Enthusiastic Healthcare Administrator eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Motivated to learn, grow and excel in the healthcare industry.
· Perform audits and deep document reviews to verify compliance with applicable laws
· Sole Medical Treatment Facility liaison facilitating Medical Affirmative Claims for the Hospital and Air Force, Navy, and Army legal offices, increasing hospital revenue by $120,000 per year.
· Train Military Treatment Facilities' staff during in-processing, quarterly and as needed on procedures to identify potential MAC-related encounters and information required
· Collect and review trauma data electronically or with a paper AF 1488, Daily Injury Log, for accuracy and completeness; forward to MCRP (Medical Cost Reimbursement Program) or local JA office daily
· Initiate/track MAC (Medical Affirmative Claims) packet, AF Form 438, Third Party Liability Notification, for all current & future medical documentation pertaining to the case
· In coordination with the Budget Analyst, conduct a monthly reconciliation of MAC (Medical Affirmative Claims) cases to ensure audit of deposits and receipts match closed cases; that all MAC are collected to the correct line of accounting and fiscal year; and that the DD Form 1131, Cash Collection Voucher, are reconciled in CRIS/DEAMS
· Complete quarterly MAC (Medical Affirmative Claims) reconciliation with the MCRP (Medical Cost Reimbursement Program) of open/transferred/ closed cases to resolve any discrepancies
· Maintain MAC (Medical Affirmative Claims) Log to include date sent to MCRP (Medical Cost Reimbursement Program), (JA for OCONUS), status of claim, amount billed, and amount/date collected
· Collaborate with Patient Administration and clinic check-in clerks to ensure all points of service are verifying patient's eligibility of care, and that patient information is kept up-to-date
· Conduct Third Party Collections compliance audit monthly to ensure clinics are complying with the medical facilities' protocols
· Facilitate expeditious collection and documentation of OHI (Other Health Insurance)
· Processing TPC (Third Party Collections) Inpatient and Outpatient Refunds, increasing hospital revenue by $1.5 million per year.
· Process Medical Treatment Facilities' staff requests for Professional Certification Reimbursements
· Review and approve or disapprove proposed trips based on trip data, estimated costs, balance in budgets, and exceptions to DoD (Department of Defense) travel policy as an appointed Certifying Official with the responsibility for the mission and the authority to obligate funds to support temporary duty travel for the mission
· Collaborate with various agencies and workplaces to extend workplace understanding and enhance compliance
Certified Electronic Health Record Specialists-02/2018
Certified Coding and Billing Specialist- Expected 09/2020
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