Summary
Overview
Work History
Skills
Additional information
Timeline
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Tiffanie Gerkman

Kanab,UT

Summary

Healthcare professional with comprehensive background in managing healthcare practices and delivering operational excellence. Known for fostering collaborative work environments and achieving high standards of patient care. Adaptable to changing needs and consistently reliable, excel in administrative duties, staff management, and regulatory compliance. Forward-thinking professional bringing more than 15 years of experience working for fast-paced physician practices. Exceptional success driving financial improvements and revenue increases for specialty practices.

Overview

23
23
years of professional experience

Work History

Practice Administrator

SOFI Research, LLC
10.2017 - Current
  • Practice administration and full cycle revenue management for a 4 provider surgical practice. All aspects of revenue cycle management from beginning to end. Hiring and development of new employees. Creation and auditing of SOP's, handbooks, forms and paperwork. Malpractice and business insurance policy management, health benefits procurement and auditing, contracting, full credentialing including but not limited to facility, insurance and provider. CAQH, NPPES, PECOS and Medicare enrollment and credentialing. Phone systems, hardware, software, device installation and upkeep. Payroll bi weekly, quickbooks reconciliation, accounts payable and receivables. All things required to start up and expand a growing medical practice.
  • Developed and implemented administrative procedures, enhancing workflow efficiency across departments.
  • Coordinated communication between stakeholders, facilitating effective collaboration and project updates.
  • Oversaw budget management for research projects, optimizing resource allocation and cost control measures.
  • Trained new administrative staff on company policies and operational systems, fostering a knowledgeable team environment.
  • Streamlined data collection processes using electronic health record systems to improve accuracy and accessibility of information.
  • Oversaw daily practice operations to guarantee seamless service delivery for patients and providers alike.
  • Managed financial aspects of the practice, including budgeting, billing, and insurance claims processing.
  • Fostered a positive work culture by promoting open communication, teamwork, and professional development opportunities among staff members.
  • Ensured compliance with industry regulations and best practices to maintain a safe and efficient work environment.

Owner

Practical Billing Solutions
03.2012 - 05.2020
  • Operations and billing consultation company with full revenue cycle management. Oversaw daily medical billing of three long term clients. Contracted as a Practice Consultant for multiple clinics including the largest Behavioral Health Clinic in Alaska.
  • Responsible for negotiating, completing and submission of all contracts with insurance companies. Also included renegotiation and re-credentialing for providers.
  • Credentialing and enrollment of providers, facilities and insurances for all major commercial payers, Medicare, Medicaid. Also managed PECOS, NPPES, CAQH and other credentialing databases for multiple locations.
  • Maintained compliance in areas such as progress note creation and updates.
  • Training of providers and staff all aspects of EHR and Practice Management software to include: Data entry of demographics, scheduling, insurance company creation, clearing house claims submission and maintenance, progress note, intake and treatment plan builds in accordance with CMS/Medicaid compliance, scanning and organization of documents, additional task management.
  • Consulted with large clinics on overall clinic efficiency and made recommendations to bring billing in house. Trained staff and set up Practice Management software (KAREO). Restructured clinic production module for providers. Wrote policies and procedures and trained staff and providers on compliance for the large federal entities ie: Medicaid, Medicare, HIPPA and Tricare. Assisted clinic in providing medical documentation and processes during a large scale Premera Blue Cross Blue Shield Audit.
  • Posted all charges and payments for insurance companies including both manual and electronic posting of EOBs and ERAs.
  • Verified insurance benefits and alerted staff and providers to any plan limitations or authorization requirements.
  • Set up payment plans and answered patient inquiries.
  • Merged 2 individual providers into a single practice and credentialed additional providers under the new clinic tax id and group NPI numbers.
  • Helped clinics with Marketing Strategies for new referral sources.

Practice Manager

Fuller Diagnostics, LLC
02.2010 - 06.2016
  • Oversaw daily medical office operations of a five provider multi-specialty clinic. The office was composed of two Neuropsychologists and three Licensed Clinical Social Workers. There was a staff including providers of over 12. Responsibilities included Administrative, Billing, Personnel Issues, Contracting both providers and insurances, Human Resources, Payroll, Accounts Payable, Marketing, Scheduling, IT support and integration.
  • Responsible for negotiating, completing, renegotiations and re-credentialing for both insurance contracts and Hospital Privileges.
  • Maintained compliance in areas of HIPPA, OSHA, Medicaid and Medicare regulations.
  • Prepared and distributed Payroll in addition to preparing information for contract providers 1099 yearly.
  • Post all charges and payments from insurance companies. Resubmission and Appeals of denied claims.
  • Full Revenue Cycle Management.
  • Oversaw inventory and Purchases of all office equipment and supplies
  • Full Accounts Payable to vendors, licensing boards, etc.
  • Benefit verification and Eligibility requests.
  • Full Marketing for practice including website maintenance.
  • Coordinated communication between departments, improving collaboration and workflow efficiency.
  • Ordered all office supplies and kept check on inventory levels.
  • Facilitated communication between staff members, fostering a collaborative work environment that improved overall team performance.

Billing Supervisor

Ophthalmic Associates, LLC
08.2009 - 02.2011
  • Hired to restructure billing department and ensure process and policies were efficient and billers were capturing maximum reimbursement. Worked directly with six Ophthalmologists to ensure charges and reimbursements were correct and providers were being paid correctly on clinics production module. Made recommendations to senior management and owners about improvements and implemented new processes and procedures.
  • Created streamlined process to move all paper EOBS to electronic format which made secondary billing 3 times more efficient and less time consuming.
  • Worked with staff on processes and cleanup of old A/R, captured 82% of outstanding 120+ AR within 4 months.
  • Ensured coding was capturing all provider charges and documentation levels were correct with CPT and ICD9, adhered to medical policies to ensure maximum reimbursement
  • Full credentialing, re credentialing and enrollment of new and existing providers.
  • Streamlined payment posting and charge entry.
  • Worked to build a team environment and improve overall staff moral
  • Supervised billing team to ensure accurate and timely processing of patient accounts
  • Implemented billing procedures that enhanced operational efficiency and reduced errors
  • Conducted regular audits of billing processes to maintain accuracy and adherence to regulations
  • Collaborated with clinical teams to resolve discrepancies in patient billing inquiries

Practice Manager

Providence Behavioral Medicine Group
01.2003 - 08.2008
  • Practice Manager of all outpatient behavioral clinics for Anchorage and Valley locations. All aspects of practice Management for multiple locations and staff of over 40 employees and providers. Also worked to create new specialty clinic and helped integrate concussion based testing into over 20 schools within the state. The testing later went on to become a required regulation for all athletes in 7th grade through 12th in the State of Alaska.
  • Oversaw daily practice operations, ensuring adherence to policies and procedures.
  • Developed and implemented efficient scheduling systems, enhancing staff productivity.
  • Collaborated with healthcare teams to streamline patient flow and improve service delivery.
  • Managed budget allocations, optimizing resource utilization for maximum operational efficiency.
  • Trained and mentored new staff, fostering a supportive work environment.
  • Analyzed performance metrics to identify areas for improvement in service quality.
  • Led strategic initiatives to enhance patient satisfaction and engagement levels.
  • Addressed patient concerns promptly and professionally, demonstrating empathy and excellent problem-solving skills.
  • Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.

Skills

  • HIPAA compliance
  • Operations management
  • Scheduling coordination
  • Patient communication
  • Patient relations
  • Revenue cycle management
  • Medical billing
  • Human resources management
  • Credentialing management
  • Electronic health records
  • Schedule management
  • Practice management
  • Records management

Additional information

  • Software Proficiencies
  • Kareo EHR and Practice Management Lytec Billing Software Office Alley Office Hours EPIC AdvancedMD Multiple McKesson products NextGEN MedEase Full Microsoft Office Practice Fusion

Timeline

Practice Administrator

SOFI Research, LLC
10.2017 - Current

Owner

Practical Billing Solutions
03.2012 - 05.2020

Practice Manager

Fuller Diagnostics, LLC
02.2010 - 06.2016

Billing Supervisor

Ophthalmic Associates, LLC
08.2009 - 02.2011

Practice Manager

Providence Behavioral Medicine Group
01.2003 - 08.2008

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Tiffanie Gerkman