healthcare Support

Cross-Functional Expertise

Pro-active and results-oriented. Well-disciplined with proven ability to manage multiple tasks efficiently under pressure. Strong team builder and facilitator with Supervisory and entry-level Managerial experience: fosters an atmosphere that encourages professionals to balance high-level skills with maximum production. Plans appropriate strategies to achieve results, effectively communicates direction, and commits people to action.

Summary of Qualifications

••••• years Customer Service experience
IT Systems Analyst - Hospital Business Office applications
Revenue Cycle Management: Staff performance analysis, reimbursement analysis for accuracy and compliance, Managed Care contract assessment & implementation, Billing and Collections

Professional Experience

MaineGeneral Medical Center- Waterville, ME
Account Resolution Specialist/Per Diem
Reimbursement analysis for facility and professional billing; Government payers-UB•••••/••••• claims

Public Consulting Group-State of Maine/DHHS
Research Analyst/Contract
Provider claims issue research and analysis for DHHS Mainecare Medicaid; UB•••••/••••• claims

Golden Hour Data - Phoenix, AZ
Project Lead/Contract
-Compliance review for Medicare, AHCCCS/Medicaid and Commercial billing; ••••• claims
-QC ••••• paper claims and review clearinghouse reports for rejects. Assisted with billing required.
-Reviewed current billing processes for improvement opportunities

Methodist Healthcare - Dallas, TX
Manager: Patient Accounts System Analyst/Contract
-Maintained Central Business Office IT system; dictionaries, contract databases, system generated reports
-Compiled month end reports for corporate distribution
-Processed billing statements daily through eTactics website
-Reviewed current processes for improvement opportunities



Parrish Medical Center- Titusville, FL
Reimbursement Analyst
-Updated and maintained Business Office Managed Care prorations, contract dictionaries and related system generated reports. Implemented system upgrades for Business Office, Central Scheduling and Patient Registration after Test process.
-Maintained all Managed Care databases; correcting and updating proration rules based on current contracts.
-Reviewed current billing processes with the hospitals physicians group for accuracy and compliance.
-Gallop Survey Team Coordinator for Business Office, Central Scheduling and Patient Registration.
-Performance Management Team Lead assessing Business Office FTE processes for increased job proficiency and employee success. Implemented My Opinion Counts initiative where volunteer teams were established and inter-departmental goals were set.

Parrish Medical Center - Titusville, FL
Credit Balance Analyst
-Supervised A/R credit balance team for both commercial insurance and self pay accounts. Reviewed refund requests from recovery agencies, patients and the hospitals refund vendor. Reduced credit balances •••••% and averaged 8% below the targeted 1 A/R day.

EDUCATION:

Warner Southern College, Lake Wales, FL Master of Science Management, Business
BA, Organizational Management
Andover College, Portland, ME AAS Degree, Computer Programming

Brevard Community College, Cocoa, FL - Medical Coding


References available upon request