SHARON MOORE
Decatur,GA
Summary
Seasoned Revenue Cycle Manager with a proven track record in elevating medical billing efficiency and boosting revenue collections.
Overview
22
22
years of professional experience
Work History
Front Desk Receptionist/admissions PT
Decatur Center for Nursing and Healing
08.2023 - Current
- Greet and assist visitors, enhancing first impressions and streamlining admissions processes.
- Coordinate patient admissions, achieving seamless transitions and improving patient satisfaction.
- Manage front desk operations eff efficiently, ensuring smooth daily functioning and quick issue resolution.
Remote Medical Revenue Cycle Manager
Medical Billing Management Services LLC
02.2014 - 08.2023
- Managed a staff of 14; responsible for the accounts receivable of 4 clients totaling $15,000,000 in charges each month, including credentialing, denial management, and third-party follow-up.
- Analyzed the top denials for each client and identified solutions to increase cash and A/R days.
- Reduced average days in A/R from 79 to 30 in a 3-month time period.
- Increased net collections from 65% to 85%.
- Built collector work files, worked with the clearinghouse and the payers to ensure all claims were processed and received by the insurance companies in a timely manner.
- Reduced clearinghouse denials from 39% "BOMB" rate to 15% in a 6-month period of time.
- Maintained a strong relationship with all clients and presented trends to them on a monthly basis.
- Wrote policies and procedures for billing, collection, and posting, responsible for the charge-entry, payment-posting, and follow-up of one of our largest accounts which had a monthly charge capture upwards of 3 million dollars.
- Worked the denials and followed up with insurances via telephone, direct insurance sites, Availity, and CMS.
Medical Billing Financial Case Manager
Easter Seals
05.2012 - 01.2014
- Collections, follow-up, monthly provider reports, monthly closing of each provider account.
- Provider and patient services, credentialing, provider information implementation into database.
- Contract billing for the state of Connecticut, commercial, HMO, PPO, Medicare, Medicaid.
Medical Billing Coordinator
Advanced Medical Billing Associates
07.2009 - 05.2012
- Managed 7 specialties in the following areas: surgery, infectious disease, cardiology, diabetes and endocrinology, geriatrics, pulmonary medicine, department of medicine.
- Patient registration, charge entry, payment posting, accounts receivable, SNF billing, DME billing, follow-up, eligibility and insurance verification, evaluating E/M services for compatibility and level, corrections, billed and rebilled, provider services.
- Implemented training for new recruits, worked with all commercial plans, Medicare and Medicaid, HMO's PPO's, indemnity and managed care, IDX/GPMS billing system.
Medical Coding Manager/billing Supervisor
Community Health Services, Inc
01.2004 - 06.2009
- Supervised and managed 27 employees, responsibilities included: ICD-9 and CPT, J-codes, HCPC coding for clinic including pediatrics, adult medicine, women's health, podiatry, dental, optometry, mental health, and substance abuse.
- Reviewed medical records for completeness and to abstract and code clinical data, such as diseases, operations, procedures, and therapies, using standard classification systems.
- Chart audits, edited system library for updates, delegated and assisted in workload for payment application, account reconciliation, balancing, charge entry, special billing projects, accounts receivable, monitored account aging, created detailed reports, followed-up on accounts, and collections.
- Created training manuals for coding and protocol for providers and intake staff training for customer service, patient registration, and authorizations.
- Researched electronic errors and rejections reports, resolved issues and made corrections for all insurance carriers including Medicare.
- Generated electronic claims submission, claims printing, electronic claims reconciliation, input of insurances and payer organization ID numbers to create plan code numbers and electronic billing capabilities.
- Updated diagnoses, procedure codes, pricing, and revenue codes in EHS database.
- Assistant to the Director of Revenue Service and CFO, created system roll-up codes, month-end closing, monitored and completed quarterly forms for credit balance reporting for Medicare.
- Worked with HealthPro and EHS billing systems.
Education
Bachelor of Science - Healthcare Administration
Baker College Online
Flint, MI12.2013
Diploma - Administrative Medical Assistant
Fox Institute of Business-West Hartford
West Hartford, CT12.1993
Diploma - undefined
Connecticut Business Institute
East Hartford, CT12.1991
Diploma - General Equivalency Diploma
State of Connecticut Department of Education
Hartford, CT12.1987
Skills
- Medicaid
- Project Management
- Analysis Skills
- Workflow Optimization
- Revenue Cycle Management
- Performance Metrics
- Management
- Athenahealth
- Contracts
- Microsoft Suite
- Financial Analysis
- IVR
- Leadership
- Insurance verification
- Medicare
- Accounts Receivable
- Epic
- EDI
- Healthcare Management
- Medical Collection
- Communication Skills
- Account Reconciliation
- Practice Management
- EMR Systems
- Interviewing
- Cerner
- HCPCS
- ICD-10 and CPT
- HIPAA
- Budgeting
- Strategic Planning
- Succession Planning
- Time Management
- Team Management
- Insurance Verification
Work Type
Full TimeWork Location
RemoteOn-SiteHybridImportant To Me
Work from home option401k matchPersonal development programsFlexible work hoursWork-life balanceCareer advancementTimeline
Front Desk Receptionist/admissions PT
Decatur Center for Nursing and Healing
08.2023 - Current
Remote Medical Revenue Cycle Manager
Medical Billing Management Services LLC
02.2014 - 08.2023
Medical Billing Financial Case Manager
Easter Seals
05.2012 - 01.2014
Medical Billing Coordinator
Advanced Medical Billing Associates
07.2009 - 05.2012
Medical Coding Manager/billing Supervisor
Community Health Services, Inc
01.2004 - 06.2009
Bachelor of Science - Healthcare Administration
Baker College Online
Diploma - Administrative Medical Assistant
Fox Institute of Business-West Hartford
Diploma - undefined
Connecticut Business Institute
Diploma - General Equivalency Diploma
State of Connecticut Department of Education
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