Cherise Randle

Lead A/R clean-up initiatives to reduce DSO and outstanding balances, manage a team of 16, and oversee the full A/R portfolio in Zirmed with emphasis on Medicaid and government payers.

Led an A/R Specialist team, managed the full A/R portfolio in Zirmed, met corporate cash and DSO goals, and collaborated across departments to improve revenue cycle processes.

Led a reimbursement team, increased patient accounts resolved within 60 days from 51% to 80%, and exceeded prior authorization goals, setting department records.

Managed retrieval of medical-necessity documentation, educated customers on payer criteria, and processed authorization approvals and denials in compliance with payer rules.

Obtained authorizations for high-dollar DME, conducted peer-to-peer reviews, negotiated pricing for Letters of Agreement, and trained staff on Medicare guidelines and coding.

Submitted CMS-1500 claims, followed up on claim status, worked reviews and appeals, and resolved payer issues while training new hires.

Processed UB-04 and CMS-1500 claims for third-party, Medicare, and Medicaid payers, and managed appeals, denial follow-up, payment posting, and A/R aging.

Verified insurance coverage and patient financial responsibility, collected co-payments, and resolved complex patient financial situations under Allina financial policies.

Supported nurses in the care of critically ill children, coordinated unit communication, transcribed medical orders, and processed admissions, discharges, and transfers.

Property Management Certification from Hennepin Technical College.

Associate Degree in Business Administration with a focus on Administrative Accounting.

Nursing Assistant and Home Health Aide Certification from Hennepin Technical College.