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Click here or scroll down to respond to this candidateSMCandidate's Name
EMAIL AVAILABLE PHONE NUMBER AVAILABLE Clarkston, GA Street Address
Talented Administrator highly successful at motivating teams and streamlining operations. Analytical problem solver and persuasive communicator with talent for thinking outside box for creative solutions. Leadership RolesAccounts ReceivablesMicrosoft ExcelMedical Oce ExperienceHospital Revenue Cycle ManagementPractice ManagementMedical TerminologyMedical CodingManaged CareICD-9, ICD-10Medical CollectionsAccount ReconciliationInsurance VericationBank ReconciliationHIPAAMedical RecordsAnatomy KnowledgeManagementDocumentation reviewCPT codingIVRCustomer serviceTypingEDICash handling, Payment PostingFront End AdministratorAudits (10+ years)Basic math10 key calculatorPhone etiquetteAccountingPrimary care, FQHC, Multi-specialty billingPatient serviceMedical schedulingMedicareHealthcare managementLaboratory experienceSupervising experienceEmployment & labor lawEpicMedicaid (10+ years)Contracts (10+ years)NATIONAL DEAN'S LIST FRESHMAN YEAR- BakerCollegeMANAGEMENT, PROJECT MANAGEMENT,SUPERVISION, MICROSOFT OFFICE SUITE,CENTRICITY, IDX, GPMS, Athena Health,RAINTREE, EMR/EHR, CERNER, nTHRIVE, KAREO,CENTRIXCMS 1500, CM-1450/ UB-04,HIPPA COMPLIANCEProject ManagementBudget DevelopmentAttention to DetailOakhurst Pediatrics Decatur, GAFront Desk Administrator11/2020 - CurrentPatient registration, eligibility, check-in, check-out, follow-up, scheduling, payment posting, faxing, scanning, payment collection, emails, Athena Health systemMaintained transaction security by verifying payment cards against identicationDesigned employee work schedules to address complete operational needs Generated reports to suggest corrective actions and process improvements SummarySkillsExperienceAided colleagues, managers and customers through regular communication and assistanceAdapted to workow changes and implemented continuous process improvements to overcome obstacles.MEDICAL BILLING MANAGEMENT LLCAtlanta, GAREMOTE MEDICAL REVENUE CYCLEMANAGER02/2012 - 03/2020Monitored and guided revenue cycle operations over 14 million Supported clinical team members with revenue cycle procedures and addressed issuesCompleted nancial reporting and analysis for billing revenue cycle for hospitals group practices and SNFIdentied discrepancies between budgetary targets and actual revenue and expensesProvided guidance and service on various nancial problems in order to assist taxpayers' in resolving tax issuesRecruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunitiesPerformed routine closings, maintained clean, accurate and accessible records and kept close eye on transaction updates throughout each quarter Assessed current revenue cycle procedures and implemented improvements to foster eciencyPerformed banking, business administration and nancial tasks to guarantee ve-star service for clients.Managed a sta of 14Reduce turn around time in collectionMonthly ReportingEvaluated revenue cycle processes for hospitals established actionable methods to increase productivity and eciency.Provided revenue cycle process support to all clinical personnel, including resolving procedure challenges.Monitored revenue and compared to targets to address variances and resolved actual-to-budget variances.Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions. Analysis of trends and patterns leading to lower denial rates on UB-04 and CM-1500 for hospitals, Group practices, FQHC and specialty facilities Oversaw complete lifecycle of revenue operations for hospitals, group practices and Professional Billing, hospital billing and denial management Participated in revenue cycle processes, working to maximize protability and increase revenue.LifePoint Health Atlanta, GARemote Contract Modeler11/2016 - 01/2017Mastered professional use of Software modeling programs to input and update contract plus gained working knowledge of various other programs.Built library of standard models for use and customization on multiple projects, saving costly rework on future jobs.Approved contract rates and negotiations with insurance for multiple hospitals.Reviewed patterns for payments over and underAdvancedMD Springeld, MA Supervised 12 employees, duties included medical billing and collections, SR. REIMBURSEMENT SPECIALIST12/2011 - 02/2013denial management in a CBO for Multispecialty providers, groups, and hospitalsSupervision of the junior Denial reimbursement specialist Reporting trends and patternsAppeals, grievances, write-os,Set-up system codes to capture denials, payment posting, and insurance vericationSkip TracingMaintained condentiality and integrity of patient data. Researched rejections, investigating problems to appeal claims. Determined medical necessity, using individual insurance carrier regulations.Easter Seals Windsor, CTMEDICAL BILLING FINANCIAL CASEMANAGER06/2011 - 10/2012Resolved billing issues by applying knowledge and completing in-depth research.Developed improved standard operating procedures to increase billing accuracy and cash ow.Conducted insurance verication and pre-authorization, coded procedures and managed patient charts.Set up and maintained electronic billing system.Built high-performance team by collaborating with new members on procedural, administrative, collections and compliance areas. Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions. Articulated growth objectives and operating plans. Negotiated contract terms and rates with banking institutions to increase protability.Community Health Services, IncHartford, CTMEDICAL CODINGMANAGER/BILLING SUPERVISOR04/2004 - 07/2009Supervised and managed 27 employees, responsibilities included: ICD-9 and CPT J-codes, HCPC coding for clinic and hospital coding, including pediatrics, adult medicine, women's health, podiatry, dental, optometry, mental health, and substance abuseReviewed medical records for completeness and to abstract and code clinical data, such as diseases, operations, procedures, and therapies using standard classication systems for chart auditsEdited system library for updates, delegated and assisted in workload, payment application, account reconciliation, balancing, charge entry, special billing projects, accounts receivable, monitored account aging, created detailed reports, followed-up on accounts, and collections Created training manuals for coding and protocol for providers and intake sta for customer service, patient registration and authorizations, researched electronic errors and rejections reports Resolved issues and made corrections for all insurance carriers including Medicare and MedicaidGenerated electronic claims submission, claims printing, electronic claims reconcilationInput of insurances and payer organization ID numbers to create plan code numbers and electronic billing capabilitiesUpdated diagnoses, procedure codes, pricing and revenue codes in EHS databaseAssistant to the director of revenue service and CFO Created system roll-up codes, month-end closing, monitored and completed quarterly forms for credit balance reporting for Medicare, worked with Healthpro and EHS billing system, Applied HIPAA privacy and security regulations while handling patient information Completed and submitted appeals for denied claims, Reviewed claims for coding Eective communications between patients, billing personnel and insurances, providersVeried insurance information and obtained billing authorization Reviewed account information to conrm patient and insurance information is accurate and complete Oversaw medical coding, charge entry, claims, pharmacy communications and other day-to-day operations of billing department, Maintained high accuracy rate on daily production of completed reviewsCompleted and submitted appeals for denied claims. Kept accounts current with facility-approved reporting and analysis strategies.Advanced Medical Billing AssociatesFarmington, CTMEDICAL BILLING COORDINATOR06/1999 - 04/2003Managed 7 specialties in the following areas: surgery, infectious disease, cardiology, Diabetes and endocrinology, geriatrics, pulmonary medicine, department of medicine,Patient registration, charge entry, payment posting, accounts receivable, SNF billing, DME billing, follow-up, reporting, eligibility and insurance verication, evaluating E/M for compatibility and level, corrections, billed and rebilled, provider services,Implemented training for new recruits, worked with all commercial plans, medicare and Medicaid, hmo's PPO's, indemnity and managed care, idx/gpms billing system Completed and submitted appeals for denied claims. Reviewed claims for coding accuracy.Applied HIPAA privacy and security regulations while handling patient information.Oversaw medical coding, charge entry, claims, pharmacy communications and other day-to-day operations of billing department. Collins Medical Associates Hartford, CTMEDICAL BILLING COORDINATOR02/1997 - 06/1999Registration, billing, collections, write-os, deposits, bank Reconciliation, accounts receivable and reporting for 5 specialty practices: hematology/Oncology, geriatric, pulmonary, endocrinology, cardiology, follow-up, referrals andRebilled all insurance types including medicare and medicaid, utilized the IDX/GPMS billingWheeler Clinic Plainville, CTMEDICAL BILLING REPRESENTATIVE01/1995 - 02/1997Medicaid/Medicare and HMO's billing for 15 clinicians and doctors, obtained referrals,Partial hospital and intensive out-patient treatment authorizations for substance abuseAnd mental health, payment posting, follow-up and rebilled accounts receivable, write-Os, appealsPosted charges, payments and adjustments.Prepared and submitted claims to insurance companies electronically and manually.Completed appeals and led and submitted claims.Veried proper coding, sequencing of diagnoses and procedures. Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.ORTHOPEDIC ASSOCIATES OFHARTFORD, BILLED Hartford, CTBILLING REPRESENTATIVE03/1993 - 01/1995Medicare, medicaid, hmo's, liability, and worker's compensation for 16 physiciansIncluding dme billing, veried eligibility, private collections, accounts receivable,Payment posting, follow-up and rebilled on idx/gpms billing systems Submitted claims to insurance companies and researched and resolved denials and explanations of benet rejections.Worked with outside parties to obtain payments and solve problems. BAKER COLLEGE ONLINE Flint, MIBACHELOR OF SCIENCE Degree09/2013HEALTHCARE ADMINISTRATION 3 Years CompletedFox Institute of Business, GENERAL West Hartford, CT Certicate in Administrative Medical Assistant03/1993CONNECTICUT INSTITUTE oF BUSINESS East Hartford, CT CERTIFICATE in Nurse Assisting in Nurse Assistant01/1991State of Connecticut Hartford, CTDIPLOMA in GED12/1987ASSISTANT CONNECTICUT BUSINESS INSTITUTE - East Hartford, CT CERTIFICATIONS BILLING (10+ years) COLLECTIONS (10+ years) Payment Posting (10+ years) IDX (8 years) MEDICAL BILLING (10+ years) QUICKBOOKS (10+ years) DATA ENTRY (10+ years) CPT (10+ years) MANAGEMENT (10+ years) REVENUE CYCLE (10+ years) claimsADDITIONAL INFORMATION, Authorized to work in the US for any employer EHS BILLING SYSTEM, AVAILITY, CMS INVOICING, QUICKBOOKS, CODING, MEDICAL BILLING AND COLLECTIONS, WRITE-OFFS, APPEALS, REGISTRATION, REVENUE CYCLE MANAGEMENT, DENIALS, FOLLOW-UP, PAYMENT APPLICATION, SYSTEM CONTRACT IMPLEMENTATION, REPORTING, MONTH-END CLOSING, REGISTRATION, ELIGIBILITY AUTHORIZATIONS, VERIFICATION, INPUT OF CHARGES, PAYMENT POSTING, RECONCILLIATION OF EOB'S AND RA'S Candidate's Name EXPERT IN MEDICAL BILLING/REVENUE CYCLEEducation and TrainingAccomplishmentsAdditional Information |
