Antoinette Mouzon
Contract Specialist
Hiram,GA
Summary
Motivated and dedicated professional with over 20 years of experience in the Healthcare industry. Strong understanding and knowledge of reviewing, negotiating, and maintenance of contracts, as well as experience with Payer Credentialing, Claim Auditing, Billing & Follow-up, Denial & Appeal Management, Insurance Eligibility Verification and Authorization. Consistently demonstrates effective time management skills while managing a heavy workload and effectively prioritizing to meet deadlines for multiple projects simultaneously.
Overview
20
20
years of professional experience
1
1
Language
Work History
Contract Specialist
Gentiva Hospice
Atlanta, GA
2015.10 - Current
- Prepare, review, and maintain Hospice, Home Health, Palliative, Managed Care, Physician contracts, and other healthcare entities to ensure compliance with company, State, and Federal guidelines.
- Work jointly with legal, finance and compliance teams, and other departments to mitigate risk and ensure compliance with contract terms.
- Collaborate with internal departments, such as compliance and risk management as needed to ensure adherence to contract terms.
- Track and organize documentation pertaining to contractual arrangements for company. Provide support for contract renewals and departmental communication with Business Operations. Maintain reporting that allows for visibility and tracking.
- Providing support to operations and strategic business development team (ex: clarifying contract processes, ensuring all parties remain in accordance with company policies and state and federal regulations etc.)
- Develop a systematic approach to risk analysis, evaluation, and mitigation for identifying areas for concerns and orchestrating corrective actions to minimize liability risk for the acute care and behavioral health hospitals, providers, and physician practices.
- Assists with the development and implementation of physician contracting standards and policy and procedures for the contracting process.
- Ensures that each physician contract is supported by essential documentation such as approval signatures, fair market value analysis, commercial reasonableness and statement of business necessity.
Sr. A/R Billing & Insurance Follow-Up Specialist
Gentiva
Atlanta, GA
2007.10 - 2015.10
- Boosted revenue recovery by identifying and resolving errors in billing and coding practices.
- Maintained thorough documentation of all follow-up activities, ensuring proper tracking and reporting of account status.
- Ensured accuracy, compliance, and maximizing revenue, often including tasks like billing, claims processing, accounts receivable, insurance follow-up, and collections.
- Provided training support to all new employees
- Communicated effectively with patients, insurance providers, and internal teams to resolve billing and payment disputes.
Hospital Biller & Collector
FRR Recovery, Inc.
2005.05 - 2007.09
Education
Bachelor of Arts - Communications
College of Mount St. Vincent
New York, United States 2004.01 - 2004.05
Skills
- Develop, negotiate, and implement contract terms
- Strong analytical skills to easily assess risks, requirements, or provisions as well as remain up-to date with industry trends
- Understand technicalities and legal requirements across many healthcare arrangements
- Excellent problem-solving and decision-making skills to produce effective decisions and recommendations while resolving conflicts
- Strong organizational skills as well as tracking and controlling a variety of changes or details within contracts
Timeline
Contract Specialist
Gentiva Hospice
2015.10 - Current
Sr. A/R Billing & Insurance Follow-Up Specialist
Gentiva
2007.10 - 2015.10
Hospital Biller & Collector
FRR Recovery, Inc.
2005.05 - 2007.09
Bachelor of Arts - Communications
College of Mount St. Vincent
2004.01 - 2004.05