SUMMARY:

• Over 10 years experience in management functions of the healthcare industry with special skills in managing, supervising, training, project management, and data analysis.
• A hardworking, energetic, and motivated leader who takes initiative, solves problems leading to higher productivity, and produces quality work while maintaining production targets.

EXPERTISE AREA:

• Mentoring Employees
• Training
• Leadership Development
• Employee Engagement
• Organizational/Industrial Psychology
• Certified Scrum Master

PROFESSIONAL EXPERIENCE:

Confidential

SCRUM Master/AGILE Product Owner

Responsibilities:

• Organize and facilitate release planning, daily stand - up meetings, sprint reviews, grooming meetings, retrospectives, planning, and demos amongst diverse groups
• Facilitate retrospectives at key project milestones and final project completion, to confirm project acceptance and satisfaction, and to establish lessons learned
• Coach team members on Agile principles and Scrum methodology
• Gather/report all relevant Agile metrics (burn down charts, Team velocity, cycle time, cumulative flow, etc.)
• Ensure the development teams are practicing the core agile principles of collaboration, prioritization, team accountability, and visibility.
• Update Rally (agile tracking) system to ensure transparency
• Assist team with making appropriate commitments through story selection and task definition
• Identify and remove impediments, preventing distractions, that interfere with the ability of the team to deliver the sprint goal
• Prioritize epics, features, and user stories for current and future sprints
• Inspire and motivate the team to deliver innovative solutions with the appropriate with an appropriate sense of urgency
• Facilitate discussion and conflict resolution
• Experience in business analysis and requirements gathering.
• Experience managing personnel in compostable teams, made up from different
• Proven Leadership and management skills
• Experience working with an Agile methodology on large scale, technically complex projects
• Delivered on Paragon’s Patient Management and Claims system software integration project
• Worked on Paragon Revenue Cycle Front-End projects
• Experience working in two and four week Sprints
• Experience with Rally/CA Agile tools
• Experience with Kanban board
• Provide statuses to Executive Management and Business Stakeholders
• Knowledge of SAP, TFS, SHAREPOINT, CLARITY, AGILE, SCRUM TEAM
• Assigned to mentor employees

Confidential

Project Manager/Implementation Consultant/Business Analyst

Responsibilities:

• Provide subject matter expertise in the area of Healthcare revenue.
• Primary responsibility in the delivery of clear and complete requirement/specifications.
• Responsible for designing, developing, modifying, and evaluating, programs, applications software, and/or services for clients.
• Lead virtual meetings and document key points
• Occasional travel to client sites to conduct info gathering sessions.
• Interacts effectively with internal and external customers to bring about problem resolution in a professional manner.
• Partners with clients/and or business users to identify, evaluate, and develop products, procedures and/or systems which are cost effective and meet business needs
• Recommend changes in software development, business processes, maintenance, and/or system standards for Paragon’s Ambulatory PM and Ambulatory Clinical front-end projects
• Knowledge of SAP, RALLY, TFS, SHAREPOINT, CLARITY, AGILE, WATERFALL
• Assigned to mentor employees

Confidential, Rock Hill, SC

Supervisor

Responsibilities:

• Manage and provides leadership to 11 registration FTEs in the Patient Access areas of the Heart Center, Lab, Wound Care, and Pain Care Center
• Provides documentation and supporting analysis for improvement within Patient Access. Identifies potential quality and efficiency improvements, resulting in a better use of the system and/or processes.
• Oversee and educates staff with regards to the Patient Access Initiatives and the Patient Access Resource Guide (PARG)
• Produce monthly analytical reports for management. Responsible for updates, weekly reporting, and training regarding regulatory compliance.
• Conduct interviews on job applicants.
• Assigned to mentor employees
• Responsible for departmental tracking of HIPAA practices and disclosures
• Interacts effectively with internal and external customers to bring about problem resolution in a professional manner.
• Knowledge of CAREPRICER, CARETRACKER, REV RUNNER, KRONOS, MEDITECH, PBAR, ENTERPRISE, ACE, COMPLIANCE CHECKER, SHOWCASE STRATEGY, PASSPORT applications

Confidential, Gastonia, NC

Business Office Manager

Responsibilities:

• Manage 18 staff members to ensure all quality and production goals are met
• Oversee Accounts Receivable and Contract Compliance: Billing, Collections, Prior Authorization, Screening and prepare referral application
• Follow up on Account Receivable reports: Data input for all contract sources
• Human Resources: Check references and employment history for potential candidates
• Create and maintain personnel files
• Input employee information such as training, update salary information and termination into company software package
• Complete and submit human resource paperwork to corporate for new hires
• Follow up with employees on collecting IFCS property upon termination
• Liaison between Human resources and Employee Relations
• Conduct interviews on job applicants
• Connected families to community resources
• Submitted referrals and assessments/evaluations/diagnostics to Pathways, LME
• Familiar with Family Centered Treatment model to help with ideas and education regarding parenting in unusual or difficult circumstances
• Work with the members of the family to resolve conflict, more effectively meeting communications or attention needs or when the task of daily lives becomes overwhelming.
• Knowledge of KRONOS and ORACLE
• Mentored employees into Supervisor roles and to further their education

Confidential, Burlington, NC

Supervisor

Responsibilities:

• Supervise 17 staff members to ensure all quality and production goals are met
• Train and orient new staff members within Third Party Billing department
• Problem solve Medicaid claim issues for Physician office and Field Clients by use of previous work experience
• Show Flexibility with changing duties, priorities and standard operating processes
• Maintain inventory logs,
• Work effectively as a team member, provide support and make recommendations to management initiating implementation of new procedures and processes
• Trouble shoots and research issues for Director and Manager
• Prepare financial reports
• Conduct interviews on job applicants
• Assigned to Mentored employees

Confidential, Charlotte, NC

Manager

Responsibilities:

• Manages and provides leadership to 28 FTEs in the Emergency Department of Patient Access
• Cross-Trained Pre-Registration, Registration, Cashiers, Scheduling, Financial Counselors and Insurance Verification
• Provide ongoing and annual feedback on performance
• Coaches staff in developing a plan to achieve personal career goals
• Provide an atmosphere of teamwork; Identifies performance trends, and establishes productivity standards
• Continuous improved core processes of the department
• Provide educational updates and training of contracted payers including but not limited to Managed Care and Government payers
• Conduct interviews on job applicants
• Manages HR issues and budget resources for Patient Access Department
• Embraces change and acts as a change agent
• Increased collections at discharge from $15,000 to $29,000
• ONTRAC Coordinator for Triad and the Southern Piedmont Region
• Mentored employees into a supervisor role while employed

Confidential

Supervisor

Responsibilities:

• Supervise the daily insurance verification, scheduling, and pre registration workload of approximately 22 FTEs
• Responsible for authorizations of high dollar and length of stay account/claims of 3 days or more
• Responsible for laboratory, radiology, and diagnostic testing
• Monitored reimbursement rates of Managed Care, Medicare, & Medicaid
• Responsible for negotiating dedicated physician accounts/claims (Total Spine and Matthews Hematology)
• Maintained productivity of staff to 90% for over three years consecutively
• Maintained secure to admit of 90% for Pre-Certifications for over three years consecutively
• Provide educational updates and training of contracted payers
• Liaison for Central Business Office & Business Development and sales to generate new contracts as well as maintain the integrity of existing accounts
• Completed and administered various performance and coaching evaluation
• Trained staff on state and federal regulations governing healthcare facilities
• Conduct interviews on job applicants
• Knowledge of ONTRAC, HBOC REPORTS, SMS/DOCUMENT IMGING, INVISION, TEMPUS, IDX, TOUCHWORKS, GROUPCAST, AND PEOPLESOFT, CRMIT, KRONOS, SIEMENS applications
• Responsible for implementing and maintaining a rapport with various managed care organizations
• ONTRAC Coordinator for Triad and the Southern Piedmont Region.

Confidential

Quality Assurance Analyst

Responsibilities:

• Performs the monitoring of Patient Access staff through a formalized Quality Assurance process, in compliance with departmental policies and procedures.
• Communicates with the Director and management staff to optimize departmental productivity and standards for continuous quality improvement with compliance of all Federal and State regulatory guidelines and JCAHO requirements.
• Responsible for consistent, timely, and accurate monitoring, validation, and feedback of the staff performance.
• Frequently communicates with the department management staff to provide input on staff performance and training needs or modifications.
• Assists with written reports and statistics on the performance of the staff for use in evaluations and to determine departmental education needs.
• Promote departmental objectives through cooperation and quality performance.
• Maintains and demonstrates professional competency according to department policies procedures and protocols.
• Complies with and supports department and organization policies and procedures.
• Demonstrate a positive image of Presbyterian as a caring and concerned organization at all times.
• Assumes other duties and responsibilities as assigned.

Confidential, Charlotte, NC

Appeal Representative / Customer Service Representative I & II

Responsibilities:

• Responsible for processing all incoming denials from patients as well as Physician Practices
• Provide constant feedback to Customer Service Representatives to ensure accurate benefit information was relayed to external customers
• Liaison for Northwestern and Southeastern contracted negotiated for healthcare providers
• Coordinate educational training and updates to senior management in the Northwestern and Southeastern Regions of the United States
• Create and implemented spreadsheets that outlined various denial process and trends