Meredith Wilkes
Miami,FL
Summary
Proven leader in healthcare collections and case management, notably with the University of Miami, where I spearheaded initiatives that significantly enhanced revenue recovery and team productivity. Expert in staff management and training, I excel in creating efficient workflows and fostering teamwork. My adaptability and attention to detail have consistently improved customer satisfaction and operational outcomes.
Overview
20
20
years of professional experience
Work History
Supervisor of Physicians Collections
University of Miami
07.2019 - Current
- Oversaw daily operations of the team, ensuring smooth workflow and timely completion of tasks and adjusted employees assignments based on business needs.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Increased team productivity by creating and implementing efficient workflows and setting clear expectations for staff members.
- Conducted performance evaluations for staff members, in accordance with policies, procedures and guidelines while identifying areas of improvement and guiding professional development plans.
- Perform ongoing Quality and Productivity audits and provide feedback to staff and management.
- Approve staff time weekly for payroll processing. Review and approve/decline staff time off request based on business needs.
- Train staff, outside vendors and provide support in the resolution of all duties related to collection and billing activities to include creating tip sheets and workflows.
- Review procedures, diagnosis and modifiers to ensure payer policies and guidelines are properly being followed.
- Review Professional Billing AR Metrics in order to identify AR issues, trends or areas of opportunities and provide feedback at weekly Metrics meetings.
- Review Departments KPI (Key Performance Indicator) report in order to identify AR issues, trends or area of opportunities and prepare agenda to present on department liaison meetings.
Senior Medical Collector
University of Miami
02.2016 - 07.2019
- Enhanced revenue recovery by efficiently managing a high volume of medical claims.
- Safeguarded patient privacy by strictly adhering to HIPAA regulations throughout the collections process.
- Evaluated aged accounts receivable reports regularly, prioritizing collection activities based on aging categories for optimal results.
- Strengthened interdepartmental relationships through regular communication with key stakeholders regarding outstanding account balances or related concerns.
- Identified trends in unpaid claims, developing targeted collection strategies to address specific issues.
- Collaborated with healthcare providers to obtain necessary documentation for successful claim submission.
- Reduced claim rejections by maintaining accurate patient information and diligently verifying insurance coverage.
- Improved team productivity by providing ongoing training and support to fellow Medical Collectors.
- Maximized reimbursement rates through a thorough understanding of medical coding practices and payer-specific requirements.
- Contributed to company-wide goals by consistently meeting or exceeding individual collection targets month over month.
- Processed online and paper appeal submissions and refund requests.
- Reviewed Explanation of benefits in order to submit written or online appeal submissions on denied or unpaid claims for adjudication and resolution. Attempting to successfully overturn insurance decisions.
- Request adjustments or refunds when required.
Workers Compensation Case Manager
First Service Residential
05.2004 - 11.2015
- Responsible for setting up, delaying, investigating, coordinating, and managing both litigated and non- litigated Worker’s Compensation claims.
- Taking statements, interviewing injured workers, witnesses, and immediate supervisors.
- Aggressively pursued all claim resolution opportunities, which most effectively managed payout, return to work, and discontinuance of benefits through litigation.
- Oversee medical claims, payments, and provider referrals.
- Ensure the timely bi-weekly payments of claimant’s temporary, permanent disability benefits.
- Assist the legal, Medical Management, Customer Service, and fraud department with claims investigation.
- Record all accidents on OSHA 300 log; excel spreadsheet to provide reports to upper management on a monthly basis.
- Report all work related injuries using the Liberty Mutual Business Direct system and PMA Management Corp system.
- Ensure that claimants are compliant with their medical care.
- Conduct investigation to ensure claimant is not filing a fraudulent claim in order to obtain Worker’s Compensation benefits.
- Performed administrative and office support activities for the director of Safety and Workers’ Compensation department. Duties included screening telephone calls, receiving, and directing visitors, creating spreadsheets, filing, Internet research, and data entry, meeting with vendors, served as a translator when needed.
Education
CRCR Certification
HFMA
02.2022
High School Diploma -
Miami Jackson Senior High School
Miami, FL06.1998
Skills
- Training and mentoring
- Staff Management
- Priority management
- Teamwork and Collaboration
- Time Management
- Attention to Detail
- Excellent Communication
- Adaptability and Flexibility
- Professionalism
Timeline
Supervisor of Physicians Collections
University of Miami
07.2019 - Current
Senior Medical Collector
University of Miami
02.2016 - 07.2019
Workers Compensation Case Manager
First Service Residential
05.2004 - 11.2015
CRCR Certification
HFMA
High School Diploma -
Miami Jackson Senior High School