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Brian Case

Payment Resolution Specialist

Information Technology and Services

Canton, MI

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Description

Feedback to departments Contract Management Training & Education on best practice . Worked with the multi prison system in Boston, MA and was successful in leading a team to payment adjudication on claims that were as old as four to five years from the date of service. Net receivables exceeded $750 ,000. . Worked with problem payers on special projects which created addition

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Skills

Professional Credentials

No Credentials

Experience

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Payment Resolution Specialist

Denials

06/2019 - 11/2020

Analyst working with Medicare and Medicare Advantage plans specifically with lack of authorization Denials and medical necessity issues.

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Senior Analyst

Denials

08/2014 - 05/2019

Hospital Business Office Analyst identifying financial opportunities with Medicare, Medicare Replacement Plans Part C, Medicaid, Medicaid

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Subject Matter Expert

UNIVERSITY OF MICHIGAN HEALTH SYSTEMS

06/2013 - 08/2014

claims and the re-billing of problem accounts

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Independent Financial Consultant

CASE CONSULTING

01/2004 - 12/2013

Re-designed and re-engineered Business Office functions within Patient Financial Services, identified trends to overcome Denials to maximize

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Healthcare Revenue Consultant

COAST to COAST CONSULTING LLC FRASIER HEALTHCARE CONSULTING

01/2000 - 12/2004

Consulted with Home Care Facilities, Hospice Billing Operations, Hospital Business office for I/P and O/P billing guidelines and revenue r

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Business Office Manager

MICHIGAN VISITING NURSES

01/1997 - 12/2000

. Supervised registration, data entry, benefit enrollment, billing, collections, cash posting, appeals, obtaining physician orders for

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Reimbursement Coordinator

ARBOR HOSPICE PERSONALIZED NURSING SERVICE

01/1994 - 12/1997

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Reimbursement Specialist

ARBOR HOSPICE PERSONALIZED NURSING SERVICE

01/1991 - 12/1994

. Performed registration, data entry, billing, collections, payment posting, Medicare credit balance reports, Nursing Home Hospice bed

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Education

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Bachelor of Arts - BA

Eastern Michigan University

0 - 1990

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