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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

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