Tricia Sellers

Skilled Revenue Cycle Manager adept at increasing work process efficiency and profitability through functional and technical analysis. Expertise in urgent care, primary care, and complex laboratory billing. Strong leader who has managed 20+ direct reports split into 3 cross-functional teams, handling all aspects of the billing cycle.

Senior AR Analyst at Carbon Health (2024-09 – Present)

• Managed and monitored medical accounts receivable to ensure timely reimbursement from insurance companies, government payers, and patients.
• Reviewed and analyzed denied, rejected, or unpaid claims; identified root causes and took corrective action.
• Submitted corrected claims and appeals with supporting documentation to maximize reimbursement.
• Verified insurance coverage, benefits, and authorization requirements.
• Posted payments, adjustments, and contractual write-offs accurately.
• Reconciled accounts and resolved billing discrepancies.
• Communicated with insurance representatives to follow up on outstanding claims.
• Collaborated with billing, coding, and clinical teams to resolve claim issues.
• Orchestrated regular meetings with external clients to assess financial health, analyze contributing factors, and devise collaborative solutions for enhanced financial outcomes.

RCM Manager at Experity (2006-11 – 2024-07)

• Manage the monthly billing process for 60+ practices nationwide, ensuring task completion by the third business day of the following month.
• Review billing problems, research billing issues, and resolve billing concerns for patients and RCM customers.
• Maintain up-to-date knowledge of all government (Medicare, Medicaid, and Tricare) and non-government (BCBS, Commercial, HMO, and PPO) billing practices and procedures.
• Train and mentor staff on procedures, compliance requirements, and collection techniques.
• Meet with multiple customers monthly to discuss financial health, including reviews of financial reports showing DSO and the percentage of aged AR, focusing on dollars outstanding over 90, 120, and 150 days.
• Review, analyze, and communicate EDI denial/rejection trends for 60+ practices to proactively identify potential issues related to contracting and credentialing, insurance under/overpayments, or other fee schedule, charting or documentation concerns due to software or end-user errors.
• Conduct performance reviews and implement team member development plans.
• Perform system beta testing to assist software developers in enhancing new functionality in both the practice management system and Electronic Medical Record.
• Track team member production and quality metrics to ensure benchmarks for each billing cycle task are consistently met or exceeded; meet with each member to discuss, mentor, and motivate.
• Establish internal audit procedures, including assisting with the creation of internal production reports in the practice management system for all revenue cycle tasks.
• Perform and communicate each team's quarterly production and audit results for all tasks, including charge entry, payment posting, credits/refunds (patient, insurance, worker's compensation, and employer-paid services), and AR follow-up on outstanding patient and insurance balances.
• Generate, QA, and submit monthly invoices to companies for employer-paid services, including drug screens and DOT physicals.
• Ensure monthly patient collection reconciliation is completed, verifying that all collection adjustments in the system match the acknowledgment report from each external collection agency.

High school diploma – Freeport High School (1990-08 – 1994-01)