MARY WASHINGTON
Brusly,LA
Summary
Energetic Supervisor successful at motivating and building positive team dynamics with over 20 years of experience to accomplish aggressive goals. Dedicated to open, communicative culture where employees feel empowered to contribute to company's success.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Supervisor
Woman’s Hospital
03.2016 - Current
- Yearly Evaluations, Payroll, Quality Review, Daily Huddle
- Monthly Denial Trend High Risk Reporting
- Work with all 5 Medicaid Bayou Health Provider Relations Representatives on submitted claim reconciliations, claim appeal status, denial trends and any complex billing issues
- Coordinate with scheduling monthly meeting with all bayou plan provider representatives
- Initiate Enrollment application process for Out of State Medicaid plans, Medicare Advantage Plans
- Responsible for identifying, calculating and submitting Outlier claims to DHH/LDH for reimbursement.
- LDH State Ambulatory, Inpatient and Outpatient services within 24 hours of Inpatient discharge audit, In-house Monthly auditing of 24 hour In/Out exception report
Patient Accounting Floater
Woman’s Hospital
02.2015 - 02.2016
- Assists Revenue Management Manager with special projects in Physician Billing
- Worked as Medicaid Application Specialist, Financial Counseling and Clinic Credentialing specialist during staff vacancies
- Educate/Train staff on Medicaid billing functions
Sr. Patient Account Representative
Woman’s Hospital
12.2006 - 02.2015
- Review and work assigned A/R in order to bring account to completion
- Refilling claims, appealing any inappropriate reimbursements and/or denial decisions
- Works closely with staff, governmental agencies, managed care companies, third party insurance companies and various departments of the hospital in order to resolve billing/reimbursement issues in a professional and efficient manner
- Obtain authorizations from appropriate departments when needed to file claims
- File all hospital insurance claims for contracted and non contracted providers on UB-92 claim forms electronically through MedAssets or hardcopy paper claim using appropriate CPT4 and HCPCS codes
- Review and applying any necessary contractual adjustments to patient accounts according to Medicaid/Medicare payment methodology
- Take appropriate action steps to resolve any corrected/adjusted claims quickly to bring any trends in the industry that may cause a negative financial impact to the hospital
- Complete Medicaid and Breast and Cervical Cancer applications
- Screen patient for Charity Care.
Sr. Lead Patient
Baton Rouge General
02.2004 - 12.2006
- Proven ability to develop and implement creative solutions to complex problems
- Exercised leadership capabilities by successfully motivating and inspiring others
Customer Service Representative
Baton Rouge General
10.2003 - 02.2004
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions
Follow-Up and Discount Specialist
Baton Rouge General
01.1997 - 10.2003
- Review assigned A/R to analyze and resolve a variety of complex billing issues on account balances greater than $25,000.00
- Calculate Outlier reimbursement for NICU high dollar Humana Newborn baby account
- Worked with collectors/biller staff in the commercial follow-up department with problem A/R accounts in order to bring account closer to completion, including refilling claims, appealing any inappropriate reimbursements and/or denial decisions
- Analyzes and resolves a variety of complex billing issues for high volume of patient and insurance company incoming phone calls
- Reported production daily for commercial follow-up staff
- Assist discount/cash department with posting of daily lockbox payments and apply correct adjustments to patient accounts according to insurance explanation of benefits received from insurance companies
- Filed claims to primary and secondary payers.
Education
BBA - Business Administration
Capella University
Minneapolis, MN05.2025
Associate - Applied Science
Valor Christian College
Canal Winchester, OH12.2022
Skills
- Leadership
- Workflow Monitoring
- Resolving Complaints
- Nthrive
- File Hold
- Onbase
- Huron
- Meditech
- Microsoft
- Analytics
- Time Management
- Customer Service
Accomplishments
- Woman's Hospital Best Place to Work Committee
- Woman’s Hospital Patient Accounting Employee Committee
Certification
Certified Medicaid Application Specialist
CPR (Infant/Adult)
Timeline
Supervisor
Woman’s Hospital
03.2016 - Current
Patient Accounting Floater
Woman’s Hospital
02.2015 - 02.2016
Sr. Patient Account Representative
Woman’s Hospital
12.2006 - 02.2015
Sr. Lead Patient
Baton Rouge General
02.2004 - 12.2006
Customer Service Representative
Baton Rouge General
10.2003 - 02.2004
Follow-Up and Discount Specialist
Baton Rouge General
01.1997 - 10.2003
BBA - Business Administration
Capella University
Associate - Applied Science
Valor Christian College