Kristine M. Burke
Clay,NY
Summary
Innovative and goal-oriented Management professional committed to providing excellent customer service . Dedicated team player skilled at mediation and conflict resolution.
Overview
17
17
years of professional experience
Work History
Financial Customer Services Manager
SUNY Upstate Medical University
Syracuse, NY
05.2014 - Current
- Monitor ACD phone lines for coverage keeping abandoned call rate as low as possible with shortages of staff
- Assist with escalated patient and insurance calls and support staff with their questions
- Develop training scripts for incoming calls; having one call resolution
- Identify registration errors and inform area managers of issues found
- Trend payer issues and provide other area managers information to seek resolution on payer issues
- Ensure daily mail in handled and processed appropriately and timely
- Manage workflow of correspondence received from insurance companies making sure that all mail is triaged, scanned, uploaded and sent to WQ has to enable Follow-up to have their work timely
- Collaborate with Training/QA audit team, to develop training and process improvement to increase staff accountability
- Identified signs of fraud and took proactive action to protect institutional assets.
- Corresponded with various other departments, discussing company plans and agreeing on future paths to be taken.
- Recruited, interviewed and hired 13 employees and implemented mentoring program to promote positive feedback and engagement.
- Oversaw 3 departments to include high-volume call center, mailroom, document processing-person team focused on payment resolution , AP/AR and other financial management needs.
- Coordinated efficient department operations by effectively supervising employees, delegating assignments and personally handling routine and advanced problems.
Ambulatory-Office Manager
SUNY Upstate Medical University
Syracuse, NY
09.2012 - 05.2014
- Supervised, trained, coached and mentored administrative staff for 3 clinics (Bariatric, General Surgery, Thoracic Surgery )Provided administrative oversight for additional ambulatory clinics at Community Campus ( Urology, Midwifery, ENT/Audiology & Cardiovascular)
- Established administrative policies and procedures to ensure efficient and effective operations
- Accountability reports for monthly budget reports; monitor monthly expenditure by training and reviewing use of supplies, OTPS and FTE's
- Identify volume, quality, customer service and financial indicators to monitor performance
- Super user during EPIC Go-Live, providing guidance and assistance to maximize work flow
- Increased surgery center productivity be re-engineering work flow; streamlined paperwork and created more efficient pathways for clinic visits, procedures and surgeries
- Developed new hiring and orientation processes
- Administered monthly and annual reviews to direct reports and set clear and measurable goals, action plans and follow-up procedures.
- Stayed calm, collected and logical during stressful moments to identify and implement optimal solutions.
- Facilitated meetings to communicate team performance goals and results.
Supervisor of Follow up
Upstate University Hospital
Syracuse, NY
05.2008 - 09.2012
- Supervised, trained, and monitored work-flow for Follow up, Customer Service/Contact, Support Services
- Handled patient complaints, making determinations and escalating as needed
- Routinely met with staff to review process changes and determine need for further improvements
- Communicate and update staff on administrative policy/procedures and any third party billing rules changes
- Responsible for review of complex payer issues, departmental audits and quality control
- Monitor accuracy of completed work, track results and identify areas for improvement
- Establish and maintain relationships with internal and external departments
- Educate and train staff, monitor staff performance, behavior and attendance, discipline as needed
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Maintained compliance with company policies, objectives and communication goals.
- Worked with management team to implement proper division of responsibilities.
- Performed annual evaluations and reviews for large staff of employees.
- Set overall vision and provided team leadership.
- Interviewed, hired and trained new employees multiple positions.
- Streamlined operations of multiple lines of business within organization.
- Developed training, task and process guidelines and communicated clear and concise directions to employees.
- Managed team 10 employees, overseeing hiring, training, and professional growth of employees
- Carried out day-day-day duties accurately and efficiently
- Developed team communications and information for meetings
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
Credentialing & Contract Specialist
Sport PT Of NY
East Syracuse, NY
01.2006 - 05.2008
- Supported full billing cycle for 59 facilities through,
- Performed coding entry, and corrections to ensure correct billing of claims in timely manner
- Posted insurance payments, self-pay payments and balanced daily ledger for assigned facilities
- Coordinate credentialing process for new and existing providers and facilities
- Built and maintained working relationships with large and small insurance provider reps regarding contracts and credentialing via email, telephone and internal and external visits
- Effectively communicate contract and credentialing issues to senior management
- Set -up and maintain CAQH website for 129 providers statewide
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
- Performed duties in accordance with applicable standards, policies and regulatory guidelines to promote safe working environment.
- Received and evaluated applications to look for missing and inaccurate information.
- Conducted primary source verifications such as background checks and board certifications.
- Conducted primary source verifications such as background checks and board certifications
Business Office Associate
Sports Physical Therapy of NY
East Syracuse, NY
01.2006 - 03.2007
- Electronically submitted bills according to compliance guidelines.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Entered client details and notes into system for interdepartmental access and review.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Communicated with 10 insurance providers to resolve denied claims and resubmitted.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Reconciled accounts, managed audits and updated financial records with remarkable accuracy.
- Reconciled company bank, credit card and line of credit accounts, investigating and resolving discrepancies to keep accounts audit-ready.
- Verified deposits, rectified discrepancies and processed end-of-day paperwork
- Applied core knowledge to effectively communicate sensitive or technical information while adhering to regulatory guidelines
- Logged charges and payments for 29 facilities within Medent
- Processed billing calls and answered questions from patients and third-party carriers
Education
BBA - Business Administration
SUNY Empire State College
Saratoga Springs, NYAssociate of Applied Science - Business Administration
Onondaga Community College
Syracuse, NY05.1993
Skills
- Relationship Building
- Risk Assessment
- Critical Thinking
- Adaptable to Changing Conditions
- Business/ Team Relationship Management
- Strategy Development
- Quality Assurance
- Prioritizing and Planning
- Time Management
- Employee Training Oversight
Timeline
Financial Customer Services Manager
SUNY Upstate Medical University
05.2014 - Current
Ambulatory-Office Manager
SUNY Upstate Medical University
09.2012 - 05.2014
Supervisor of Follow up
Upstate University Hospital
05.2008 - 09.2012
Credentialing & Contract Specialist
Sport PT Of NY
01.2006 - 05.2008
Business Office Associate
Sports Physical Therapy of NY
01.2006 - 03.2007
BBA - Business Administration
SUNY Empire State College
Associate of Applied Science - Business Administration
Onondaga Community College
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