Driven and compassionate Business Office Manager with a 10 years hands-on experience in fast-paced Skilled Nursing Facility. Accountable and responsible with a strong focus on managing staff, finances/budget management, facility operations and admission while providing excellent customer service.
Education and Training
: , Expected in June 2008 San Leandro Adult School - , GPA:
Pharmacy Technician
Certificate in Pharmacy Technician: , Expected in Boston Reed College - , GPA:
BS: Business Administration, Expected in May 2006 Chabot College - , GPA: Business Administration
Certificate in Business Management: , Expected in - , GPA:
Skill Highlights
Staffing management ability
Time management skills
Team player and diplomatic
Knowledge of policies/procedures/regulations
Knowledge of Payroll
In depth claim knowledge
Effectively influence others
Cultural awareness and sensitivity
Staff Training and development
Proficient in variety of software
Professional Experience
Admitting Representative, 11/2011 to Present Providence Health & Services – Manhattan Beach, CA,
Serve as resource to others, may orient, train and check the work of other staff.
Excellent Customer Service Instructs & reviews with patient, information concerning hospitalization Identifies all uninsured or under-insured patients admitted to facility; refer to Financial Counselors for further action Obtains verification & necessary pending authorizations from non-KP insurers (including Medicare, Medi-Cal and COB) on members & non-members when Financial Counselor is not available Promotes patient satisfaction & retention through the successful facilitation of the revenue collection process Calculates member liability based on benefit plan Collects financial liability for elective procedures & discharged patients Report findings to Manager/Supervisor/Designee Analyzes revenue data to determine obstacles in cost share collections Collects all information necessary to bill second-party payers Interviews patients for pre-admission or admission to the hospital, collecting personal, demographic, financial, & medical information in person or by phone per KP policies Enters complete data into the KP information systems & review for accuracy per department, local, regional, & regulatory compliance Provides up-to-date information concerning admission & hospital practices & administrative procedures per HIPAA guidelines & Kaiser Permanente Corporate Compliance Facilitates the timely admission of patients throughout the hospital by coordinating patient information w/the physicians, Emergency Room, Clinic Departments, House Nursing Supervisor, Patient Care Unit Staff, & outside Care Coordinators per local policy Obtains appropriate signatures on permits & consents per California Hospital Association (CHA) consent guidelines Distributes relevant brochures/letters to patient/agent (e.g.
Medicare letter, Coordination of Benefits (COB) Brochure, advance directive brochure, cost share letter, etc.) Receives, documents, secures & releases patient valuables according to Standard Procedure as appropriate Performs other related duties as required.
Business Office Manager, 05/2005 to 07/2015 Augustana Care Corporation – Shakopee, MN,
Training Staff- serve as a resource to others, provide feedback, assist, orient, coach and disciplined staff as needed Supervises and evaluated the activities of medical, nursing, technical, clerical and other personnel in absence of Administrator Provide support and advice to Administrator- act as a liaison between management and other departments.
Resolves dispute between the members or patient and performs service recovery as needed.
Provided administrative and leadership to the staff and help improve annual survey rate from 3 star to 5 star.
Assist/Coordinates Administrator with development of short and long range goals and project in timely manner.
Account Receivable- responsible for Collecting Medical SOC or PRIVATE PAY, Co-Insurance, Deductible from the resident/family members Assisting Member or Family Member in Applying for Medical/Medicaid Benefits and Other Insurance Submit necessary documents as requested by the Medical Office for eligibility application of residents- follow up and verifies if Medical is Approved or Pending.
Develops and Send Census or Daily Report for Department Staff, Corporate Office and Billing Maintain and Ensure timely data entry and quality.
Verifies and review eligibility, modify and adjust according to payor edits Check various payor verification systems, including but not limited to CWF, DDE and Insurance website ( provider log on) Follow up and research on unbilled claims to determine why the claim is being held, not processed and not paid.
Completes TAR and PASSAR screening with accurate, quality and timely manner for submission to Medical Office-verifies and follow up if TAR is Approved, Deferred and Denied and make some correction if necessary.
Maintains and Troubleshoots office Equipment's Attend and Participate in local and corporate meetings, workshops or in-service.
Ensures protection and security of residents business files and records Acts as liaison between the facility and family members during pre-admission and admission process Perform other duties as required.
Skills
administrative, Benefits, Billing, brochures, Brochure, Business Management, clerical, coach, Counselor, Excellent Customer Service, data entry, Staff Training, Financial, information systems, Insurance, leadership, regulatory compliance, letters, meetings, Office, Nursing, office Equipment, Patient Care, Payroll, personnel, Pharmacy Technician, policies, quality, research, Staffing, Supervisor, Team player, phone, Time management, website, workshops
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School Attended
San Leandro Adult School
Boston Reed College
Chabot College
Job Titles Held:
Admitting Representative
Business Office Manager
Degrees
Pharmacy Technician
Certificate in Pharmacy Technician
