Misty Gorman
China Spring,TX
Summary
Results-driven revenue cycle supervisor experienced in financial statement review, auditing and reporting. Well-versed in producing reports, evaluating department operations and handling month- and year-end closings. Meticulous, conscientious and methodical in approach.
Overview
8
8
years of professional experience
Work History
RCM Billing Supervisor
Thriveworks Counseling LLC.
11.2020 - Current
- Lead and manage a team of medical billing specialists, providing guidance, support, and mentorship to ensure high performance and productivity.
- Conduct regular performance evaluations, providing feedback, and identifying training needs to optimize team performance and individual development.
- Oversee the daily workflow of the billing team, assigning tasks, setting priorities, and ensuring timely completion of billing activities..
- Perform regular audits of billing data and documentation to ensure accuracy, completeness, and compliance with regulatory requirements and organizational policies.
- Provide ongoing training and professional development opportunities to billing staff, keeping them updated on industry changes, regulations, and best practices.
- Address billing inquiries, resolving billing disputes, and coordinating with insurance companies and patients to resolve issues and ensure prompt payment.
- Generate and analyze billing reports and performance metrics to track key indicators, identify trends, and make data driven decisions to improve billing processes and outcomes.
- Develop and implement streamlined policies, procedures, and workflows to enhance efficiency and accuracy in billing processes, minimizing errors.
- Collaborate with department heads, administrators, and clinical staff to ensure timely and precise billing of services rendered.
- Manage relationships with third party payers and collection agencies to resolve billing issues and denials promptly.
- Oversee the processing of ACH transactions, including direct deposits, payments, and electronic funds transfers (EFTs).
- Managing ACH processing systems and software, including configuration, maintenance, and troubleshooting to ensure smooth operation
- Monitoring ACH transactions for accuracy, completeness, and timeliness, and resolving any issues or discrepancies that arise.
- Coordinating with financial institutions, ACH operators, and other parties involved in the ACH network to facilitate the exchange of funds and information.
- Conducting training sessions and workshops for staff members on ACH processes, regulations, and best practices to ensure understanding and adherence.
- Identifying opportunities for process improvement and automation within the ACH workflow to enhance efficiency, reduce errors, and streamline operations.
Medical Billing Clerk
Living Tree Pediatrics
12.2019 - 03.2020
- Process claims to various insurance entities such as commercial, Medicare, Medicaid, Workman's compensation, vision insurance, and government agencies
- Follow up on claims that have been submitted to the insurance companies, monitor unpaid claims, complete claim corrections, and resubmit claims and/or appeals as needed
- Balance daily batches of both insurance and patient payments that are paid in either live checks or electronic fund transfers
- Research information for patients' inquiries of their billing issues, correcting as needed, as well as communicate effectively with the patients via phone, email, and in person
- Process patient statements, final notices, and make collection calls as needed
- Provide medical records to authorized persons as needed
- Train new employees on the policies, procedures, and workflow of the billing department
- Assist the billing manager with various projects to determine all problem trends and finding solutions to resolve them in a timely manner
- Review the hybrid medical records to assure that claims are submitted with the correct information
- Adhere to strict HIPAA, privacy, security, and confidentiality policies to protect personal health information.
Medical Billing Clerk
Chico Eye Center
05.2017 - 05.2019
- Process claims to various insurance entities such as commercial, Medicare, Medicaid, Workman's compensation, vision insurance, and government agencies
- Follow up on claims that have been submitted to the insurance companies, monitor unpaid claims, complete claim corrections, and resubmit claims and/or appeals as needed
- Balance daily batches of both insurance and patient payments that are paid in either live checks or electronic fund transfers
- Research information for patients' inquiries of their billing issues, correcting as needed, as well as communicate effectively with the patients via phone, email, and in person
- Process patient statements, final notices, and make collection calls as needed
- Provide medical records to authorized persons as needed
- Train new employees on the policies, procedures, and workflow of the billing department
- Assist the billing manager with various projects to determine any and all problem trends and finding solutions to resolve them in a timely manner
- Review the hybrid medical records to assure that claims are submitted with the correct information
- Adhere to strict HIPAA, privacy, security, and confidentiality policies to protect personal health information.
Patient Access Representative
Feather River Hospital
04.2016 - 05.2017
- Check patients into the hospital to be seen on an emergency basis, as well as for surgeries
- Verify the individual demographics for each patient, up to and including; contact information, emergency contacts, and insurance information
- Receive the proper documentation for consent before and after patient had been seen
- Assist patients and their families with needs while in our facilities
- Answer phone calls to help with any questions or complaints, as well as directing the calls to the proper location
- Assist clinical staff with registration and patient information
- Adhere to HIPAA laws and regulations.
Education
High School Diploma -
Hamilton High School
Hamilton City, CA06.2004
Skills
- Team Development
- Staff Management
- Vendor Management
- Strategic Decision-Making
- Performance Management
- Reporting and Regulatory Requirements
- HIPAA Compliance
- Billing systems and software
Timeline
RCM Billing Supervisor
Thriveworks Counseling LLC.
11.2020 - Current
Medical Billing Clerk
Living Tree Pediatrics
12.2019 - 03.2020
Medical Billing Clerk
Chico Eye Center
05.2017 - 05.2019
Patient Access Representative
Feather River Hospital
04.2016 - 05.2017
High School Diploma -
Hamilton High School
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