La Keitha Smith
Summary
Energetic health care professional with more than 20 years of revenue cycle experience. Strengths include revenue integrity, top-notch customer service, EPIC, Meditech 6.1 workflows and functionality, CDM build and maintenance.
Overview
28
28
years of professional experience
Work History
Revenue Integrity Analyst
Steward Healthcare
02.2019 - Current
- Collaborate with the clinical departments and Imaging & Therapy Services (ITS) by creating and updating charge code requests per guidelines within the chargemaster. Monitor and assist with internal departments regarding corrections of rejected or late charges. Performs charge master review for appropriate coding and compliance per government and payor guidelines. Assist with variety of projects related to charge capture and compliance audits.
Supervisor, Third Party A/R Follow-up & Billing
Piedmont Healthcare INC.
02.2016 - 10.2018
- Supervised staff of 19 employees that performed follow-up for Medicaid/Commercial A/R; Functioned as first point of contact on technical, procedural, and policy questions. Keep team informed of new processes and general updates including all associated vendors; Assisted in work distribution to ensure high levels of productivity and critical thinking by providing operational support, training others, and conducting audits on work quality.
Team Lead-Third Party A/R Follow-up & Billing
Piedmont Healthcare INC.
08.2014 - 02.2016
- Supervised a team of 6 Follow-up, and Billing Analysts. Oversight of Medicaid Account Receivables. Communicated and interacted with clinical teams supporting problem resolution and root cause analysis. Reviewed system enhancements that impact revenue, workflow and/or functionality within the department/organization; Prepared quarterly Medicaid credit balance reports Submitted Medicaid Audits to governmental healthcare agencies.
Third Party A/R Follow-up & Billing
Piedmont Healthcare INC.
06.2008 - 08.2014
- Resolved complex claim processing issues by reviewing and following policy and procedures; Became a liaison for PFS and Case Management; Ensured claims are received and processed by payer via websites; Maintained a superior quality rating in claims resolution that exceed monthly departmental goal.
Medical Billing Specialist
Village Podiatry Centers
07.2007 - 06.2008
- Responsible for billing and collecting patient accounts; Ensured timely and accurate government and commercial reimbursement; Received customers to assist them with collections of patient balances and to answer patient billing questions. Prepared reports for aged accounts and followed standard protocol to collect accounts for individual physicians; Met monthly collection goals that helped strengthen company receivables.
Patient Account Representative I & II
Harvard Vanguard Medical Center
05.2001 - 06.2007
- Dedicated resources to clinicians and other business staff to reduce insurance denials and improve revenue as well as provide feedback regarding coding errors. Acted as a liaison and provided training to staff members regarding registration check-in, referral process, worker’s compensation and motor vehicle accidents. Collected outstanding balance on medical accounts. Forwarded billing transactions to insurance companies. Prepared delinquent accounts for collection agency.
Member Service Representative I & II
Harvard Pilgrim Healthcare
10.1999 - 05.2001
- Provided customer service to healthcare members; Resolved issues regarding premium/medical bills; Answered inquiries related to eligibility/benefits; Dedicated person for claims inquiries as well as being liaison with other departments within the organization
Provider Service Representative
Harvard Pilgrim Healthcare
01.1998 - 10.1999
- Answered telephones for healthcare providers seeking claim status, eligibility/benefits; Processed and adjusted claims according to healthcare providers contracts Gained knowledge of healthcare plans (PPO, POS & HMO); Effective liaison between customers and internal departments
Education
Burdett Business School
Boston, MA01.1995
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Cohasset Jr./Sr. High School
Cohasset, MA01.1994
Skills
- Claims management
- Data validation
- Revenue cycle management
- Medical coding
- Healthcare billing
- Charge capture
- Attention to detail
- Problem-solving abilities
- Team collaboration
- Customer service support
- Effective communication
- Decision-making
- Adaptability and flexibility
- Denial management
Timeline
Revenue Integrity Analyst
Steward Healthcare
02.2019 - Current
Supervisor, Third Party A/R Follow-up & Billing
Piedmont Healthcare INC.
02.2016 - 10.2018
Team Lead-Third Party A/R Follow-up & Billing
Piedmont Healthcare INC.
08.2014 - 02.2016
Third Party A/R Follow-up & Billing
Piedmont Healthcare INC.
06.2008 - 08.2014
Medical Billing Specialist
Village Podiatry Centers
07.2007 - 06.2008
Patient Account Representative I & II
Harvard Vanguard Medical Center
05.2001 - 06.2007
Member Service Representative I & II
Harvard Pilgrim Healthcare
10.1999 - 05.2001
Provider Service Representative
Harvard Pilgrim Healthcare
01.1998 - 10.1999
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Cohasset Jr./Sr. High School
Burdett Business School