SUMMARY:

• Experienced Director of Practice & Revenue Cycle Management
• Highly experienced Healthcare Manager with 15 years of experience in various aspects of healthcare coverage and reimbursement methodologies for multi - physician practice, Out Confidential t and Rehabilitation settings including large call center environments. Possess excellent organizational, effective verbal and written communication skills with key senior executives and key decision-makers. Proven leader with exceptional supervisory skills that can exercise discretion, sound judgment. Excellent organizational, multi-tasking and problem solving skills. Adaptable to fast pace and demanding environment adapt well to changing environments and grasp new tasks rapidly with minimal direction. A servant minded thinking leader, that exercise discretion, sound judgment and personal initiative to determine and implement process and procedures while utilizing the most effective approach to take in any routine and non-routine situations to achieve departmental goals. Reliable, dependable a team player.
• Communicate and formalize process protocol between corporate, and facilities
• Problem-solve and make good decisions
• Customer focused
• Hire, train, coach & mentor new employees
• Identify and resolve conflict
• Embrace our values, vision and the future with eagerness
• Views problems as opportunities
• Critical and creative thinking on various project
• Tolerance for ambiguity, Positive attitude towards change
• Committed to innovations that are best for the center
• Setting high expectations for everyone on the team
• Design accurate performance indicators to hold everyone accountable

TECHNICAL SKILLS:

Technology and Tools: Cross-functional Medical Team Leadership, Project Management, Human Resources, Business Development, Executive Management, Account Management, Marketing, Interviews, Talent Management, Talent Acquisition, Recruiting, Team Building, Sourcing, Strategic Planning, Team Leadership, Management Consulting, Employee Relations, Change Management,, Strategy, Coaching, Leadership, Management, Operations Management, Organizational Development, Performance Management, Leadership Development, Employee Engagement

WORK EXPERIENCE:

Director of Revenue Cycle & Practice Management

Confidential - Senatobia, MS

Responsibilities:

• Supervise the daily activities of a multi - specialty clinic with multiple locations while managing over 30 employees.
• Supervise the daily activities of a Confidential t centered call center with multi-specialties & multiple locations with 50+ customer support representatives.
• Extensive NextGen, Excel, Salesforce, ADP, Medhost, Meditech, Sigmund, Visio, & SharePoint.
• Vast Knowledge and Concentration in Urology, Gynecology, Family and General Practice.
• RHIT Credentialing.
• Physician Credentialing.
• SQL Experience & Programs.
• Review and analyzes potential contracts for financial effect, cost benefit, and utilization.
• Revenue Cycle Management
• Explanation of Benefits.
• Tracking audit reports for accuracy dealing with payments, cash posting, and allowances.
• Organization of EFT, ACH and ERA enrollments.
• Oversee contractual relationships with managed care organizations and other third party payers regarding rate structures for services, clinical and financial reporting obligations, establishment of other business terms.
• Manages internal data and reporting on payer relationships.
• Create and update insurance modules.
• OSHA & HIPPA Regulation and .
• Extensive experience with the Home Care & Hospice electronic medical record's systems.
• Resource & Advocate for Home Health & Hospice Compliance Programs.
• Enter insurance upon verification, claim submission, and provide explanation of benefits and consent for Confidential ts.
• Schedule & coordinate physicians' schedules for joint surgeries.
• Schedule and coach monthly continuing s subjects.
• Extensive marketing to promote growth for the practice.
• Ensure the office is always neat, clean, and operating at maximum efficiency.
• Obtain the necessary pre from insurance companies for Confidential t's surgeries.
• Communicate denials with supervisors to resolve issues.
• Follow up on all claims from billing through final solution.
• Identify and resolve any claim delay issues that impact billing and collections to conclusion.
• Resolve credit balances and account issues.
• Follow up on payment errors, low reimbursements, denials.
• Accurate communication of denials with physicians to resolve issues.
• Facilitate bi weekly meetings with all staff and Physicians to ensure maximum reimbursements and Confidential t service.
• Initiate and track appeals as necessary.
• Durable Medical Billing.
• Medicare & Medical Billing & Coding.
• Confidential t Relations/Service.
• ICD 9 & ICD 10 Coding.

Head Pharmacy Technician- Office Manager

Confidential - Bessemer, AL

Responsibilities:

• Oversee the daily activities of a clinical pharmacy to ensure its smooth operations.
• Order supplies and medicines to ensure it is set in according to merchandising plan - o-grams and is in good condition.
• Oversee daily ordering activities to ensure all daily orders are made and the appropriate amount of supplies are available each evening.
• Review profit and loss and other financial reports to identify sales and expenses control opportunities.
• Maintain and communicate to all associates all pharmacy opening and closing procedures.
• Ensure the office is always neat, clean, and will fit.
• Oversee the prevention of shrinkage by enforcing corporate policies and procedures.
• Maintain the pharmacy management manual.
• Marketing & Project Management.
• Durable Medical Billing.