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Click here or scroll down to respond to this candidateCandidate's Name
Lawrenceville, GA Street Address C: PHONE NUMBER AVAILABLE EMAIL AVAILABLEQUALIFICATIONS & SKILLSHonoring over 24 successful experienced years in Business Management, Administrative Operations, Project Management, Project Development, Implementation, and Human Resource duties for both clinical and nonclinical settings while utilizing my entrepreneur mindset, talents, crafts and gifts.Administrative duties, personal assistant duties, calendar management, organizational management, documentation review, time management, data entry, analytics, databases, project management softwareOrganized meetings, travel planning, set up meetings, filing and retrieving corporate records, documents, complete reports sheets, deadlines in a fast-paced quickly changing environment, excellent verbal and written communications skills.Implementation, project management, data entry, system corrections and understand revenue matrix.Expert proficiency with Microsoft Office, Microsoft Outlook, QuickBooks, PowerPoint, SharePoint, Zoom, Microsoft Teams, Google Suite, Access, SAP, Excel office, multiple Office and EMR systems, ability to type 60 WPM.Create policies and procedures, lead policy strategy decisions, providing though leadership and recommendations.Effective leadership and motivational skills, self-motivated, driven, teachable and coachable.Utilize great skills such as organization skills, prioritizing, multi-tasking, negotiating, networking and delegating.Excellent people skills and demonstrable diplomacy in dealing with issues while maintaining practice policies.Knowledge and understanding of healthcare insurance benefits and rules; commercial, government, WC and PI payers.Maintain a high level of professionalism and integrity and display a strong standard of ethics and outstanding customer service.PROFESSIONALBlueCross BlueShield of Tennessee August 2023- CurrentHealthcare Navigator (Remote-Contract)Designs, implements, and maintains organizational programs in support of corporate strategy.Manages all aspects of an organizational program to ensure all projects within the program are implemented, accepted and accomplished within a set deadline.Organizes and coordinates processes and procedures for all project teams to follow within the program.Plans and monitors program development to ensure that quality standards and goals are achieved.Serves as a liaison and builds bridges among project teams within the program. Translates corporate objectives into program objectives and practices.Invo Healthcare November 2022-February 2023Eligibility and Authorization Specialist (Contract Completed)Managed accounts day-to day with kids with Autism.Investigate claims, follow up with payors, and input data and supporting information into the system.Verified patient benefits in a timely manner.Submitted claims to CMOs and Medicaid payors.Claim follow up on pending authorizations.Appeal follow- up and set up peer to peer review for denied claims.Collected liabilities on clients with outstanding balances.EMR-Central Reach.Ambulatory Management Solutions (Chicago) June 2022 September 2022Operations Coordinator (Remote Contract)Lead the day-to-day operations for Texas (Dallas/Houston) and North Carolina RegionsOnboard new AMS and medical entity new hires in Green House Recruitment System. Review and screen all resume applicants for physicians, nurse, clinical, and nonclinical staff. Conducted phone screening and interviews.Assigned and monitored completion of mandatory education courses and requirements in Health Stream Data Base SystemWorked very closely with IT and the support team to assure that all new hires received their credentials timely.Scheduled and lead weekly and monthly team huddles and meetings. Prepared agenda/minutes for various meetingsPrepare quality documents for clinical review and serving as a resource to our clinical staff in the field.Implemented and revised policies and procedures based on the states updated rules and regulations.Ordered supplies for staff such as name badges, scrubs, and items thats needed to assure their jobs are done effectively.Made travel arrangements for staff members, including booking flights, hotel, and rental car reservations.Worked daily, weekly, and monthly reports and analysis. Making sure that all reports were up-to-date in a timely mannerMayo Clinic January 2022 June 2022Administrative Assistance IIProduct and Experience Support - Center for Digital Health (Remote - Contract)Daily planning, calendar management, organizational management, set up meetings, make changes and updates as needed on behalf of point of contact among executives.Proficiency with Zoom video and Outlook Teams conferencing with ability to draft presentations, meeting minutes/actions, and coordinate oral and written communication for executives, proficiency with Mac and the Google suite of business programs, especially Google calendar, mail, drive, docs and sheets.Manage information flow in a timely and accurate manner.Filing and retrieving corporate records, documents, and reports.Make travel arrangements for executives.Meet deadlines in a fast-paced quickly changing environment.Utilize good time-management skills day to day and meet all deadline requirements.Work daily using systems Word and Outlook Excel and other similar email system.Wipro Technologies (Atlanta GA) January 2021 December 2021Project Manager II Change Healthcare (Remote Contract)Define the project scope and determine available resources. Set realistic time estimates and evaluate the teams capabilities.Exercise the lead role in planning, executing, monitoring, controlling and closing CHC system projects.Develop clear, straightforward plans that stimulate the team to reach their full potential.Define activity, sequence activity, estimate the duration of activity, develop a schedule, and maintain a schedule.Implement and structure projects to clients needs. Making sure the project is delivered on time, within the budget, and brief while keeping everyone in the know.Minimize uncertainty, avoid any unwanted surprises, involve clients in projects, maintain effective communication and keep all clients up to date.Conduct internal and external meetings daily/weekly to follow up on the process and task.Present comprehensive reports documenting that all project requirements are fulfilled, as well as the projects history including what was done, who was involved, and what we can/could have done to make it better.Fusion Autism Center / BlueSprig (Lawrenceville, GA) February 2020 January 2021Executive Administrative Assistant / Administrative Operations ManagerSupervise a team of 16 employees and oversee the need of 16 clients while working hand and hand with the Center DirectorSocially focused with center staff and parents while cheerfully addressing critical needs and driving operational and financial objectivesLead key operational functions including, but not limited to; staff scheduling, onboarding new hires, onboarding clients, handling billing, insurance authorizations and credentialing.Coordinating and scheduling all activities and services/sessions provided by the center, ensuring compliance with established company policies and procedures.Managing the office within budget guidelines to include clerical and auxiliary supply purchases, equipment upgrades, and labor cost increasing.Acting as a liaison for clients to explain insurance benefits and communicating daily with payers concerning insurance benefits and authorizations.Maintain center and equipment cleanliness and safety and reports and/or corrects hazards when necessary.Monitoring employee time, attendance and reimbursement programs. Verifying employee time sheets, monitoring approvals, processing edits and communicating with human resources concerning any pay discrepancies. Providing impeccablecustomer service to clients, parents and center teamCan maintain a high level of professionalism when facing difficult situations and when delivering feedback to staff members.Perform multiple tasks and organize work in a systematic and efficient fashion.Summit Spine & Joint Centers Pain Management (Lawrenceville, GA) January 2018 - February 2020Administrative Specialist/ Insurance Practice Manager (Contract)Managed a medical pain clinic for a team of Anesthesiologist and supervised 12 employees.Supervised and supported the day-to-day task of the Authorization Team, Submitting and obtaining authorization, utilization, appeals, insurance and benefit verifiers, financial counselors, schedulers, (PI) Personal Injury and Workers Comp claims.Build relationships and work closely with Attorneys, Funding Companies, Case Workers and Adjuster.Work hands on and work Commercial Insurance, Managed Medicare, Medicare, Medicaid Government and Self Pay payors.Manage Data Entry process; Work various managing systems for Insurance and Authorization processing.Coordination of the day-to-day operations of all Clinics and ASC Surgical CentersPromote excellent customer service by all levels of staff, patients and clients.Develop, implement, and maintain office policies and procedures, conduct Interviews, hires, discharge. Work closely with company HR and ControllerEnsure patient satisfaction, including troubleshooting when there is a complaint and developing process improvements to prevent recurrences.Coordinate staff meetings for administrative and clinical staff and provide and interpret statistical reports weekly and monthly reports.Piedmont Medical Center Tenet Healthcare (Rock Hill, SC) July 2002 - December 29, 2017Financial Counselor / Medical Eligibility Program (Supervisor) May 2007 - December 2017ER Registrar Representative (Lead) May 2007- July 2002(Relocated to Georgia)Supervised 20 Registrars and three Financial CounselorsCounseled and explain patients benefits to help them understand their financial responsibilities which included co-pays, deductibles, co-insurance and self-pay rates.Managed hospital budgets, expense reports, month-end and financial reportsManaged Hospitals Revenue Codes and Financial I-Plans for accuracyMaking sure UP04 Billing forms are completed timely with the correct revenue codes, patients information, providers information and facilities information.Set up payment plans, and payment arrangements as needed.Verified benefits, create estimates and initiate pre-certification and authorizations timely.Responsible for identifying all sources of potential payers including auto insurance, Workers Compensation, commercial insurance and private insurance to route account appropriately in the Patient Accounting environment.Reviewed Medicare patients Lifetime Reserve days to ensure they are properly notified when days are being used.Responded to high volume emails from hospital personnel regarding financial resolutions.Knowledge and understanding of Insurance Laws, Federal Laws and HIPAA guidelines.EDUCATIONYork Technical College, Rock Hill, SC Office Systems Technology Certificate 1999 Cornerstone Christian Collage, Georgia Continued Education Diploma 2007 Rock Hill High School, Rock Hill, SC High School Diploma 1997SYSTEMS AND PROGRAMSHIS System Assurance CHC System EMR NextGen Claim Master Management System Administrative Payroll Systems EPIC eClinical Work Kareo Central Reach Sorian Acombina HCHB Rycan Trubridge Emdeon/ChangeHealth PaySpan Availity Office 365 SAP Programs Microsoft Office Word Excel Spreadsheet Access Meditech PBAR Simplee PassportDDE Bed Board A-4 Compliance Checker EDR Rev-Runner Fire MIAP Fax Portal US Bank Payment System Clear Quote Finality Phone System Non-profit Charity apps Availity Trizeto QuickBooks ADP Paycor Paylocity Teclor Microsoft Teams Zoom Google Suite PowerPoint SharePoint GreenHouse Nexus SalesForce SwipeSimpleHONORS AND ACHIEVEMENTSCPR CertifiedE- CommerceCertified CollectorSales and MarketingProject ManagementExecutive AssistantAdministrative AssistantCertified Financial CounselorsCertified Medical Trainer / BillerState of Georgia Notary Republic |
