Lisa Piro
Freeport,NY
Summary
Dynamic Billing Manager with a proven track record at Sandata Revenue Cycle Management, enhancing revenue by 30% through effective policy development and staff training. Skilled in financial reporting and denial management, I excel in optimizing billing systems while fostering strong customer relationships and leading teams to achieve operational excellence.
Overview
26
26
years of professional experience
Work History
Billing Manager
Long Island Consultation Center
Elmhurst, NY
07.2023 - Current
- Developed and implemented financial strategies to maximize profits and reduce costs.
- Developed and maintained a comprehensive billing system database for accurate record-keeping and reporting.
- Established clear billing policies and procedures, ensuring consistent application across all client accounts.
- Managed and supervised billing department staff, including training, evaluation, and workflow distribution.
- Worked with customers to resolve billing disputes in a timely manner.
- Researched complex billing issues using internal resources and external sources as needed.
- Prepared monthly reports on accounts receivable status and aging analysis.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Collaborated with IT department to troubleshoot and resolve billing system issues promptly.
- Coordinated with internal departments such as medical staff services or risk management to resolve any issues identified during the verification process.
- Completed enrollments into Medicaid, Medicare and private insurance plans.
- Monitored accounts receivable balances to ensure timely payment from third-party payers.
- Implemented new software systems designed to streamline billing operations.
RCM BILLING MANAGER
SANDATA REVENUE CYCLE MANAGEMENT
Hicksville, NY
01.2020 - 04.2023
- Healthcare Billing Manager oversaw billing, payroll, and support operations teams to maximize revenue for RCM clients through optimization of their Pay/Bill systems; ensured accurate and on time filing; archived submissions
- Oversaw resolution of department system edits, EDI rejections, and new accounts integration for 12 home health agencies multiple states/systems
- Billing Medicaid, MCO, VA and Medicare payors
- Positioned company growth by implementing processes and procedures supporting third party billing (HHA Exchange software)
- Improved revenue 30% over the previous year for special billing project and reported gains to client
- Provided support and feedback to RCM clients concerning all billing, resubmission, and authorization issues
- Supervised account management and facilitated implementations of new and existing patients
- Implemented and updated changes for new states, state programs, payers, processes, and agency management systems
- Liaised with customers, payers, vendors, and other RCM departments; reported and discussed issues and trends with management
- Oversaw correct codes, rates, changes, and retroactive billing for system loading of customer payer contracts
- Trained and supported eight employees for optimum performance and continuous improvement
- Managed and created schedules, implemented deadlines
RCM BILLING AND PAYROLL SUPPORT SUPERVISOR
SANDATA REVENUE CYCLE MANAGEMENT
Hicksville, NY
01.2018 - 01.2020
- Managed billing, payroll, claims resubmission, and authorization entry process
- Oversaw resolution of billing error edits, resubmission edits, and EDI rejects
- Ensured that all changes, codes, and rates were loaded and correct for payer contracts
- Trained and supported four employees in policies and procedures for daily billing exporting; facilitated continuous improvement with employees; created schedules to ensure sufficient workforce capacity
- Company customer service rep provided feedback to RCM clients for authorization and billing issues
- Developed new procedures and processes to maximize efficiency and accuracy
- Created trend reports for upper management
PHYSICIAN AND HOSPITAL BILLING FOLLOW UP SUPERVISOR
MEDISYS MANAGEMENT
Melville, NY
01.2015 - 01.2018
- Supervised follow-up staff of 12, evaluated performance and personnel actions; managed work allocations, training, and problem resolution
- Maximized collection of medical services payment and reimbursements from patients, insurance carriers, and financial aid with annual total of $90 million
- Trained new and existing staff on applicable operating policies, protocols, systems, standards, and procedures
- Liaison between follow-up and senior staff, Epic employees, cash posting; resolved billing issues, work allocations, training, and problem resolution
- Investigated payer claim denials and ensured accuracy by reviewing services patients received; made coding/charging corrections; handled and resolved patient complaints
- Created and maintained active monthly and annual account receivables and productivity reports
- Maintained fee schedule documents and all master data tables
REVENUE CYCLE MANAGER
PORTECK CORPORATION
Jericho, NY
01.2014 - 01.2015
- Managed daily business and operational activity of nine high-volume multi-specialty physician practice groups
- Resolved billing issues, set policy and procedures; communicated with physicians, practice administrators, and other staff
- Reviewed Electronic Practice Management System and clearinghouse rejections; created databases and spreadsheets for reporting accuracy
- Analyzed and ensured reimbursements consistent with contracted rates from managed care networks and insurance carriers
- Appealed all claims denied due to medical necessity, experimental, investigation, and other related denials
- Led and scheduled monthly meetings with physicians, provided issue tracker, agenda, and monthly deliverables, discussed status of rebilling and reimbursement process to ensure account resolution
ACCOUNTS MANAGER
MILLIN ASSOCIATES
Lynbrook, NY
01.2013 - 01.2014
- Supervised, trained, and audited performance of staff of five
- Assigned responsibilities of supervising billing staff
- Analyzed fee schedules and payer trends; established standard medical billing procedures
- Contacted insurance carriers to resolve outstanding accounts
- Appealed and/or resubmitted unresolved invoices to insurance carriers
- Conducted quarterly billing audits, ensured accurate payment, followed up with payors
- Scheduled weekly conference calls with clients regarding accounts receivables
BILLING MANAGER
ISLAND DIAGNOSTIC IMAGING
Massapequa, NY
01.2009 - 01.2013
- Managed radiology billing department for practice of five physicians
- Executed aging reports to billing staff for follow up with insurance carriers
- Developed, implemented, and maintained new billing system, office policies, and procedures
- Retrieved and maintained electronic claims filing and edit reports
- Reviewed monthly billed vs
- Applied payments, identified target problem payers, reduced accounts receivables for practice
- Prepared outstanding patient accounts for collection
- Hired staff, performed timely employee evaluations, executed disciplinary actions, and terminations
- Assisted front desk when necessary
ACCOUNTS RECEIVABLE SPECIALIST
METROPOLITAN DIAGNOSTIC IMAGING
Garden City, NY
01.1999 - 01.2009
- Managed patient accounts from billing though collections of reimbursement from insurance carrier and/or patient responsibility
- Organized work and documents on accounts receivable collection worksheet with range of outstanding claims over 120 days
- Prepared and attached all required claims documentation for appeals process
- Analyzed accounts to determine correct adjustments and reimbursements; ran monthly aging reports
- Performed quality entry system reports ensuring correct claims reimbursement
Education
Home Health Coding Reimbursement Certification - CPC Physician Based Medical Coding Certification, CPPM Practice Management Training Certification
AMERICAN ACADEMY OF PROFESSIONAL CODERS
OnlineMedical Assistant Secretary Certification -
NEW YORK SCHOOL FOR MEDICAL AND DENTAL ASSISTANTS
New York, NYSkills
- Revenue enhancement strategies
- Billing system optimization
- Insurance claims processing
- Staff training and supervision
- Project leadership
- Customer Service and Support
- Organizational skills
- Communication Skills
- Policy development
Accomplishments
- In February 2024 a attach against ChangeHealthcare resulted delay with claims submission . Within two weeks I was able to ensure billing which led to minimal backlog of unpaid claims
- Stepping up to support our customers , ensuring new accounts are implemented quickly and smoothly
References
References available upon request.
Timeline
Billing Manager
Long Island Consultation Center
07.2023 - Current
RCM BILLING MANAGER
SANDATA REVENUE CYCLE MANAGEMENT
01.2020 - 04.2023
RCM BILLING AND PAYROLL SUPPORT SUPERVISOR
SANDATA REVENUE CYCLE MANAGEMENT
01.2018 - 01.2020
PHYSICIAN AND HOSPITAL BILLING FOLLOW UP SUPERVISOR
MEDISYS MANAGEMENT
01.2015 - 01.2018
REVENUE CYCLE MANAGER
PORTECK CORPORATION
01.2014 - 01.2015
ACCOUNTS MANAGER
MILLIN ASSOCIATES
01.2013 - 01.2014
BILLING MANAGER
ISLAND DIAGNOSTIC IMAGING
01.2009 - 01.2013
ACCOUNTS RECEIVABLE SPECIALIST
METROPOLITAN DIAGNOSTIC IMAGING
01.1999 - 01.2009
Home Health Coding Reimbursement Certification - CPC Physician Based Medical Coding Certification, CPPM Practice Management Training Certification
AMERICAN ACADEMY OF PROFESSIONAL CODERS
Medical Assistant Secretary Certification -
NEW YORK SCHOOL FOR MEDICAL AND DENTAL ASSISTANTS
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