Summary
Overview
Work History
Education
Skills
References
Timeline
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Kaitlyne Fox

Berea

Summary

Strategic and results-driven healthcare operations leader with over 5 years of experience managing full-cycle billing, financial reporting, and administrative functions in behavioral health settings. Proven ability to oversee complex revenue cycle operations, implement systems that enhance efficiency, and maintain a clean claim rate exceeding 90% annually. Experienced in collaborating with executive leadership and CFOs on financial reconciliation, budgeting, and compliance initiatives. Adept at leading cross-functional teams, optimizing processes, and aligning operational goals with organizational mission and regulatory requirements. Recognized for driving innovation through EHR and billing software implementation, improving data accuracy, reporting, and overall operational performance.

Overview

8
8
years of professional experience

Work History

Billing Supervisor

Ethan Health
01.2021 - Current
  • Solely responsible for full-cycle medical billing and revenue cycle operations across residential and outpatient services, maintaining an annual clean claim rate above 90% for over five years.
  • Lead all prior authorization processes independently for both Residential and Outpatient levels of care, ensuring timely approvals and payer compliance amidst evolving Medicaid and MCO requirements.
  • Work directly with the CFO to support monthly reconciliation, assist with balancing books, and ensure accurate financial reporting aligned with organizational budgeting and grant funding requirements.
  • Produce weekly executive reports highlighting key financials, admissions, program utilization, and performance metrics for leadership and board review.
  • Track all IOP activity, admissions, and authorizations, identifying trends and opportunities for improvement while ensuring appropriate billing and documentation practices.
  • Oversee and lead the administrative support team, ensuring efficient workflows, professional development, and strong interdepartmental communication.
  • Implemented two new enterprise systems: a new EHR platform and billing software, training staff, migrating data, and improving overall billing accuracy and productivity.
  • Conduct internal compliance audits and support external reviews to maintain alignment with state, federal, and payer regulations.
  • Coordinate daily operations of the outpatient clinic, including scheduling, vendor relationships, and facilities oversight to ensure seamless service delivery.
  • Collaborate closely with the CEO and leadership team to develop and implement systems, policies, and strategic initiatives that drive efficiency, compliance, and long-term sustainability.
  • Maintain financial and administrative documentation for internal controls, grant reporting, and monthly reconciliation with external accountants.
  • Uphold strict HIPAA compliance and data security protocols, ensuring ethical handling of all patient records and financial data.

Billing Specialist

Ethan Health
01.2020 - 01.2021
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Posted and adjusted payments from insurance companies.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.

Administrative Assistant

Kentucky Dermatology and Cosmetic Surgery Center
05.2017 - 11.2019
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
  • Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
  • Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
  • Ensured accurate record-keeping with diligent data entry and database management for vital company information.

Education

High School Diploma -

Prestonsburg High School
05.2012

Skills

  • Leadership
  • Project Management
  • Accounts Receivable
  • Communication
  • Problem-solving
  • Team Development

References

Available upon request.

Timeline

Billing Supervisor

Ethan Health
01.2021 - Current

Billing Specialist

Ethan Health
01.2020 - 01.2021

Administrative Assistant

Kentucky Dermatology and Cosmetic Surgery Center
05.2017 - 11.2019

High School Diploma -

Prestonsburg High School

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Kaitlyne Fox