Susan Caruso

Work with providers and administration regarding continued documentation and coding support

Manage reports for adminitrator related to provider compensation, specialty referrals, process improvement opportunities.

Assist department directors and managers correct work flow issues

Manage specialty HMO claims work flow

Responsible for daily outpatient, inpatient, nursing home and surgery center professional, facility and PET and CT scan and general radiology and lab services charge coding, charge entry and audit functions for 27 specialties, 137 providers.

Provider and staff coding education

Implemented a provider documentation review program to improve documentation to support service and reduce audit and pay-back risk, the program was implemented corporate wide Improved charge capture and data entry accuracy during my tenure as well as transitioned staff and providers to EMR systems.

Payer communications, set up and credentialing

Insurance claims and denials, government, commercial and managed care payers.

Patient billing

Front desk functions

Supervision of 29 staff members