Susan Green

Requirements:

Duties/Responsibilities:

• Executed front office registration duties, including collecting patient demographic information, inputting insurance details, verifying benefits, and obtaining signatures on ER consent forms to ensure accurate patient data entry.
• Enters all patient information into the EHR and billing software and completes the records by scanning all signed documents and medical reports in patient files.
• Organized and filed patient records in compliance with DSHS guidelines to support efficient retrieval and management of patient information.
• Provides medical records to other providers as requested; upon completion of authorization to release information signed by the patient.
• Logged payments and cash receipts through Square while accurately maintaining cash drawer during shift to ensure financial accountability.
• Maintains accurate records for the billing office through the payment log regarding TOS payments and payer information.

Required Skills/Abilities.

• Basic knowledge of medical terminology.
• Excellent active listening skills and a strong service orientation.
• Basic computer knowledge.
• Detail and multitask-oriented.
• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.
• All employees of Ally comply with privacy and security laws and internal policies and procedures. They play an active role in protecting the company's sensitive data and treat patients' information with the utmost care and confidence. Report any concerns or infractions to ensure the company addresses them appropriately.
• Protected the credentials provided to access Company (and customer, where applicable) networks, systems, and data.
• Maintained the confidentiality of all Ally and customer data accessed. Reported any suspected compromises of Ally proprietary data or customer data to Management immediately.
• Adhered to the Company’s Information Security Policy and Procedures while supporting standard operating procedures to protect Company systems and data.
• Alerted management immediately about any expected system or data compromises and/or system failures impacting the security, confidentiality, availability, and integrity of Ally Medical and customer data.
• Participated in annual Information Security Awareness Training to ensure compliance.

• Supervises the daily business functions of the patient visit from point of entry to accurate adjudication of the patients' accounts. Scope of responsibilities includes appointment scheduling, insurance eligibility processes; charge processing; claim submission and processing; payment processing; collections and accounts receivable management; denial management; reporting of results and analysis; concurrent and retrospective auditing; proper coding; credentialing; customer services relative to revenue cycle; training and development relative to revenue cycle; analytics, and all other revenue cycle management activities. Resolves escalated and unique revenue cycle issues.
• Monthly, prepares revenue cycle financial analysis, including aged accounts. Monitors and assesses business metrics in order to refine processes and improve Guides individuals and teams toward priorities; clarifies roles and responsibilities of others; coordinates resources to meet objectives. Cascades goals down to staff's annual objectives.
• Championed new initiatives, acted as a catalyst for change, and managed effective implementation of changes. Addressed difficult issues by taking ownership and accountability.
• Developed and maintained revenue cycle training materials; conducted training on SOPs, systems, metrics, and government regulations to ensure compliance and competency.
• Audited staff work to ensure compliance with quality standards, deadlines, and the Practices Standard Operating Procedures (SOPs).
• Executed tasks to align with team objectives and support overall revenue cycle management.
• Coordinated front office duties, including scheduling, check-in, and collection of co-pay and co-insurance.
• Interviewed candidates, recommended hires, assessed performance, and suggested salary changes, while enforcing adherence to the Practice's and US Oncology policies.

• Reviews and appeals unpaid and denied claims
• Attaches appropriate documents to appeal letters
• Researches and evaluates insurance payments and correspondence for accuracy
• Logged appeals and grievances, tracking progress to ensure timely resolution of claims
• Maintained up-to-date reports, noting trends in insurance denials to inform corrective actions
• Calls insurance companies to inquire about claims, refund requests and payments
• Manages Accounts Receivable reports for the Billing Department
• Utilizes EMR system to submit and correct claims
• Posts patient and insurance payments
• Answers patient billing questions
• Coordinates medical and billing records payments with patients and/or third-party payers
• Handles collections on unpaid accounts
• Identified and resolved patient billing complaints, enhancing patient satisfaction and trust
• Answers phone calls to the Billing Department in a timely and professional manner
• Processes credit card payments over the phone and in person
• Serves and protects the practice by adhering to professional standards, policies and procedures, federal, state, and local requirements
• Enhances practice reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
• Adheres to Advanced Pain Care’s Policies and procedures
• Executed additional tasks to support team objectives

• Works closely with various vendor operations teams (Prior authorization, Claims and Appeals) to oversee operations activity that directly impacts the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
• Tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
• Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
• By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
• Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
• Develops goals and metrics to link department and revenue cycle initiatives with the organization's strategy.
• Develops, manages and monitors successful completion of implementation and project plans.
• Created workflows and tracking systems for the designated revenue cycle function.
• Provided expertise and support for designated revenue cycle function, enhancing team knowledge and effectiveness