ERICA SATTERFIELD

• Performs detailed AR analysis and makes decisions and process flow changes based on financial analysis
• Tracks performance of metrics and identifies payor trends and variances and implements corrective action plans as needed
• Monitors and manages ongoing Revenue Cycle performance through use of key performance indicators
• Guides design, development and documentation of various internal system and billing process workflows from inception to implementation
• Analyzes billing effectiveness/ cash flow and making recommendations to increase productivity and profitability
• Leads development of vision for operations team and ensuring direct reports meets staff and organizational needs
• Works accounts from assigned area(s) to maximize reimbursement
• Educated 7 physicians, 5 clinicians, and 6 billing team members regarding changes in coding standards and regulations.
• Identified and resolved payment issues between patients and providers.
• Contacted responsible parties for past due debts.
• Identified and resolved payment issues between patients and providers
• Balanced and reconciled accounts
• Generated receivables reports and offered improvement recommendations
• Developed financial projections and forecasts to guide management decisions

• Directed provider coding and billing functions, including accurate invoicing of all client services and resolution of EPIC claim edits
• Manages Revenue Cycle for portfolio of clients across multiple specialties, practices, and facilities
• Monitored ongoing Revenue Cycle Performance through use of Key Performance indicators
• Managed coding staff at multiple sites to reduce errors that result in delayed reimbursement
• Conduct random internal audits and review activities to improve revenue cycle and coding integrity
• Monitored open encounters to develop and maintain work plan to reconcile charges
• Reviewed denial trends for documentation or charging issue opportunities
• Identified negative trends to determine root cause and potential improvements
• Conducted random internal audits and review activities to improve revenue cycle and coding integrity
• Provide tactical follow-up ensure proper payments were fully collected.
• Researched and resolved billing discrepancies to enable accurate billing.
• Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
• Verified accuracy of accounts payable payments, resulting in 95% reduction in payment errors and check reissues
• Created improved filing system to maintain secure client data
• Reconciled accounts receivable to general ledger
• Generated monthly billing and posting reports for management review
• Maintained accurate records of customer payments

Work accounts receivable for all commercial and government insurances

• Posting insurance payments making sure payments are posted properly
• Registering patient information and verifying insurance coverage
• Knowledge of PIP claims and workman’s’ compensation regulatory and procedural policies
• Print claims and submit claims electronic through clearing house
• Work clearinghouse and insurance rejected claims.
• Prepared and mailed invoices to customers, processed payments, and documented account updates.
• Utilized Microsoft Excel, QuickBooks and Oracle software to manage invoices and payments.
• Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
• Communicated with insurance providers to resolve denied claims and resubmitted
• Located errors and promptly refiled rejected claims
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
• Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy
• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers
• Precisely completed appropriate claims paperwork, documentation and system entry
• Prepared billing correspondence and maintained database to organize billing information
• Liaised between patients, insurance companies, and billing office
• Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts
• Maintained and updated collections tracking spreadsheet to help organize payment information

• Work closely with Medicare and commercials insurance companies to obtain payments and resolve claim issues
• Posting and reviewing insurance reimbursements for proper payments
• Used knowledge of coding systems to assign appropriate CPT, HCPCS, ICD-9-CM, ICD-10-CM and DRG codes
• Conduct research as required, document detailed results in written format and escalate issues as appropriate for higher level claim matters
• Issues request for refund for patients and insurance with credit balances
• Registering patient information and verifying insurance coverage
• Answer patient calls to resolve insurance and payments issues
• Obtaining prior authorization request for testing and injections
• Maintained strict confidentiality with all personal data as per company guidelines.
• Submitted alternate billing for clients belonging to special demographics using Chirotouch software portal, reconciled EOBs or denied claims and conducted accounts receivable follow-up.
• Determined key areas prime for process improvements.
• Reviewed full history of past due accounts and contacted client or attorney regarding collection, implementation of payment plan or pursuit of legal remedies on unpaid accounts.
• Evaluated aging reports to identify members to be included in monthly outbound collection calls.

• Work closely with Medicaid and commercials insurance companies to obtain payments and resolve claim issues
• Perform comprehensive medical records review to assure compliance with all official policies and standard procedures
• Conduct research as required, document detailed results in written format and escalate issues as appropriate for higher level claim matters
• Posting and reviewing insurance reimbursements for proper payments
• Issues request for refund for patients and insurance with credit balances
• Registering patient information and verifying insurance coverage
• Answer patient calls to resolve insurance and payments issues
• Obtaining prior authorization request for testing and injections
• Researched and resolved billing discrepancies to enable accurate billing.
• Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
• Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
• Worked with multiple departments to check proper billing information.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.
• Verified accuracy of accounts payable payments, resulting in 80% reduction in payment errors and check reissues
• Researched and resolved billing discrepancies to enable accurate billing
• Monitored customer accounts to identify and rectify billing issues
• Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments
• Worked with multiple departments to check proper billing information
• Identified, researched, and resolved billing variances to maintain system accuracy and currency
• Identified payment trends and adjusted billing processes accordingly to retain customers
• Generated monthly billing and posting reports for management review

• Work closely with insurances and commercials insurance companies to obtain payments and resolve claim issues
• Conduct research as required, document detailed results in written format and escalate issues as appropriate for higher level claim matters
• Posting and reviewing insurance reimbursements for proper payments
• Issues request for refund for patients and insurance with credit balances
• Registering patient information and verifying insurance coverage
• Answer patient calls to resolve insurance and payments issues
• Obtaining prior authorization request for testing and injections
• ACA provider relations and enrollment specialist| HP enterprises/Delaware Medicaid program
• Followed up overdue payments and payment plans from clients to establish good cash flow.
• Prepared and mailed invoices to customers, processed payments, and documented account updates.
• Generated monthly accounts receivable reports to submit developments for management review.

• Process applications for providers to become enrolled in Delaware Medicaid
• Follow state regulations and guidelines
• Interpret eligibility for Delaware Medicaid members
• Analyze provider claims and discuss why it denied or how it paid
• Answer incoming calls in professional manner
• Negotiated and renegotiated contracted with physicians/physicians’ group
• Assisted in credentialing and re-credentialing process to ensure provider's applications are correct and expedited
• Claim resolution
• Built and maintained professional relationships with providers to ensure provider satisfaction
• Secured and serviced contracts with large health care systems, clinics, and individual provider offices for network expansion
• Proofed, updated, and distributed provider directories
• Prepared and processed provider enrollments with Medicaid in multiple states.
• Monitored credentials and contacted practitioners when expiration dates were nearing.
• Assisted clients with completion of applications and paperwork.
• Communicated with people from various cultures and backgrounds on application process.
• Followed guidelines when reviewing applicant data to determine eligibility for economic assistance.