Meredith Barbour
Gilbertsville,PA
Summary
Accomplished Reimbursement Manager with a proven track record at Philips, adept in Denial Resolution and fostering positive employee relations. Excelled in streamlining processes and enhancing revenue cycle management through strategic data analysis and vendor relationship management. Achieved significant improvements in collaboration and accuracy, demonstrating strong written and verbal communication skills.
Overview
30
30
years of professional experience
Work History
Reimbursement Manager
Philips
02.2022 - Current
- Streamlined communication between departments involved in the reimbursement process, fostering collaboration and accuracy.
- Reviewed billing and collections process and determined improvements to streamline workflows.
- Continually revised strategies based on analysis of KPIs results, leading efforts towards continuous improvement within the reimbursement department.
- Held weekly staff meetings and implemented team building exercises, which promoted positive working environment.
- Analyzed data to identify patterns and opportunities for improvement within the reimbursement process.
- Monitored accounts receivables by reviewing payor account listings.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Identified and documented payor trends and made recommendations to increase revenue opportunities and issues resolution.
- Guided staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
- Trained department employees in proper billing and accounting procedures.
- Oversees and monitors vendor relationships to ensure contract compliance and performance to maximize cashflow.
- Collaborates with Finance and Strategic Contracting to ensure compliance with USGAAP and Sarbanes Oxley.
- Billed and collected for claims submitted on clients' behalf with sales totaling $30,000,00.
- Collaborated with insurance providers to clarify requirements and ensure proper submission of claims for faster processing times.
- Maintained up-to-date knowledge on national healthcare policies affecting reimbursements, advising senior leadership on necessary adjustments or updates to internal processes accordingly.
- Reduced errors in reimbursement claims through rigorous attention to detail and thorough documentation.
Team Manager Patient Access - Revenue Cycle
Penn State St. Joseph's
02.2020 - 02.2022
- Responsible for planning, organizing, managing and evaluating the activities of Provider and Patient Access Services Revenue Cycle group of staff, which included Pre-Registration, Insurance Verification, Scheduling, Referrals and Authorization.
- Daily responsibilities included schedules, payroll, yearly merit increases and evaluations, recruiting and training of new team members, budget and census reports.
- 38 direct reports in multiple locations - AR/Billing Specialists, Administrative Assistants, and registration Clerks.
- Oversaw the collections functions for all services ensuring accurate and timely resolutions of denials, including the initiation of goals and procedures.
- Oversaw the daily operations and coordinating efforts to expedite payment of accounts.
- Manages all aspects of the Reimbursement Services functional team including Billing, Remittance, Collections, and the banking process in multiple locations.
- Documented and analyzed payer issues to determine root cause of denials as well as ensure issues were resolved in a timely manner.
- Reviewed metrics, determined workflows, and staffing needs to address any gaps swiftly.
- Analyzed quality assurance and productivity metrics with employees on a regular basis.
- Responsible for interviews/staffing, ongoing training, development, and retention.
- Oversaw and monitored vender relationships to ensure contract compliance and performance to maximize cashflow.
Patient Access Supervisor/Admissions/Financial Counselor
Einstein Healthcare Network
02.2018 - 01.2020
- Implemented quality assurance measures to ensure that patient access processes adhered to hospital policies and industry best practices for optimal service delivery.
- Implemented performance metrics to track department productivity, identifying areas for improvement and driving overall efficiency gains.
- Reduced employee turnover rate by fostering a positive work environment and providing ongoing support for professional development opportunities.
- Established strong relationships with insurance providers through effective communication channels to expedite claim processing activities when necessary.
- Optimized staff scheduling to maintain adequate coverage during peak hours, minimizing patient wait times and improving service quality.
- Conducted regular performance reviews for staff members, providing constructive feedback and setting goals for future growth and development.
- Served as a liaison between patients, physicians, and administrative staff to address concerns or questions related to registration or billing issues effectively.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Oversaw and managed daily collection of deductibles, co-pays and deposits, ensuring all payments posted and reconciled to appropriate accounts.
- Completion of ADC and Census reports for manager review.
- Managed budgets effectively, ensuring optimal financial performance while investing in necessary resources for business growth.
Supervisor Hospital Team (May 2005 - Feb, 2018)
Quest Diagnostics
02.1994 - 02.2018
- Provided Supervision for day-to-day Clinical Laboratory operation including payroll edits/approvals, yearly performance evaluations, merit increases and PTO approvals.
- Interviewed and hired new hires.
- Trained and counseled staff developing high performing team that met production and quality assurance standards.
- Appointed Senior Project Leader for "Inspira CPU/EMR" acquisition including launch and team development.
- Identified department inefficiencies and implement process improvements.
- Participated in unit based Quality Assurance/Test in Question Program.
- Duties included updating departmental "Clinical Standard Operating Procedure" binder to reflect current policies and practices.
- Traveled to various regional business units to train management and first line employees on new production systems.
- Created travel team that assisted business units across regional geographies with outstanding production obligations.
Education
High School Diploma -
William Penn High School
Philadelphia, PA04.1993
Some College (No Degree) - Secretarial Studies
Community College of Philadelphia
Philadelphia, PASkills
- Denial Resolution
- Revenue Cycle Management
- Data Analysis
- Vendor Relationship Management
- Performance Appraisal
- Data Recording
- Claims Management
- Payment posting
- Insurance Verification
- Medicare knowledge
- Documentation
- Issue Resolution
Timeline
Reimbursement Manager
Philips
02.2022 - Current
Team Manager Patient Access - Revenue Cycle
Penn State St. Joseph's
02.2020 - 02.2022
Patient Access Supervisor/Admissions/Financial Counselor
Einstein Healthcare Network
02.2018 - 01.2020
Supervisor Hospital Team (May 2005 - Feb, 2018)
Quest Diagnostics
02.1994 - 02.2018
High School Diploma -
William Penn High School
Some College (No Degree) - Secretarial Studies
Community College of Philadelphia
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