Gerard Simon

Coordinated custom and retail orders, managed production timelines, and developed quality control procedures to ensure product consistency.

Implemented workflow automations that accelerated response times and improved conversion of leads. Executed a lead-recovery initiative, auditing years of historical inquiries to re-engage missed opportunities and ensure 100% follow-up across the customer lifecycle. Managed complex customer escalations, maintaining a 96 NPS and streamlining account documentation to reduce resolution times.

Collaborated with regulators and managed care plans to secure licensing, fee structures, and billing workflows for Louisiana’s first pediatric mental health PHP. Secured Medicaid and commercial contracts for expanded services. Led quarterly QA audits, achieving perfect ABA audit scores. Implemented a new EHR and clearinghouse, developed training, and supported a multi-specialty team through launch

Managed administrative functions across two clinic locations, coordinating workflows and support for a second location entirely remotely. Analyzed provider and patient data to improve referral efficiency, patient satisfaction, and operational decision-making. Developed referral relationships with healthcare providers and community partners to support patient growth and strengthen market presence.

Resolved denied and unpaid insurance claims through payer research and follow-up with commercial and government insurers. Utilized Epic to manage accounts receivable work queues, document follow-up activities, and track claim status. Coordinated claim corrections, appeals, resubmissions, and record requests to support timely reimbursement and reduce outstanding accounts receivable.

Evaluated complex applicant data and documentation to make precise eligibility determinations across all Louisiana Medicaid programs in compliance with federal and state regulations. Supported implementation of the LaMEDS system through data cleanup, end-user training, and go-live support.

Provided leadership for daily store operations by directing team workflow, coaching partners, delegating responsibilities, and maintaining operational excellence through inventory and merchandising oversight.

Standardized the Eligibility Counselor role by streamlining case management workflows and screening. Conducted needs assessments to verify provider networks and prescription coverage, supporting plan selection and maximizing APTC. Coordinated with multidisciplinary teams to resolve barriers to care. Authored a Patient Access Handbook and trained staff on FQHC requirements.

Sustained community-based independence for high-risk participants by developing comprehensive care plans and coordinating interdisciplinary interventions to successfully prevent nursing facility placements.

Managed end-to-end revenue cycle operations, including insurance verification, patient registration, charge entry, claims submission, payment posting, and follow-up, while supporting daily practice operations.

Completed the Google IT Support Professional Certificate through Coursera.

Earned a Bachelor of Science in Psychology with a minor in Social Work at Louisiana State University A&M.