Description
Professional Summary Mission is to facilitate resolution of healthcare policies and the resulting issues through my experience and education in healthcare administration and law. Admitted to Practice * Illinois Bar 2013 Missouri Bar 2012 Focus Areas Experienced with Medical terms and coding (CPT, HCPCS, ICD, CMG). * Medicare and Medicaid compliance, audits, policies and revenue cycle management. * Contract Negotiation. * Policy and Policy Analysis * Legal Writing and Research Summary: Researched and drafted petitions, FOIA requests, subpoenas, interrogatories, motions for summary judgments, and appellate briefs for the MO Court of Appeals and the US Court of Appeals for the 8th Circuit. * Discovered clause in provider contract allowing price undercutting which nullified chiropractic group's claim and forced dissolution. Supervisor - Medical Billing Surgical Care Affiliates - Santee, CA January 2008 to August 2010 Summary: Led team tasked with billing claims for all Ambulatory Surgical Centers across the country that were failing accounts receivable goals. * Initiated company-wide review of provider contracts to ensure full reimbursement. * Audited collection reports, identified proper procedure codes and implemented improvements that cut accounts receivable days in half. Patient Accounts Representative - Government Programs Summary: Combined duties of biller and collector appealed and cleared Medicare and Medicaid aged accounts. * Learned Medicare and Medicaid billing practices for rehabilitation hospitals (CMG codes). * Specialized in complex aged accounts. Medicare Specialist Summary: Managed accounts that were approaching Center for Medicare and Medicaid Services' filing deadline and monitored the claims until all reimbursements were realized, including secondary insurance. * Audited and reduced the credit balance of Medicare accounts by over $8 million during a three month-long solo project. * Specialized in "problem accounts" requiring splitting and/or bundling of claim (s).
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