Sordana R.
Revenue Cycle Leadership
- Role
- Reimbursement Supervisor at Public Consulting Group
- Location
- Boston, MA, US
- LinkedIn followers
- 500 followers
About Sordana R.
Healthcare revenue cycle leader with more than 25 years of progressive experience driving…
Experience
Reimbursement Supervisor
Feb 2022 — Present · US
Oversee remote staff and daily operations of Revenue Cycle. Responsible for interviews, hiring, training/coaching, and personnel matters. Experience with multiple temp agencies as well. Report on staffing metrics for merit and quarterly bonuses. Update and maintain policy and procedures as well as creation of Job Aids for staff. Streamline work processes/flows based on project needs. Utilize SQL, Excel and Tableau to analyze claim responses. Monitor and analyze rejections/denials for trends to identify individualized training opportunities and/or outreach to external stakeholders and client with the goal of improving overall acceptance rates. Handle escalated provider issues. Create blast email articles to assist providers, to provide clarity and guidance based on the trend of rejections. Utilize Microsoft Dynamics to assist the Call Center with cases opened by the providers. Work directly with X12 vendors to assist with file and claim rejections for providers. Assist with onboarding new providers providing training and resources. Assist with EDI testing, creation of testing templates, and maintaining a master listing of all testing done. Identify system issues and work with Developers to correct/mitigate issues and meet Service Level Agreements (SLA). Familiar with raw EDI files (837, 277, and 835). Maintain the adjudication matrix in the system, monitoring new CARC and RARC codes so they are routed appropriately according to billing guidelines. Maintain insurance, CPT, and ICD10 Master Code Value (MCV) tables within the system.Software utilized Trizetto, Change Healthcare, SQL, Notepad++, Workday, Ceridian, Lattice, PPM, Salesforce, Microsoft Dynamics, Teams
Education
CPC Certification
CPC
At Home Professionals
Billing Certification Completed
2000
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