| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEExperienced medical administrative professional that can lead motivate and educate. Positive proficient individual with the ability to implement policies and procedures. Proven success in diverse environments, including compliance regulatory and effective marketing strategies.EducationBryant & Stratton College Graduated March 2006Medical Billing/Coding CertificateBachelor of Science in Healthcare Administration Graduated August 2017Medical Careers Institute, School of Health Sciences of ECPI UniversityCertificationsCertificate: Medical Billing/Coding March 2005Certificate: Lean Six Sigma, Green Belt July 2016ExperienceExternship Site 1: PAC Home Association June 2017-July 2017Length: Five WeeksReviewed resumes, pre-screened candidates, conducted interviews, and advised mandatory back ground checks on all new hires.Shadowed the owner of a private adult care home for seniors.Attended meetings with the family, durable medical equipment suppliers, physicians and nurses.Learned about the different types of long-term care insurance policies, cost, reimbursement, and benefits verses Medicare and Medicaid.Created the companys application for employment and employee time sheetExternship Site 2: Freda H. Gordon July 2017-August 2017Hospice and Palliative Care of TidewaterLength: Five WeeksAssisted human resources with filing, verification of required employee training and setting up new hire packets for nursesAssisted the medical office manager with filing, faxing, scanning, and uploading documents electronically into the patients medical records.Set up new patient packets for registrationAttended weekly care meeting with the nurses, chaplain, and activities directorExternship Site 3: Westminster Canterbury May 2018- July 2018On the Chesapeake BayLength: Ten WeeksThe administrator was the preceptor, who gave the opportunity to work with the Director of nursing, Infection Control, Dinning supervisor, Admissions Director, Nutritionist, Recreational Therapy department, Billing Department, Quality, Human Resources and the Assisted Living department.Reviewed resumes, pre-screened new hires, and assisted with the interviewsAssisted with the marketing plan to include identifying the target market and the development of a brochure.Inspected the facility rooms for new patients and survey preparationUsed and learned about the importance of using Virtual Reality Gargles for reduction of pain and decrease in anxietyLearned about the importance of an effective disaster recovery processAttended budget meeting with accountantsAttended the onboarding of a new physicianCreated agenda for a meetingCreated mock survey form to use for short stay residentsInterviewed short stay residentsAttended Quality Assurance and Performance Improvement meetingsAttended patient care planning meetings and resident council meetingsWorked with the dinning supervisor who inspected the kitchen, discussed state regulations, citation preventions, quality of food, preparation of food, adaptive eating utensils, and sanitation.Met with Accounts Receivables Specialist to discuss, bill submission, payment, expenses and budget allowance.Completed Alzheimers computerized training for employees through Relias.Assisted with floor programing for the cognitively impaired populationReviewed Navihealth Referral system, requirements for admission, and refusalsCTR Group August 2018 - CurrentStaffing AgencyInvestigated insurance denialsAppealed claims with appropriate documentsContacted insurance companies via phone or internet to receive claim statusProcessed refunds for insurance and patient overpaymentsResolved patient billing complaints and explain benefitsSet up financial arrangements with patients to ensure paymentConduent October 2017 - April 2018Reimbursement SpecialistRegister patients into a prescription assistance programEnsure that the patients complete the manufactures consentScreen patents to verify eligibilityReceive prescription insurance information from eRx Network websiteSet up cases for declined transactions, authorizations, and merge accountsMail out prescription assistance cards to patientsTrack packages through UPS website to ensure receipt.Transfer patient and pharmacy calls to the required departmentsReview FDA approve usage for prescription and safety with the patientReport side effects of the prescription to the manufacturerCherokee Nation Businesses, Portsmouth, VA September 2014 June 2017Administrative ClerkDetermine Tricare eligibility in the Defense Enrollment Eligibility Reporting SystemRegister beneficiaries in the systemVerify and update demographic informationUpdate other health insurance informationMake PCM assignments for military treatment facility prime enrolleesBook medical appointments at military treatment FacilitiesSet up referrals to specialty clinicsPrint discrepancy reports and filingMedical Management Services October 2010 February 2014Patient Account Representative, Chesapeake, VAInvestigated insurance denialsAppealed claims with appropriate documentsContacted insurance companies via phone or internet to receive claim statusNegotiated payments for out of network insurance companiesRequested and prepared write-off and charge corrections documentsProcessed refunds for insurance and patient overpaymentsResolved patient billing complaints and explain benefitsSet up financial arrangements with patients to ensure paymentSet up and approved charity request for indigent patientsCentura College April 2010 October 2010Instructor- Courses below, Norfolk, VAMedical TerminologyHospital BillingMedical InsuranceComputers in The Medical OfficeKeyboardingAdvanced Pain Management February 2008 April 2010Virginia Oncology Associates February 2007 October 2007Patient Account Representative, Norfolk, VAInvestigated insurance denialsAppealed claims with appropriate documentsContacted insurance companies via phone or internet to receive claim statusNegotiated payments for out of network insurance companiesRequested and prepared write-off and charge corrections documentsProcessed refunds for insurance and patient overpaymentsResolved patient billing complaints and explain benefitsSet up financial arrangements with patient to insure paymentSet up and approved charity request for indigent patientsMirrus Systems June 2005 February 2007Client Account Specialist, Virginia Beach, VAInvestigate unpaid insurance claims greater than 90 daysHospital, physician, and third party billingAdecco Staffing February 2003 June 2005Administrative Clerk at Portsmouth Naval Hospital, Portsmouth, VADetermine Tricare eligibility in the Defense Enrollment Eligibility Reporting System.Register beneficiaries in the system.Verify and update demographic informationEnter other health insurance.Make PCM assignments for military treatment facility prime enrolleesSchedule medical appointments at military treatment Facilities |
