To work in a Profession that will challenge my leadership, management, and billing and Coding skills as well as continuing to develop my expertise in healthcare.
· Calculates financial liabilities for members served, provides individualized financial liability education to patients and families and processes payments.
· Establishes payment plans in accordance with Telecare's policies and protocols, and in collaboration with both facility leadership and the corporate financial services team.
· Ascertains insurance coverage and benefits to ensure accuracy of fiscal responsibility and is responsible for all revenue collection at hospital site.
· Generates key fiscal reports for facility and corporate leadership to monitor aging debt, missing authorizations, revenue collections, and write-offs.
· Determines action plan for uncollected debt; determining cases meeting criteria for collection or for consideration of a write-off with the revenue cycle team and leadership.
· Serves as primary liaison between program leadership and corporate fiscal and revenue cycle teams.
· Successfully navigates a sophisticated automated billing system as well as a manual system and the electronic medical record system.
· Works with Avatar, Kaiser portal, Noridian, Medi-cal, Medicare and has extensive experience in Epic.
· Actively manages, updates, and audits the facility contract binders. Engages with contracted vendors and partners to ensure all contracts and insurance information is up-to-date and meets Joint Commission regulations.
· Conducts infection control audits, Guard1 electronic rounding audits, non-clinical nursing audits and inventory audits; generates reports and recommendations based on findings.
· Fully CPI (Crisis Prevention Institute) trained and participates in behavioral health interventions, monitoring and support of the members being served.
· Lead participant in and co-facilitator of the Employee Engagement Action Group, working to improve employee morale, overall services, and to proactively support DEI (diversity, education and inclusion).
· Launched new role at Heritage Psychiatric Health Facility, building operational support for the Administrator, Director of Nursing, the nursing departments and mental health specialists.
· Served as primary liaison in the implementation of a new electronic rounding system for the monitoring of patients. Responsible for educating nursing and mental health staff on all three shifts.
· Led efforts with Guard 1 team and clinical leadership to problem solve Guard1's adaptation to a healthcare and psychiatric setting. Worked to obtain all required reports and problem solve operational glitches and system limitations.
· Designed inventory tools, auditing process and report. Maintained inventory, ordered supplies, tracked deliveries and worked with vendors to address delays.
· Prepared PPE and inventory reports for the Administrator for weekly corporate wide and Medicare mandated reports.
· Conducted infection control audits, Guard1 electronic rounding audits, non-clinical nursing audits and inventory audits; generated reports and recommendations based on findings.
· Fully CPI (Crisis Prevention Institute) trained and participated in behavioral health interventions, monitoring, rounding, and support of the members being served.
· Generated 24 hour rounding reports for clients and maintained rounding section in the medical charts.
· Served on Heritage leadership team and safety committee meetings.
· Trained all new staff on Guard1 monitoring system; maintained access list, onboarding and off boarding staff as needed.
· Actively managed, updated, and audited the facility contract binders. Engaged with contracted vendors and partners to ensure all contracts and insurance information was up-to-date and met Joint Commission regulations.
· Selected for a competitive slot for the Emerging Leader program.
· Piloted program performance improvement initiatives.
· Collected all vital insurance and financial information from the patient to assist in the determination of fiscal responsibilities and payer information.
· Processed and tracked insurance authorizations for patient services.
· Provided patient education and responded to inquiries regarding billing questions.
· Updated patient information in the electronic medical record system, Epic.
· Managed high-volume calls and in-person patient interactions at the registration desk; conducted appropriate triaging.
· Served in a key role for patient relations and grievance mitigation with successful proactive customer relations approach.
· Triaged and responded to inbound phone calls and emails from current and potential customers.
· Provided follow-up to customers regarding appointments and completed all documentation related to customer communication and action plans.
· Verified protected health information and authorizations for services.
· Followed all HIPAA protocols and utilized standard templates for correspondence with customers and providers.
· Scheduled initial appointments for new clients and entered all required information into computer system.
· Developed role over time to increase responsibilities related to customer communication, authorization verification, documentation and protocols.
· Served in a key role for customer relations with successful proactive customer relations approach.
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