Susan Booth

Current responsibilities are but not limited to are:

• Charge Capture for the Emergency Room entails running and maintaining daily ED admissions and discharges.
• Reviewing the EMR to ensure all procedures performed and are properly documented by the provider are captured and charged, ensure medical necessity for Hydrations, that Infusions and Injections are identified with the proper hierarchy to ensure appropriate reimbursement from the Health Plans billed for services.
• Charge Capture for department servicing prison inmates with contracting providers.
• Run reports to create DNFB for Revenue Cycle and for RCI for several facilities and distribute to other staff for review.
• Report the ED Volume count distinguishing between IP, OBSV, and Discharges to CFO and Cerner Special Project Associate as well as department Manager.
• I have in the past, assisted with Medicare ADR's downloaded from Medicare Noridian web Portal or by requests received via paper notifications from Medicare by gathering documentation. Contacted ordering provider for supporting documentation.

• I was provided with Leadership Training by Cerner that included ongoing education via ULearn.
• Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
• Monitored workflow to improve employee time management and increase productivity and or address inefficiencies.
• Evaluated employee performance and coached and trained to improve weak areas.
• Routine meetings with associates to keep informed of any changes related with Government Providers, ie; Medicare and Medi-Cal for Billing and Follow-up.
• Assisted with review and intra-department communication of reports for DNFB and Bill Holds to monitor and reduce unbilled services. Focus was given to Denials, review to identify any issues that
• Part of my tasks included analyzing reports to find opportunities for improved collection and balance resolution to eliminate delay.
• WorkQueue's in RCI - Monitored associates to ensure productivity and focus given to high dollar accounts to resolve issues timely. I was also responsible for working in multiple WorkQueue's for appropriate action required to move the account forward to resolution.
• Medicare Credit Balance Reports working with Senior Accountant/Finance. Reports, documenting, maintaining supporting documentation.
• Zero Pay Zero Balance Reports.
• Bill Hold Reports.
• Supervisor Refund Resolution Self Pay Queue to review and approve Patient Refunds.
• DNFB reports, pivot, review and report to departments that need to make corrections to allow holds to be removed.
• KIR
• Safe's for Associates
• Quarterly Reported to the Maddy Fund (EMS) Volume of ED visits and the hospital would benefit financially for this completed data/reporting.
• Reviewed and approved time cards and PTO for Team.
• Worked with AH Corporate, Huron, and Cerner Teams meeting with Director to maintain compliance, objective and decision making that would affect our department and associates.
• Support to Director and Manager in every possible way.

• I completed Leadership Development sponsored by AHBD in 2017 Cerification
• Trained new team members by relaying information on company procedures and safety requirements.
• Coached team members in techniques necessary to complete job tasks.
• Assisted with research of government entities for updated Fee Schedules, billing regulations, and guidance to communicate with staff and other departments based on necessity. Maintained files and distribute bulletins and resources to Director and staff.
• Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills. Provide assistants to associates with resolving billing and or follow-up problems.
• DNFB Reports
• Denial Reports
• Medicare Credit Balance Reports Including yearly reporting completing of the required forms and formatting for Finance to complete their Medicare Reporting.
• Medicare Bad Debt Reporting
• EMS Maddy Funds for Kern County
• KIR
• Multiple Work Queue's, both working and monitoring
• Worked closely with Registration, Case Management, and HIM to maintain positive working relationships and communication to ensure more timely, positive outcomes and reimbursement.
• Worked with HURON and Cerner consultants to implement new products, workflows and educate the staff
• Point of contact with Patient Financial Services for Finance/Accounting Corporate Auditors
• Experience in MS4, SSI BIlling Software, MediAnalytics, HealtheAnalyics

• Prepared, reviewed and submitted billing claim forms for both facility and contracted providers. Delivered timely and accurate charge submissions.
• Verified Medicare and secondary insurance coverage.
• Communicated with Health Plans to resolve denied claims and resubmitted.
• Adhered to established standards to safeguard patients' health information
• Analyzed Explanation of Benefits (Remittance Advice) forms to verify correct reimbursement, change to follow-up or secondary Health Plan, prepare secondary billing,
• Responded to customer concerns and questions on daily basis. Negotiated self pay payments schedules with customers.
• Review of Medicare Credits, file a report quarterly Medicare Credit Balance reports for Noridian Medicare. Requirement for Compliance in the Medicare program.
• Maintain Medicare Bad Debt preparing CMS spreadsheets and present to AH Finance that is used for yearly Cost Reporting
• Research of Bulletins, Change Requests, Transmittals to ensure our Government Billing Team and I were thorough and compliant.

Experience with: MS4, SSI (Billing Software), Rev Works-RCI Patient Accounting, Power Chart.

Familiar with CPT codes, ICD10 Dx and Procedure Codes

Excel

Word