Shonte Perry

Oversee a team of 30+ employees 100% remote (includes international partners); Manages the daily activities of insurance verification and authorization functions for targeted drug delivery for the clinic and home setting.

• Assists SR Financial Services Director with monitoring adherence to policies and procedures and performing audits as designated.

• Monitors and evaluates intake employees' productivity and performance to ensure alignment with department goals.

• Trains new and existing employees and conducts ongoing training and skills assessments as necessary.

• Works with across departments to manage the entire process of verification/authorization, billing to final collection.

• Ensures work assignments are processed within SLA's.

• Develops, monitors, coaches and manages staff, ensuring the development of employees through orientation, training establishing objectives, communication of rules, constructive discipline.

• Builds employee morale, motivation and loyalty and fosters a team-like environment.

• Recognizes patients' rights and responsibilities and supports them in the performance of job duties, respects patient's rights to privacy and confidentiality.

• Maintains a thorough understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.

• Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.

· Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources.

· Provide assistance to members and/or providers regarding website registration and navigation.

· Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application.

· Process written customer correspondence and provide the appropriate level of timely follow-up.

· May coordinate member transportation and make referrals to other departments as appropriate.

· Maintain performance and quality standards based on established call center metrics including turn-around times.

· Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment.

Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction

· Responsible for accurately registering inpatients, outpatients, and/or ER patients in the EMR, including validating patient information, verification of insurance coverage, calculation of and collection of patient co-insurance/deductibles/co-pays, authorization for services, and balancing of cash.

· Ensures the patient's experience is best in class and demonstrates effective communication skills with patients and families’ physicians, nurses, and insurance companies.

Abreast & knowledgeable of and compliant with federal and state regulations related to acute-care patient registration

· Perform posting charges.

· Perform completion of claims to payers

· Conduct duties in a professional and timely fashion.

· Submit billing data to the appropriate insurance providers.

· Process claims.

· Resolve denial instances.

· Achieve maximum reimbursement for services provided.

· Deploy, maintain and report on various programs.

· Do Medicare reviews.

· Do Medi-Cal reviews

. Conduct audits