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Click here or scroll down to respond to this candidateCandidate's Name
Medical Office ManagerPrinceton, WVEMAIL AVAILABLEPHONE NUMBER AVAILABLETo obtain employment where my experience and skills can be utilized to better not only my agency, but the lives of the individuals we serve.Willing to relocate: AnywhereAuthorized to work in the US for any employerWork ExperienceOffice Manager- HIPAA Privacy OfficerAllay Home Care - Beckley, WVMay 2018 to PresentAssess incoming referrals for medical necessity. Complete patient packet and all required paperwork. Insurance verification, benefits and eligibility, prior authorizations if required. schedule deliveries and pickups.Management of the Customer Service/Office Staff. Staff scheduling and training, as well as on boarding of new staff. Provide ongoing mentoring and support to ensure Customer Service staff function at the optimum level. Compile all billing to be sent to contracted billing company. Complete all reports, budgeting and end of month Reconciliation documentation. Medical Support AssistantNon VA CareMarch 2017 to December 2018Perform administration of Non VA services in accordance with the policies and procedures of the Veterans Health Administration. Reviews medical record documents and interpret the type of care being requested. Review and determine veteran eligibility for Non VA Care. Review medical claims and associated documents to verify that services rendered were authorized. Process Non VA Care requests (review consults, obtain approval/disapproval, create an authorization, entering information and data into the Fee Basis Claims System). Update, monitor and track all authorized Medical Non VA Care services in the Fee Basis Claims System. Process scheduling and cancellation of appointments in the Vista Appointment Management System. Ensure all required clinical documentation is received and appropriately scanned in Vista Imaging and/or the associated CPRS Non VA Care Consult is closed. Conduct research to determine authorization and claim status. Provide general administrative support for the office, such as, making copies, gathering information from various systems for special reports. Perform research on inquiries by examination of facts in resolving problems. Prepare mail and/or fax letters to veterans and Non VA Care vendors. Maintain close contact with medical providers including Physicians as well as mid-level providers, nurses, clerical staff as well as outside vendors to resolve delays and misunderstanding in the medical administrative aspect of providing care. Resolve issues and answer questions (orally or in writing) presented by veterans, providers, vendors and/or Veteran Service Organizations regarding claims and their status.Registration Team LeadRaleigh General HospitalJune 2015 to December 2016Provided supervisory support and ongoing education to hospital Registration staff. This included Interviewing incoming patients, his/her relatives, or other responsible individuals to obtain identifying and biographical information with insurance and financial information. Verified insurance information and completed bill estimates to collect patient copay's/ deductibles at time of service, when applicable. Conducted and tracked QA information for each employee to allow ongoing feedback to the employee, while reporting results to the Patient Access Director. Worked with other Team Lead to complete the employee weekly schedule for the Emergency Department. Rotated On-Call responsibility with other Team Lead to ensure support was always available and to assist with after-hours emergencies. Work closely and professionally with physicians, nurses and ancillary departments in effort to create an outstanding patient experience, and ensure that excellent customer service was provided at all times. Central Billing Office DirectorLove Family Practice GroupJanuary 2012 to June 2015Provided day to day operational oversight of all non-clinical staff to include the front desk, medical records, insurance verification, scheduling and billing & collections. Created staff schedules, completed biweekly payroll, and carried out necessary disciplinary actions to ensure that policy and procedures of the medical group were observed. Worked closely with the Operations Director and Physician to conduct cost analysis of all ancillary services offered by the group. Assisted in establishing the practice fee schedule. Maintained OSHA records and monitored possible compliance issues. Conducted new hire/ annual training of staff. Closely monitored use of the EMR/Billing software and trained staff on proper use. Utilized ICD-9, CPT, and HCPCS Coding for billing of physician office services to insurance companies. Experience with procedures and billing guidelines to Medicare, Medicaid, UMWA, as well as all private insurance companies. Provided customer service to patients with billing or payment issues. Reviewed/ approved all patient financial agreements. Reviewed patient accounts for accuracy, provided follow up, and ensured excellent service was delivered at all times. Medical Billing SpecialistPriority Medical ClaimsJanuary 2011 to November 2011Utilized ICD-9, CPT, and HCPCS Coding for billing of Ambulance Services to insurance companies. Experience with procedures and billing guidelines to Medicare, WV Medicaid, VA Medicaid, UMWA, as well as all private insurance companies. Responsible for ambulance companies in Saipan and Guam. Reviewing trip sheets for accuracy/ completion and medical necessity. Revised with EMT and Paramedic personnel as necessary. Provided customer service to patients with billing or payment issues. Also reviewed patient accounts for accuracy, provided follow up, and payment posting. Medical Billing SpecialistEppy's I.V. IncFebruary 2007 to October 2007Worked in the medical billing office for the home intravenous pharmacy. Provided every aspect of billing each account. Created and submitted claims, checked benefits and eligibility on all new referrals, obtained prior authorizations from insurance companies when applicable. Provided follow up to claims in posting payments, called on denials from payers to resolve reimbursement issues. Submitted secondary billing. Strong ICD-9 and HCPCS coding used, as well as strong customer service skills. Medical Coder and BillerJan-Care AmbulanceOctober 2003 to September 2005Utilized ICD-9, CPT, and HCPCS Coding for billing of Ambulance Services to insurance companies. Experience with procedures and billing guidelines to Medicare, WV Medicaid, OH Medicaid, UMWA, as well as all private insurance companies. Pre certified coverage's and eligibility with each patient's insurance company. Responsible for reviewing trip sheets for accuracy/ completion and revising with EMT and Paramedic personnel as necessary. Provided customer service to patients with billing or payment issues. Also reviewed patient accounts for accuracy, provided follow up, and payment posting. Assisted in credit and collections, and medical records as necessary. EducationNone in Certified Medical Office ManagerPractice Management Institute - West Virginia2012Oak Hill High School/ Plateau Vo Tech Center1994Skills CPT Coding Medical Office Experience Medical Office Management Insurance Verification Accounts receivableCertifications and LicensesDriver's LicenseCPR Certification |
