- Proficient in computer applications
- Excellent written and verbal skills
- CPT, ICD-9 and HCPC coding
- Understanding of healthcare regulatory standards
Timeline
Physician Services Lurie's Children's Level IV
Conifer Health Solutions
10.2012 - Current
Billing & Collections Specialist
Home Med Care
09.2009 - Current
Infusion Reimbursement & Collections
HHI Infusion Services
10.2003 - 06.2009
Electronic Billing & Collection Specialist
Health Link Services - DME & Medical Supplies
12.1999 - 06.2003
Care Team Coordinator
Olsten Health Services
04.1999 - 07.1999
Data Entry and Medical Transcription
Olsten Health Services
12.1995 - 04.1999
Field Staff Supervisor
Olsten Health Services
04.1994 - 12.1995
Computer Systems Operator/Infusion Billing & Administrative Payroll Coordinator
Olsten Kimberly Quality Care Regional Billing Center
09.1992 - 04.1994
Office Manager Display Advertising
Pulitzer Publishing
03.1990 - 07.1998
Payroll/Billing Coordinator
Kimberly Quality Care
03.1990 - 09.1992