Margaret Caruso
VP Payer Revenue Cycle & Market Development Director @Evolent
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WORK HISTORY
VP Payer Revenue Cycle & Market Development Director @Evolent
1/2014-Present- Market Development Sales Team• Serve as an operational contact with assigned health plan clients. • Participate in development of health plan-focused business plan development and implementation with Client Development leadership• Deliver required reporting, support meeting material development and participate in quarterly meetings with heatlh plan clients to address business needs and demonstrate IPG value.• Establish and maintain sustainable relationships with ambulatory surgical center administration, doctors and medical device representatives in territory. • Attend and participate in sales meetings, training, conventions, and trade shows.• Work closely with Customer Interface Managers and Operations leadership to ensure ambulatory surgery centers are implemented and managed with excellence.• Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks.• Demonstrates high level of professional qualities and disposition that commands attention and respect from all levels of management. 12/2010-1/2014-Billing and Collections Manager Implementation of EDI claim and EFT remits, Creating standard operation procedures, calculating revenue and generating revenue cycle management reports, Manage escalated patient and surgery partner issues, to include quality reviewsPosting patient payments, adjustments and write-offs.Validates denial reasons generate appeal based on dispute reason and contract terms, review authorization denial. Determine whether appeal requires a clinical reviewHandle all department HR duties to include payroll, scheduling and training for the billing staff.
EDUCATION
Professional Career Center
Medical Assistant
SKILLS
ABOUT MARGARET CARUSO
Objective:Results oriented individual with 20+ years’ experience in the medical…
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