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Dow Stricklin

Systems Specialist

ProSmile

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Prosmile | Aug 2015 - Present

Senior Systems Specialist & Fee Schedule Analyst

Perform rigorous testing and audits to ensure the accuracy and integrity of financial data, fortifying the reliability of reporting systems. Develop and maintain comprehensive insurance fee schedules, optimizing reimbursement rates and ensuring financial viability. Administer creation and upkeep of procedure codes, maintaining compliance and accuracy in billing processes. Provide robust revenue cycle support, contributing to financial stability and operational efficiency. Monitor and rectify unpaid claims, reducing outstanding balances, and enhancing revenue collection. Validate timely filing of all billable claims for optimal cash flow and financial health. Conduct audits on accounts and reconcile balances, ensuring accuracy, compliance, and financial integrity. Key Accomplishments: • Engineered custom dashboard reporting for enhanced data visualization, providing insightful analytics for informed decisions. • Designed and managed insurance plan coverage tables, enhancing operational efficiency and accuracy in claims processing. • Instituted custom tools for constructing intricate coverage tables, streamlining processes, and improving data precision. • Expanded database by incorporating new clinics and providers, ensuring comprehensive and up-to-date repositories. • Developed a fully integrated, self-updating dashboard to report quarterly accounts receivable data, resulting in remarkable efficiency improvement exceeding 50%. • Discovered and rectified contracted fee change, averting a potential six-figure reduction in billables to safeguard financial stability. • Attained promotion from Senior Financial Manager to Senior Systems Specialist and Fee Schedule Analyst due to showcasing exemplary performance during service.
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About Me

Detail-oriented and analytical professional with rich experience in engaging in full spectrum of research and analysis, while exploring data for business insights, evaluating needs/models, and proposing scalable solutions.

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