Stacy Kissinger
Summary
Neurology, Immunology, and Rheumatology experienced. Field Reimbursement Manager with over 10 years of experience in reimbursement support of IVIG and biologicals. Excellent reputation for resolving problems, improving customer satisfaction, and driving overall operational improvements. Quality-driven Reimbursement Manager with exemplary skills in supervising a talented team and providing required training. Meticulous professional accurately reviewing patient accounts and assisting with issue resolution.
Overview
25
25
years of professional experience
Work History
Field Reimbursement Manager
America's Choice Billing Services
10.2000 - Current
- Interface appropriately with insurance administrators, physicians' offices, patients, and internal personnel.
- Reimbursement Support Services, Benefit Verifications, Prior Authorizations, Appeals Assistance, and Quality Assurance.
- Reviewing patient insurance benefit options. Validating prior authorization requirements identifying alternate funding/financial assistance programs
- Reviewing appropriate billing and coding for products. Assisting with resolving reimbursement issues
- Educating physician office staff on the use of the client’s patient assistance and reimbursement support services including web-based provider programs. Providing information on relevant reimbursement topics related to client’s products
- Billing and Coding Support; Patient Assistance and Drug Replacement. Assistance in locating coverage for uninsured and underinsured patients, Free Drug Programs,
- Responsible for driving accuracy and quality assurance, compliance with all established policies and procedures, and sound documentation for all activities.
- Operated with high integrity, built trust, and earned sustained credibility with internal and external clientele
- Checks quality cases built by other associates to ensure the highest level of quality.
- Buy and Bill Reimbursement Support
- Developed strong relationships with insurance companies and healthcare providers, fostering collaboration and ensuring smooth communication for reimbursement matters.
- Improved patient satisfaction by ensuring timely and accurate reimbursements for their medical expenses.
- Facilitated cross-functional meetings to discuss the impact of policy changes on the reimbursement process, ensuring clear understanding among all stakeholders.
- Conducted regular audits of reimbursement activities, identifying areas for improvement and implementing corrective actions as needed.
- Maintained up-to-date knowledge on national healthcare policies affecting reimbursements, advising senior leadership on necessary adjustments or updates to internal processes accordingly.
- Streamlined communication between departments involved in the reimbursement process, fostering collaboration and accuracy.
- Analyzed data to identify patterns and opportunities for improvement within the reimbursement process.
- Reduced errors in reimbursement claims through rigorous attention to detail and thorough documentation.
- Managed a team of reimbursement specialists, providing guidance and support for optimal performance.
- Implemented new software solutions to automate aspects of the reimbursement workflow, increasing overall productivity.
- Increased efficiency in the reimbursement process by implementing streamlined procedures and guidelines.
- Held weekly staff meetings and implemented team building exercises, which promoted positive working environment.
- Monitored accounts receivables by reviewing payor account listings.
- Provided exceptional customer service when addressing patient inquiries about their reimbursements, resolving issues promptly and professionally.
- Collaborated with insurance providers to clarify requirements and ensure proper submission of claims for faster processing times.
- Observed strict data confidentiality procedures to protect patients' information.
- Monitored industry trends and regulatory changes to stay current on best practices for reimbursement management.
- Worked closely with finance department to address discrepancies or concerns related to payment collection from insurance companies or patients directly.
- Created documents in accordance with payer guidelines and submitted to appropriate parties.
- Compiled department-specific reports to help senior managers identify trends and improve progress.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Built proactive, client-specific edits into system to prevent future denials.
- Billed and collected for claims submitted on clients' behalf with sales totaling $5,000,000 monthly.
- Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Monitored and documented accounts receivable trends and account-specific profitability.
- Helped minimize escalations by reaching out to clients in advance of expected problems.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
Skills
- Healthcare billing experience
- Medicare Part B and Commercial payer knowledge
- HIPAA compliance
- Claims management
- Self-motivated
- Utilization review
- Process implementation
- Claims investigation and research
- Insurance verification
- Written and verbal communication
- Revenue cycle management
- Client account management
- Payment posting
- Strong written and verbal communication skills
- Works well independently
- Effective at multi-tasking
- Provider relations
- Billing and collections procedures
- Understanding of miscellaneous J-Code and Q-code billing
- Effective customer communication
- Buy and Bill experience in all healthcare settings
- Denial resolution
- Medicare
- HCPCS coding
- Reimbursement strategies
- Microsoft office
- ICD-10 coding
- Policy analysis
- Eligibility verification
- Copay collection
- Problem-solving abilities
- Time management
- Multitasking
- Excellent communication
- Task prioritization
- Performance management
- Goal setting
- Data analysis
- Project management
Timeline
Field Reimbursement Manager
America's Choice Billing Services
10.2000 - Current
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