RESUME
QUALIFICATIONS
I have numerous years of experience in healthcare institutions with a strong background in finance, as well as accounting, collections, customer service, HIPPA, office procedures and management. This familiarity will enable me to quickly assimilate to your organization.
I am a highly dedicated, ambitious, enthusiastic fast-learner whose personal attributes include maturity, self-motivation, organization, dependability and excellent communication skills, as well as a willingness to do what is necessary to achieve goals, while meeting specific deadlines. I take considerable pride in my responsibilities, and also have a strong ability to anticipate problems and effect solutions.
I enjoy working with people and am able to work well independently or as part of a team effort. In short, I believe that my combination of experience and personal talents would make me a resourceful asset to your company.
WORK HISTORY
Sales Associate/Vemma
I still am currently self-employed selling healthcare products to customers via the internet and in person.
Insurance Services Supervisor/Advanced Health and Wellness 2/••••• 9/•••••
My primary responsibilities included management of all billing processes, meeting with patients to establish payment plans; collect outstanding balances that were referred to a collection agency; also covered the front desk/reception area; reconstructed job descriptions, submitted suggestions to improve the over-all effectiveness of the clinic when attending staff meetings.
Accounts Receivable Follow-Up/ WI Heart and Vascular •••••/••••• 2/•••••
My responsibilities included contacting insurance carriers for payment regarding outstanding delinquent accounts. This involved rebilling with explanation of benefits and/or forwarding to a medical coder if an additional billing code was needed. I also assisted in handling pre-certification, contacting subscribers if a payment plan was required.
Accounts Receivable Follow-Up/Oncology Alliance •••••/••••• 9/•••••
It was my major responsibility to collect all the old outstanding A/R dollars from commercial insurance carriers, PPOs, and contracted services. Also composed letters to guarantors regarding outstanding balances an establish payment plans as needed. Assisted daily covering the front desk for the receptionist; which involved directing patients to the proper department, scheduling new appointments, and assisting them with their EOBs.
Office Manager/Billing Specialist/Cardiac Rhythm Specialists 3/••••• 5/•••••
My primary responsibilities included management of all billing processes, supervision and coordination of office personnel and their responsibilities, management of day to day operations at all the offices and practice development. Also handled the balancing and posting of the daily deposits, pre-certification for high dollar procedures, and coding relative to cardiac procedures.
Insurance Services Supervisor/Advanced Healthcare ••••• 1/•••••
Managed a staff of eighteen employees. I was responsible to create, review and update job descriptions; hire (individual appointments and through job fairs), mentor, counsel, discipline, and conduct performance reviews; as well as create and provide continuing education, training, and support, an implementing tools to give staff the necessary resources to perform their job functions to the best of their ability. Evaluated billing procedures on an on-going basis, an implemented change for improvement as needed. I was involved in monitoring payer contracts and patterns, establishing meetings with various insurance carriers and networks to resolve outstanding payment and/or appeals issues. I received, researched, and resolved patient concerns. The majority of the time, this involved basic knowledge of ICD••••• and CPT••••• Coding, along with contacting the physicians and/or surgeons for their input. I was involved with the implementation and continual upgrades of the current computer system (EPIC) ; participated on various committees to continually test, monitor, and improve functionality of each application of the system. This included Registration, Billing, Statements, and Collections through work queues. An additional committee I was involved on was HIPPA, which consisted of assisting in the reviewing of policies and procedures for the organization.
Insurance Lead/Childrens Health System, Inc. ••••• •••••
I planned, organized, and monitored the daily operations relative to the commercial billing area. Evaluated billing procedures, as well as recommended and implemented changes for improvement. Continually reviewed and looked for improvement to our computer system (IDX). Assisted with monitoring hospital contracts. Handled and resolved patient concerns. Established, reviewed an analyzed aging reports for follow-up purposes; along with insuring that the proper action and resolution was taken for delinquent accounts. Insured the accurate computation of discount adjustments and timely posting to the IDX system. Served as a department resource for the Commercial, Blue Cross, and Self-Pay areas. Provided input and suggestions to the registration areas and ambulatory departments in remedying solutions to procedural problems. I was also responsible for the coordination of third party audits, along with monitoring the results, maintaining logs and reconciled invoices. Handled charity adjustments, administrative write-offs, and logs. Served as a liaison with the Financial Counselors, Medicaid program, HMOs, and collection agencies. Reviewed and approved refunds and adjustments in accordance with established procedures.
Collection Supervisor/Childrens Health System, Inc. ••••• •••••
Planned, organized, and monitored the daily operations relative to the Credit and Collection functions to ensure that procedures were followed and department goals maintained. I supervised full time employees, which entailed interviewing, training, conducting performance appraisals, counseling and providing direction along with assistance to employees in meeting departmental goals. Evaluated credit and collection procedures, along with implementing changes for improvement. Handled and resolved parent concerns in a timely manner (i.e. complaints, collection agency issues, as well as billing problems). Reviewed delinquent accounts to determine that all collection methods had been exhausted prior to referral to collection agencies. Assisted with the preparation and management of the departments budget. Maintained, monitored, an updated the master files of the IDX computer system.
Financial Counselor/Childrens Health System, Inc. ••••• •••••
Responsible for reviewing and following up on problem accounts, interviewing responsible parties to obtain credit history, appraising the financial status, and determining appropriate action to expedite payment. Reviewed delinquent accounts for possible collection. Referred accounts to collection agencies in accordance with established procedures. Conferred with representatives of various welfare agencies to acquire information regarding financial assistance for those unable to pay for services.
Credit Clerk/Childrens Health System, Inc. ••••• •••••
My primary responsibilities included controlling the Bad Debt ledgers, acting as a liaison between the Financial Counselors and agency collectors. Processed collection agency remittances on a monthly basis, along with daily cash receipts. Skip-traced returned mail. Initiated adjustments on Bankruptcy and Chapter XIII cases in A/R and Bad Debt along with the transfer of credits as they occurred.
Insurance Clerk, Senior/Childrens Health System, Inc. ••••• •••••
Major responsibilities included handling all clinic psychiatric, as well as speech therapy accounts, which entailed verifying insurance benefits, billing, and follow-up with the insurance carriers to obtain prompt payment and established feasible payment plans with responsible parties. Trained, prepared and distributed work to the billing clerks. Recommended, wrote an implemented procedures in conjunction with the Patient Accounts Manager and the Department Director. Gathered, maintained, and reported billing statistics as assigned.
Insurance Clerk/Childrens Health System, Inc. ••••• •••••
Primary duties were verification of insurance coverage information, submitting medical claims on inpatient and outpatient accounts, auditing and correction of charges when necessary. Followed up on assigned claims to include resubmission, correspondence, telephone calls, secondary carrier billing, parental billing and the submission of late charges.
Insurance Clerk/Mount Sinai Medical Center ••••• •••••
My primary responsibilities were submitting claims on inpatient accounts. Followed up on the claims assigned, which included correspondence, telephone calls to various insurance carriers, and the resubmission of claims.
EDUCATION
Oak Creek Senior High School
Merit Student specialized in Business Administration graduated in •••••
Numerous hospital and clinic sponsored workshops - focusing on motivating employees, completion of Customer Care Programs, involved in being on HIPPA teams and the training of employees, involved in Dun & Bradstreet seminars relating to Communication, Credit & Collection, Human Resources, Business Writing, etc.
Planning to enroll through U.S. Career Institute (Medical Coding Course)
(After I complete the above course, I plan to take another course for a Veterinary Assistant)
INTERESTS
I have a passion for horseback riding (all disciplines); volunteer work (loved helping handicapped children to horseback ride; as well as working in the rehabilitation unit and the neonatal unit at Childrens Health Systems). I also enjoy animals, wood crafting, jewelry making, and fishing. I am also upgrading my PC skills relative to various programs, on a self-taught basis.
REFERENCES
Available upon request.