Provider Audit And Reimbursement Resume
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TECHNICAL SKILLS
- ADP
- AMSI
- Concur
- Conservice
- Deltek
- DocuSign
- Dropbox
- GoogleDocs
- GoogleDrive
- Kronos
- Lawson
- Microsoft Office
- MLS
- OMNI
- OmniCell
- Onsite
- Oracle
- Paisley
- Pegasus
- PeopleSoft
- Readydesk
- RentRoll
- RentCafe
- Salesforce
- Sharepoint
- Veritas
- VMWare
- Yardi Hardware: Copier
- Desktop
- Fax
- Hub
- Ipad
- Mobile Devices
- Printer
- Router
- Scanner
- Switch
- Tablet OS: UNIX (Solaris)
- Microsoft Windows
- ME
- XP
- Vista 7 8
- Windows Servers Mainframe:AS400
- CICS running on z/OS
- JES2
- TSO
- CA7 Other: 10 - key
- Data entry
- Microfilm
- Microfiche
- Switchboard
- Turn-key PM
PROFESSIONAL EXPERIENCE
Confidential
Provider Audit and Reimbursement
Responsibilities:
- Review the cost report and provider statistical and reimbursement report (PS&R) information to determine accurate and timely Skilled Nursing Facility (SNF), End Stage Renal Disease (ESRD) and Federally Qualified Health Centers (FQHC)/Rural Health Clinics (RHC) tentative settlements of bad debt payments or other pass - through costs
- Review cost report and supplementary bad debt logs to update pass-through payment amounts and determine lump-sum adjustments for interim rate accuracy.
- Perform limited desk reviews of cost reports for SNF, ESRD, and FQHC/RHC providers dat receive Medicare reimbursement, generates required internal/external correspondence/checklists to facilitate execution of and evidence of completion of desk reviews
- Assist the senior and/or In-Charge auditor in performing hospital audits. Performs post audit activities involving follow-up with provider representatives and preparing the final cost report package
- Serve as a specialist over various projects such as: system for tracking audit and reimbursement (STAR) updates incl the tracking of providers, cost reports, cont education and training (CET), HFS cost report software, SNF pass through logs, and PS&R backup
- Assist management in the administrative functions of the department including creating and maintaining electronic and hard copy provider cost report files, participating in continuous improvement projects, etc.
- Attend meetings away from office as needed
- Perform other duties as the supervisor may deem necessary
Confidential
QA/Quality Inspector
Responsibilities:
- Oversee quality control aspects on Hyundai vehicles at various storage locations, working independently
- Inspect and report defects on a daily basis to factory and QC management
- Sign off and release of commercially acceptable product
- Issue Quality Information Reports and Photos
- Monitor all quality concerns and defect rates
- Follow-up with processing concerns
- Approve countermeasures
Confidential
Lease Audit Coordinator
Responsibilities:
- Verification of lease compliance for related payments; base rent, percentage rent, operating expense for CAM, real estate tax and insurance obligations
- Performs detailed analysis and reconciliation of invoices and annual operating expense statements
- Conduct lease audits on landlord reconciliations ‘desktop audits’
- Convey billing errors and/or lease agreement discrepancies to landlords and process payments for valid charges
- Prepare billings for timely submission to the accounts payable department
- Assist with creation and maintenance of retail lease system reports as requested
- Analyze and interpret lease provisions and other related documents
- Recommend continuous process improvement opportunities to management for consideration and implementation
Confidential
Assistant Portfolio Manager
Responsibilities:
- Accountable for the overall operations of a residential lease portfolio = 400+ single family/residential homes
- Complete financial / lease reports, including month-end pre-close, close-out, market surveys, and lease expiration matrix
- Responsible for complete resident relations and problem resolution
- Collect delinquent and current account balances residents
- List and lease homes / Inspection of properties as necessary / Process move-ins, move-outs, and lease renewals
- Monitor and control of utility (electric, water, sewage) turn/on’s and turn/off’s through Conservice Utility Management
- Audit all lease agreements and resident files for accuracy
- Compose and prepare routine correspondence, rental notices, and other letters and memorandums
- Support various departments: acquisitions, construction, lease applications, marketing homes, and maintenance
- Support in the new hire process (interviews, paperwork, training, etc)
- Provide IT technical support to employees upon request such as workstation setup, peripheral repair, etc
Confidential
Computer Operations Specialist
Responsibilities:
- Monitor 200+ servers such as Oracle, Microsoft SQL, Exchange, VMWare, and Citrix
- Maintain and record a detailed /tracking log of all daily jobs and various tasks
- Recognize system failures, job abends; initiate recovery
- Perform system backups on client servers such as Lawson and Oracle,VMWare, and Jaxback02
- Nightly monitoring and inspections of power systems including; Generators, UPS systems, PDU units and supported cabling while environmental systems included: HVAC systems, Water systems, and Fire protection systems
- Escort vendors and/or customer visitors in data center space
- Monitor, load/unload tape drives for StorageTek L700 library
- Assist in weekly system maintenance/ IPL(Initial Program Load)
- Confirm/execute JCL and Scripts according to ledger, monitor/execute via scheduling systems
- Install software patches and upgrades as required
- Monitor, print and distribute all Lawson and Mainframe reports
- Run nightly processes: TMW/TMW CA interfaces through Citrix, People Soft/Lawson processes
- Responsible for server and mainframe password resets
- Inform employees/vendors of outages or downtime such as Mainframe, Internet, or Servers
- Troubleshoot various issues for employees such as Mainframe, Internet, Server, or Email, password reset
- Assist in rollout of new software installation
- After hours back up support to Help Desk personnel
- Support Disaster Recovery Team with testing, updates to manuals and company emergency preparedness kits
- Prior role - Equipment Control Specialist - review/prepare perdiem invoices for payment; maintain G/L for vendor accounts ($40m+/yr), maintain rapport with vendors/customers to resolve billing discrepancies, liaison among leasing companies and steamship lines during direct interchange of equipment, off-hire equipment in system database at lease end period
- Prior role - Payroll/AR - weekly timecard input via Lawson system, process/manual remittance transactions, post complex payment and contractual adjustments to client accounts, reconcile cash transactions, 3rd party remittance, and credit/debit card payments
