Scott Jersey
Rochester,NY
Summary
As a Provider Enrollment Account Manager at CGM, I lead a team of specialists who ensure the timely and accurate enrollment of providers with various payers and networks. With over 30 years of experience in health care administration, I have developed a strong expertise in credentialing, revenue cycle operations, and business process improvement. My mission is to deliver exceptional customer service and quality outcomes for our clients, while optimizing their revenue and compliance. I leverage my skills in Microsoft Excel, Echo One App, PECOS and other tools to manage and monitor the enrollment process, identify and resolve issues, and communicate effectively with internal and external stakeholders. I also enjoy building and mentoring a high-performing team that shares my passion for excellence and innovation.
Overview
23
23
years of professional experience
Work History
Provider Enrollment Account Manager
CompuGroup Medical
03.2022 - Current
- Credentialing & Enrollments for Orthopedic, PMR & acute care hospital
- Medicare PECOS and paper applications.
- NYS Medicaid provider maintenance portal and paper submissions.
- CAQH attestations and updating
- Coordination of duties with off-shore team.
- Client service meetings and collaboration.
Project Coordinator
RADNET MANAGEMENT INC
08.2021 - 01.2022
- Denial Management
- Claim Trend and Issue Resolution
- Analysis of claims for accuracy
Billing Associate
Elizabeth Wende Breast Care, LLC
02.2021 - 08.2021
- Billing and Credentialing
- Collections
Director- Credentialing
RADNET MANAGEMENT INC
11.2019 - 02.2021
- Direction of Credentialing Department for a 350 facility, 1000 Physician Radiology provider.
- Physician and Facility Credentialing including compliance, licensing and payor enrollment.
- Maintain data for Physician and Site Data tables within Imagine Billing Software and Echo One Credentialing Application.
- New facility setup including enrollment and EDI.
Manager- Billing and Credentialing
RADNET MANAGEMENT INC
06.2016 - 11.2019
- Employee interviews, new hires, evaluations, teambuilding.
- Management of Physician holds and Claim releases associated with billing.
- Client support
- Reporting through Excel, One App and Imagine.
- Teleradiology enrollment.
Supervisor- Credentialing
RADNET MANAGEMENT INC
06.2015 - 06.2016
- Analysis and resolution of credentialing/ billing issues.
- Supervision of 11 staff.
- Team workflow and project management.
Credentialing Coordinator
RADNET MANAGEMENT INC
12.2013 - 06.2015
- Responsible for credentialing of east coast radiology practices
- Facility and Physician credentialing
- Re-credentialing and new enrollments.
- Analysis of billing holds and denials.
Billing Manager
Universal Health Network
04.2012 - 05.2013
- Management of accounts receivable for multi-specialty billing company
- Staff management of thirty full time staff including hiring, evaluation, and development
- Establish new client operations and reporting
- Reporting and development for Medicare incentive programs including Meaningful Use
- Development of reporting tools used in the automation and analysis of Revenue operations.
Billing Supervisor
Rochester General Hospital
01.2011 - 04.2012
- Supervision of 18 team members including productivity, evaluation, training and growth
- Operations and receivables management for MVP, Excellus and Commercial Payers, including Worker's Comp and No Fault
- Reduced receivables by seventy percent for the legacy system conversion
- Created productivity program which improved output as well as communication.
Billing Manager
Universal Health Network
10.2009 - 08.2010
- Management of all aspects of accounts receivable for NY medical oncology practice with annual revenues of $45 million dollars
- Personnel management of seven full time staff including hiring, evaluation, and training.
- Development of reporting tools used in the automation and analysis of Revenue operations.
Owner
Maple City Billing
01.2002 - 01.2009
- Employee administration and management
- Consultant to independent Physician practices regarding front end operations and billing
- Development of monthly reports customized to the physician's need
- Radiology coding
- Supervision of all billing and collection processes.
Education
Bachelor's degree - English
State University of New York at Potsdam
Potsdam, NY05.1985
Skills
- Teleradiology
- Microsoft Excel
- Medical billing
- Revenue cycle management
- Accounts Receivable
- Epic
- Imagine Billing and Intelligence Software
- Analysis skills
- Project Management
- EDI
- One App Credentialing Software
Timeline
Provider Enrollment Account Manager
CompuGroup Medical
03.2022 - Current
Project Coordinator
RADNET MANAGEMENT INC
08.2021 - 01.2022
Billing Associate
Elizabeth Wende Breast Care, LLC
02.2021 - 08.2021
Director- Credentialing
RADNET MANAGEMENT INC
11.2019 - 02.2021
Manager- Billing and Credentialing
RADNET MANAGEMENT INC
06.2016 - 11.2019
Supervisor- Credentialing
RADNET MANAGEMENT INC
06.2015 - 06.2016
Credentialing Coordinator
RADNET MANAGEMENT INC
12.2013 - 06.2015
Billing Manager
Universal Health Network
04.2012 - 05.2013
Billing Supervisor
Rochester General Hospital
01.2011 - 04.2012
Billing Manager
Universal Health Network
10.2009 - 08.2010
Owner
Maple City Billing
01.2002 - 01.2009
Bachelor's degree - English
State University of New York at Potsdam
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