- A highly motivated person thrives on challenges and able to manage both time and resource posses the ability to adapt quickly to new situations and highly experiences in the following areas:
- Reimbursement Methodologies Electronic Health Record EHR
- Maintain Confidentiality Data collection/management
- ICD-9/CPT/HCPC II Coding Writing/Communication Skills
- Supervising skills Plan/Organizational Skills
- Data Entry/Acct Receivable Practical Accounting skills
- Customer Service Oriented Privacy Security Laws
- Medical Record management Leadership/Team Player
- Process attestation applications for State Incentive program ensure information is accurate/reliable for timely resolution.
- Researches/ identifies problem utilizing public eligibility programs system, Omnicaid, Aspen
- Respond to phone calls assisting provider with online web portal, maintain call log.
- Follow up on outstanding issues to ensure resolution, keeps the provider/customer informed on the status of application closes out case when complete.
- Communicates appropriately maintaining effective working relationship with internal external customer.
- Time management to resolve complex problems making recommendation to management to improve efficiency/effectiveness
- Prepare reports to track workload, time and quality input and audit work.
- Obtain/maintains knowledge of Federal, State local resources available to make sound decision
- Credentialing providers for various facilities/hospitals
- Ability to interpret and compliance with Federal and State requirements
- Perform audits verifying current with licensure, certificate Malpractice
- Update/ maintain credentialing database
- Continuous communication among staff act as liaison assisting to help providers credentialing process.
- Maintain confidentiality foster a team environment strong time management skills
- Supervisorial duties to a staff of 19 billers, account receivable voucher examiners .
- Conduct collection activities to reconcile/balance patient accounts to maintain account records
- Tracking monitoring 3rd party coverage information eligibility/patient data verified
- Knowledgeable of various health insurance plans/resource to assist patients
- Act as liaison consult with internal/external customers, patients hospital staff
- Direct/coordinate daily workload to comply with operating practices procedures.
- Delegate assignment to meet stringent deadlines and recommend solutions of problems.
- Interpret insurance benefits, policies and rule regulations to staff/patients providers
- Prepare/analyze operational/management reports reflecting collections, delinquent accounts etc,
- Assist with implementation a related billing software for claim submission via clearing house
- Keep self updated on policies/procedures/standards of insurance rules regulation effecting healthcare
- Recruit/on-going training, encourage teamwork and maintain confidentiality
Supervisorial duties to a staff of 11 for: denial management, billing, patient registration.
Engage in planning monitoring day to day operational function
Performing collection activities related to follow up and timely account resolution
Act as liaison consult external/internal customers to support operational procedures, delinquent accounts, negotiate write offs etc.
Conduct staff meetings leave authority, ensure adequate coverage in each section.
Communication with people at all levels State, Federal local
Detect resolve deficiencies within the revenue cycle
Provide technical assistance to management, physicians, patients billing/denials/payments issues
Identify/correct incorrect third party information posted to appropriate registration pages
Develop analyze periodic collection/financial reports interpret to staff/colleagues.
Promote team building and strives to improve business practices and workflow
Maintain confidentiality interpret billing guidelines from Federal State.
Ongoing training education to staff of ongoing changes
Hire, discharge, transfer promote employees, resolve employees complaints and initiating a corrective action
Taught various Health Information Technology courses to diverse students.
Use positive reinforcement in teaching emphasizing real work experience to effectively convey concepts to aid in learning.
Communicate orally/written applying correct grammar, punctuation or spelling.
Develop creative lesson plans to raise student awareness understanding for respective subject.
Provide support, inspiration coaching to students for success and passing the course.
Use interpersonal communication techniques to help students reach their full potential.
Assessed evaluated students progress and meet with students of learning discrepancies
Review assignment/lesson plans to modify or redesign
Enter grades, retrieve students data, maintain confidentiality
Consult professionally with students, faculty, staff and external customers
Billing Medical claims for outpatient hospital-base facility DME Medicare
Prepare claims forms 1500/UB04 submitting claims electronic/paper filing.
Data entry via the RPMS system capable of working in a hybrid environment.
Strive for optimal payment strong ability to multitask, organize and detail oriented.
Resolve any online edits, answers questions on unpaid claims denials
Generate insurance verification and update RPMS system.
Knowledge of various insurance billing regulations policies
ICD-9/CPT/HCPCS II coding
Review various billing, collections reports
Follow up on pending claims/denials maintain record
Back up Patient Registration updating demographic information
Maintain confidentiality, knowledgeable of Medical Necessity/ POA
Keep self updated through Newsletter, website CMS, trailblazer, AHIMA etc.
Provided leadership to 26 Patient Registration clerks/ 4 Medical Technicians.
Distributes balances workload to support daily operational function.
Knowledgeable of medical record police/procedures for processing medical/ legal documents
Prepares charts, interact with patients, hospital staff, oversee equipment supplies
Approve/Deny leaves, Assist supervisor and report all problems found.
Monitor all denied verifications/updates returns to Patient Registration
Maintain high standards towards internal/external customers, co-workers, etc.
Develop, maintain and analyzes health information files
Responsible for weekly/monthly work schedule and weekly station assignment.
Review productivity, tardiness, absenteeism discrepancies with supervisor.
Serve as a liaison between patient, subordinates hospital staff.
Making regular spot check, recommend changes in position rotating assignments.
Collecting, verify and insurance data/third party information into RPMS system
Knowledgeable of Medicare, Medicaid Private insurance billing regulations eligibility guidelines.