MALLORY Putney
Calhoun
Summary
Skilled professional ready to excel in leadership role with focus on results-driven performance. Proven ability to streamline operations and foster team collaboration to achieve organizational goals. Known for reliability and adaptability in meeting changing demands while maintaining high standards. Seeking to be Preeminent.
Overview
18
18
years of professional experience
2
2
Certifications
Work History
PREACCESS SUPERVISOR SOUTHEAST REGION
ADVENTHEALTH
10.2023 - Current
- Certified Revenue Cycle Representative - Completed Oct of 25'.
- Prosci Certified - Change Management Practicioner.
- Overseeing and building rapport with a Team of 52 members with 4 Individual Teams : IV, Authorizations, NOA, and STAT/ADDON for 6 Hospitals.
- Doing weekly pulse checks on each team member to make sure they feel whole, and loved.
- Completing monthly denials for six facilities, including deep diving into the research regarding each denial and providing education to the other teams and departments to prevent future denials.
- Compiling Monthly Scorecards/Metrics for each individual team member and presenting their audit/productivity to see how they are doing each month. If failing, helping the Team Members reach their goals with Productivity Journeys to be able to achieve their Targets.
- Conducting interviews for new Candidates when our Team has a New Opening/Replacing/Growth opportunities.
- Obtaining Single Case Agreements for 6 facilities for the patient's that do not have Network's (Physician and Ancillary only) coverage which includes Negotiating Rates with Third Party Companies, completing our Form, and securing before the DOS.
- Monthly Rounding Meetings with each facility to speak on any challenges from the month prior to help with bridging gaps.
- Helping CxC Interview applicants for New Supervisor, Team Lead, and Specialists position to help that Team Navigate new opportunities.
- Working Claim Edits daily to ensure we get the Claims worked promptly.
- Helping the Team Leads/Sr. Specialist grow in their individual role by coaching/teaching down to make sure they are on the correct path for Growth in their Career.
- Taking Monthly Classes for Corporate Continued Education to keep growing/staying up to date with courses such as : Understanding Personalities, Critical Thinking, PowerPoint, Excel, Speaking to Succeed, Time Management, Managing Up and Down Across the Organization, All About Documentation for Insurance Authorization, RTE, Collection Best Practices, Estimate Spotlights, Standardized Notes by Reg Area, and Financial Form Accuracy and Process.
- Keeping up with Market Payor Listings to ensure our Team has the most up to date information to be able to work accounts properly and timely.
- Work closely with Human Resources for Team Member Corrective Actions/Write Ups/Performance Journeys to make sure all Team Members are held accountable.
- Trained 2nd Supervisor to oversee NC/KY Market due to Southeast Region Growth.
- Focusing on GA Market as of 25' to help grow and strength relationships/market rapport. Due to specific call outs as Infusion Specialist, and Surgery Specialist.
CONSUMER ACCESS SPECIALIST LEAD, ADVENTHEALTH SOUTHEAST AND SOUTHWEST REGION
ADVENTHEALTH
01.2020 - 01.2023
- Working Lead - over seeing day to day Work Queues' as well as Claim Edits and running reports daily.
- Train new employee's and assist IV, Add - On, Pre-Reg and Auth Team members.Proficient in Epic, Experian, Cerner, Vyne, Revenue Cycle, Microsoft Word, Excel, PowerPoint, Outlook, UKG, The Hub, Cisco Jabber, and Teams Encourage team members in new World Class Revenue Cycle.
- Works surgery authorizations for specialties and diagnostics across Georgia, North Carolina, Kentucky, Texas, and Kansas, including 13 hospitals, 1 Imaging Center, and 1 Surgery Center.
- Monthly Team Audits - Ensure all team members are meeting monthly Log Metrics and completing accounts correct and accurately.
- Claim Edits - Research claims prior to billing 1 month before to have a higher chance of being paid.
- Denial Expert - researching CPT codes that were billed, diagnosis codes, doctors, facilities, and all pertinent clinical information to resubmit claim in timely manner.
- Submit IT tickets for all employees for access and help desk issues.
- Deferral Process knowledge - Verifying all patients documentation/authorizations are in place prior to surgery, procedure, or diagnostics testing or have a deferral in place to allow patient to proceed with services.
- Payor Website Knowledge - LMRP, Evicore, Carecore, Carelon formerly known as AIM, Availity, Gammis, NC Tracks, Quantum, Healthhelp, Cohere, Cigna Medicare, Tricare, United Health Care, Amerigroup, Caresource, Peachstate, Amerihealth Caritas, CMS.GOV - Medicare, Sunflower, NIA Magellen formerly known as RADMD, Ambetter, Wellmed, Superior health, Baylor Scott and White, and more.
- Oversees Notification of Admission's (NOA) to ensure all Admissions are completed in the individual's Insurance Companies Guidelines.
- Initiate Retro Active Claims submissions and monitor progress to ensure authorization is received for diagnostics and surgeries for all hospitals.
- Knowledge of Coverage Discovery to identify possible unknown coverage.
- Sends out Weekly Wellness updates to the team to keep health and wellness on the forefront for our Physical and Mental state.
CENTRAL SCHEDULING AUTHORIZATION REPRESENTATIVE
ADVENTHEALTH
01.2017 - 01.2020
- Began in diagnostic authorizations and moved to surgery authorizations.
- Responsible for obtaining authorizations for surgery in a timely manner.
- Interact daily with many medical clinics to gain clinicals for authorizations for both scheduled and ADD-ON/STAT procedures.
- Work closely with Registration to insure accounts are properly notated with pre-cert information.
- Experienced in Cerner, Athena, Centricity.
- Completed all Wound Care authorizations including visits, HBO Therapy, Larval Therapy, Wound Vacs, Debridement, Surgical Debridement, and skin grafts.
PATIENT ACCESS REPRESENTATIVE
ADVENTHEALTH
01.2016 - 01.2017
- Greeted patients upon entry to ED.
- Began as a PRN in ED Patient Access and then moved to a Part time position.
- Verified all demographics on patients.
- Registered patients in a timely manner in including walk-ins and ambulances.
- Insurance Verification.
- PRN for switchboard.
- Made sure Consent, HIPPA, IM's Forms were correctly documented on all patients - Worked RQA's to clear any mistakes that were clear.
SALES
COTTON AND TWINE BOUTIQUE
CALHOUN
01.2015 - 01.2016
- Greeted Customers.
- Customer Services.
- Sales.
- Social Media.
- Created Clothing Displays every other week to ensure a new look and feel.
- Quick Books.
- Priced Clothing and documented inventory to make sure all Invoices were correct.
- Ran Daily report at the end of each day to calculate sales.
SALES
FIREHOUSE GYM
CALHOUN
01.2011 - 01.2015
- Greeted clients.
- Sold memberships, products, and attire.
- Stocked Supplemental and Dietary products and made nutritional smoothies to follow Member's diets.
- Verified all Invoices for new products and priced items according.
- Responsible for appearance of facility.
- Collected Rent for Monthly Housing for Owner's Rental Property.
SALES
BIDDY BOUTIQUE
CALHOUN
01.2008 - 01.2010
- Greeted Customers.
- Customer Services.
- Sales.
- Clothing Displays.
- Assisted Owner at Market to help pick out new and upcoming fashion.
Education
GAINESVILLE STATE COLLEGE
01.2010
Skills
- Multi-tasker
- Customer Service
- Efficient/Organized
- Team Player
- Owning It
- Making it easy
- Positive
- Detail Oriented
- Eager and Ready to Learn/Evolve
- Bridging Gaps/Communication
- Empathetic
- Problem Solver
- Adaptable
References
Business and personal references available upon request.
Certification
Prosci Change Management Practioner
Timeline
PREACCESS SUPERVISOR SOUTHEAST REGION
ADVENTHEALTH
10.2023 - Current
CONSUMER ACCESS SPECIALIST LEAD, ADVENTHEALTH SOUTHEAST AND SOUTHWEST REGION
ADVENTHEALTH
01.2020 - 01.2023
CENTRAL SCHEDULING AUTHORIZATION REPRESENTATIVE
ADVENTHEALTH
01.2017 - 01.2020
PATIENT ACCESS REPRESENTATIVE
ADVENTHEALTH
01.2016 - 01.2017
SALES
COTTON AND TWINE BOUTIQUE
01.2015 - 01.2016
SALES
FIREHOUSE GYM
01.2011 - 01.2015
SALES
BIDDY BOUTIQUE
01.2008 - 01.2010
GAINESVILLE STATE COLLEGE