Michelle W

Registered patients for emergency care, accurately entering demographic and insurance information while collecting copays. Verified insurance, completed quick and full registrations, and provided comprehensive wayfinding assistance. Delivered exceptional customer service, managed high-volume telephone inquiries, and adhered to strict HIPAA privacy guidelines.

Led a team of 6 analysts, ensuring accurate and timely provider data entry and maintenance for Medicare and Medicaid, which optimized claims payment and member assignment. Investigated and resolved complex provider data management issues. Trained and mentored Provider Data Management Analysts and Team Leads.

Served as team lead for Medicare/Medicaid daily operations, ensuring providers were accurately loaded based on contract specifications and business rules. Managed statewide provider cases and accounts to assure proper credentialing, contract, and billing information. Trained and assisted team members while managing the team's workflow and distribution.

Streamlined physician enrollment processes, adhering to regulatory requirements. Rectified enrollment edits and denials promptly, positively impacting billing and claims processing. Identified trends while reviewing denials and claims work queues, contributing to process improvements.

Analyzed and resolved governmental and non-governmental insurance credits due to overpayments on patient accounts, ensuring compliance with payer regulations. Investigated billing issues, researched delinquent accounts, and resolved bad debt accounts, contributing to improved revenue cycle performance. Trained new staff in daily operations of all credit functions.

Verified data entered in the computer by reviewing printouts for errors and correcting as needed, performing statistical checks to ascertain data accuracy. Collaborated with other revenue cycle departments to resolve complex issues and meet departmental needs. Maintained high standards of data integrity.

Performed clerical duties including data entry, compiling, sorting, and filing, copying, completing, and transporting confidential information. Managed calls, sorted, and distributed incoming and outgoing mail and documents. Resolved discrepancies in records and served as back-up receptionist for Self-Pay Collections.

Completed coursework focusing on the intersection of business and technology. Gained expertise in managing information systems to support organizational objectives.