Joy Eneliko

Managed front-office operations, ensuring daily schedule capacity of 85–90% full and maintaining 80–103 patient appointments scheduled per day. Coordinated patient onboarding, RX and authorization compliance, and staff performance reviews while creating SOPs and implementing improved workflows.

Oversee 7 lines of business and manage 70+ staff with operational oversight of 160+ staff allocations. Delivered monthly executive reporting on payer behavior, collections, adjustments, productivity, quality, and AR aging while leading client and leadership meetings to drive KPI performance and workflow alignment.

Supervised daily operations for a 20-member revenue cycle team, increasing collections through proactive denial resolution and one-touch workflow strategies. Conducted deep inventory audits to identify root causes and partnered with clients on corrective actions to improve productivity and performance expectations.

Resolved government and commercial insurance denials by submitting claim corrections via Epic, Waystar, Change Healthcare, and payer portals. Authored detailed reconsiderations and appeals for authorization denials, medical necessity issues, and underpayments, and analyzed reimbursement variances to determine payer accuracy versus patient responsibility.

Collected secondary and tertiary balances while ensuring full reimbursement through denial reconciliations, claim resubmissions, and recoupment/bad debt adjustments. Verified eligibility, supported HIPAA- and payer-guideline compliance, and assisted with special AR clean-up projects.

Managed Medicare crossover billing and collections, handling claim status, eligibility verification, appeals, capitation, and CIF. Posted payments and contractual adjustments, managed self-pay and after-insurance collections, and responded to patient and insurance inquiries.