Rhodlyne Lamarre
Brockton
Summary
Billing management professional with strong expertise in financial oversight, invoicing, and accounts receivable processes. Known for fostering team collaboration and driving results, ensuring seamless operations and client satisfaction. Adept at adapting to evolving needs and establishing efficient workflows through leadership, analytical skills, and attention to detail. Highly reliable, with focus on precision and efficiency in managing billing cycles.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Director of Revenue
TaraVista Behavioral Hospital & Mira Vista Behavioral Hospital
Auburn, MA
09.2024 - Current
- Participate on revenue cycle team and all other hospital base team
- AR Review
- Train new employees
- Work with Chief Financial Officer to review monthly Financial statements. Prepare Monthly Account Receivable reports to Finance committee
- Maintain knowledge of all patient access areas ensuring high productivity and performance
- Achieve Monthly goal of revenue cycle performance
- Develop processes to identify and maximize revenue
- Establish and implement billing and collection procedures for the accounts receivable department
- Account adjustment and Reconciliation
- Payment Processing, Reconciliation and Reporting
- Monitor high dollars and aging accounts in system
- Follow up on claims and appeals including interaction with payers
- Maintain and enforce department policies while ensuring compliance with all regulatory and accreditation
- Credentialing
- Provider Billing
- Coordinate with the IT department to ensure billing processes are correct and rates are updated
Director Business Office
Westborough Behavioral Hospital
03.2023 - 12.2024
- Verifying Census daily Census and Reporting
- Coordinated A/R Review Meeting weekly to discuss issues with staff
- Monitored all major issues impacting the billing group operations and collections
- Provide leadership and managerial support to preregistration, registration
- Developed and maintain an atmosphere of positive communications with patients, third party insurance companies and collection agencies
- Achieve Monthly goal of revenue cycle performance
- Financial Cycle Oversight: Account Payable, Purchasing, Payroll
- Ensured that appropriate Business Units or Corporate personel took prompt, decisive action to remedy operational and collection problems.
- Identified, developed and implemented reimbursement strategies associated with billing and collections.
- Payment Processing, Reconciliation and Reporting
- Monitor high dollars and aging accounts in system
- Follow up on claims and appeals including interaction with payers
- Maintain and enforce department policies while ensuring compliance with all regulatory and accreditation
- Generated and analyzed requested ad hoc and standards reports as requested by the Management Team
Business Manager
Pembroke Behavioral Hospital
03.2022 - 12.2023
- Directed the billing follow up activities through receivable reports, identified areas of follow up concentration, and distributed monthly aging reports to review with each staff one on one. Ensure timely and accurate billing, collections and cash posting statewide
- AR Review
- Developed and maintained reimbursement policies and procedures including billing compliance, training manual
- Provide leadership and managerial support to preregistration, registration
- Maintain knowledge of all patient access areas ensuring high productivity and performance
- Achieve Monthly goal of revenue cycle performance
- Financial Cycle Oversight: Account Payable, Purchasing, Payroll
- Prepare monthly management reporting and analysis related to billing and collections and contract profitability
- Account adjustment and Reconciliation
- Payment Processing, Reconciliation and Reporting
- Monitor high dollars and aging accounts in system
- Follow up on claims and appeals including interaction with payers
Business Manager
West Newton Health Care
10.2019 - 03.2021
- Verifying Census daily Census and Reporting
- Verify all billing and financial data for new admission
- RFMS
- Management, Control and Reconciliation of the Residents Needs Account
- Work with Rehab
- PCC
- Financial Cycle Oversight: Account Payable, Purchasing, Payroll
- Account Receivable Mont- End closing
- Account adjustment and Reconciliation
- Payment Processing, Reconciliation and Reporting
- Private pay billing and Collections
- Medicaid application Assistance
- Responsible for team member onboarding and orientation process
- Managed care Billing, follow ups
Third Party Reimbursement and Collections Manager
Human Services Management Corporation
10.2018 - 12.2019
- Oversees the operations of Account Receivable Reimbursement and Collections Department
- Serves as the go to person for all Reimbursement and collections processes
- Plans and directs insurance documentation, workloads, and data processing to ensure accurate collections of Account Receivable
- Prepares and Analyze Reports
- Maintains contact with other departments to obtain and analyze additional information needed to document and process billing
- Audits current procedures to monitor and improve efficiency of collections
- Provides, oversees and/or coordinates the provision of training for new and existing collection staff on policies, procedures, etc.
- Analyzes trends impacting charges, coding, collection and account receivable and take appropriate action to realign staff and revise policies and procedures
- Participates in the development and implementation of operating policies and procedures
- Ensures that the activities of the reimbursement and collection operations are conducted in a manner that consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines and requirements
- Maximizes collections dollars from all payers
Director of Revenue Cycle & Third Party Reimbursement
High Point Treatment Center
New Bedford, MA
04.2018 - 06.2018
- Revamped department policies and procedures
- Remapped department workflow to work in conjunction with updated policies and procedures
- Supervised department staff
- Collaborated with staff to initiate various projects for reporting purposes
- Conducted regular meetings to adequately track projects, billing and systems issues
- Participated in weekly conferences to address system issues with software consultants
- Approved employee timecards and time off requests through Kronos system
- Assisted in gathering data related to Behavioral Health Community Partnership test file
- Maintained membership in the administrative committee and electronic medical record committee
Revenue Cycle Manager
Casa Esperanze
Roxbury, MA
01.2017 - 02.2018
- Responsible for maintaining and improving revenue cycle processes
- Oversee admission staff
- Responsible for client accounts receivables and third party reimbursement
- Provide supervision, training and support to the client services representatives
- Analyze payer fee schedules and report findings to revenue cycle team
- Analyze payer contracts and work with Development team to revise and negotiate contracts with providers
- Develop and implement collection policies with the Finance Department
- Provide ongoing education to all management staff related to receivables and reimbursement
- Coordinate audits by outside entities for compliance purposes
- Manage credentialing for all providers & staff including Virtual Gateway and other relevant systems
- Interpret and enforce third party payer rules and regulations
- Brainstorm process improvements & establish performance metrics with Director of Behavioral Health Operations, Lead Clinician and HIT Manager
- Assists in the training of personnel in procedures of Clinic procedures and receivables system
Billing Manager
Casa Esperanza
- During my time as Billing Manager, I assisted in establishing many policies and procedures related to billing. I worked closely with clinicians to ensure adequate and timely submissions in Evolve for services rendered. I was able to undertake and finish a project related to Mass Health compliance testing. I was able to bring my past billing experience to ensure a 98% collection rate, handling all held claims and resubmitting denials in a timely manner. On a monthly basis, I was billing $30,000-$40,000 in claims, calculating productivity for 4 clinicians on a weekly basis.
- Casa Esperanza, Inc. is a bilingual/bicultural behavioral health treatment provider serving Boston and the Merrimack Valley. Casa Esperanza has an operating budget of $5.2 million and more than $9 million in assets.
Business Manager
Care one
Randolph, MA
03.2021 - 12.2022
- Verifying Census daily Census and Reporting
- Verify all billing and financial data for new admission
- RFMS
- Management, Control and Reconciliation of the Residents Needs Account
- Work with Rehab
- PCC
- Financial Cycle Oversight: Account Payable, Purchasing, Payroll
- Account Receivable Mont- End closing
- Account adjustment and Reconciliation
- Payment Processing, Reconciliation and Reporting
- Private pay billing and Collections
- Medicaid application Assistance
- Responsible for team member onboarding and orientation process
- Managed care Billing, follow ups
Business Office Manager
Blue Hills Health and Rehabilitation
03.2021 - 04.2022
- Works independently and with a team to achieve business office goals
- PCC
- Strong Medicare knowledge
- Oversees the office
- Directs the overall administrative, billing, and accounting functions
- Plans, organizes, develops, and implements, and interprets the programs, goals, objectives, policies and procedures governing the business office functions
- Performs proficiently in all competency areas including patient rights, safety, and sanitation
Director of Admission & Business Manager
Waban Health Center Nursing home
06.2018 - 12.2018
- Follow the monthly accounting close calendar to ensure all financial data expectations and deadlines are met
- Review P and L on a monthly call with the Corporate office accounting department
- Ensure accuracy with resident billings and charges on resident's ledgers
- Follows AR collections guidelines and sends monthly delinquent notices
- Responsible for entering vendor invoices for payment
- Process bi-weekly payroll; aware of payroll developments, trends, regulations and business controls
- Tracking employee benefits eligibility/enrollment, time/attendance, vacation and personal/sick time
- Handling of resident records, letter and rate increase notices
- Responsible for team member on-boarding and orientation process
- Works well in an environment with minimal supervision by creating and adhering to own work schedules
- Complete state required training per regulations
Billing Supervisor
South Bay Mental Health
- During my time as Billing Supervisor, I worked closely with clinicians to ensure adequate and timely submissions in for services rendered. I ensured that all relevant documentation was submitted accurately prior to processing claims on a monthly basis, I was billing $60,000-$80,000 in claims. I assisted with CARF accreditation, ensuring all licenses were up to date. I was involved with training new staff related to billing procedures. I was charged with mediating any conflicts between staff and clients.
- South Bay is a community based behavioral health organization offering a continuum of services including adult behavioral health, substance abuse counseling and day treatment services.
Education
BBA - Business Management
Mount Vernon Nazarene University
Mount Vernon, OH03-2025
Associate of Science - Business
Maasosit Community College
Brockton, MA2020
Skills
- Project management
- Very detailed oriented
- Accounts Receivable
- Medical billing
- EHR systems
- Compliance testing
- Claims submission
- Denial analysis
- Resubmission
- Report design
- Payer setup
- Authorization management
- Productivity processing
- Revenue cycle reporting
- HIT troubleshooting
- Time management
- Multi-tasking
- Customer support
- Account management
- Medical management
- Analytical skills
- Organizational skills
- Management
- Interpersonal skills
- Communication skills
- Behavioral health
- Microsoft Office Suite
Affiliations
- Massachusetts Association of Behavioral Health Systems ( MABHS)
- Massachusetts Association of Patient Account Management (MAPAM)
Certification
Scrum master, 03/01/22, Scrum master certified
Timeline
Director of Revenue
TaraVista Behavioral Hospital & Mira Vista Behavioral Hospital
09.2024 - Current
Director Business Office
Westborough Behavioral Hospital
03.2023 - 12.2024
Business Manager
Pembroke Behavioral Hospital
03.2022 - 12.2023
Business Manager
Care one
03.2021 - 12.2022
Business Office Manager
Blue Hills Health and Rehabilitation
03.2021 - 04.2022
Business Manager
West Newton Health Care
10.2019 - 03.2021
Third Party Reimbursement and Collections Manager
Human Services Management Corporation
10.2018 - 12.2019
Director of Admission & Business Manager
Waban Health Center Nursing home
06.2018 - 12.2018
Director of Revenue Cycle & Third Party Reimbursement
High Point Treatment Center
04.2018 - 06.2018
Revenue Cycle Manager
Casa Esperanze
01.2017 - 02.2018
Billing Manager
Casa Esperanza
Billing Supervisor
South Bay Mental Health
BBA - Business Management
Mount Vernon Nazarene University
Associate of Science - Business
Maasosit Community College