Seasoned Administrator focused on business and operational improvements. Dedicated and decisive leader with strategic and forward-thinking mindset. Brings 21 years of progressive Professional Specialty Medical Fields business experience in Astute business administration professional driven to oversee operations with results-oriented mindset. Knowledgeable about all areas of Specialty billing ,coding and Insurance liaison with demonstrated track record of success in surpassing targets.
Patient care and their Rights and Privacy are the first priority most important consideration . Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Energetic Administrator offering wealth of experience in interacting with office staff and patients, supply restocking and scheduling appointments. Hardworking, educated and willing to go extra mile to complete any task.
Skills
Financial leadership
Documentation and reporting
Operations oversight
Office administration
Strategic planning
Administrative support
Technical Support
Business administration
Project Management
Mail handling
Staff Management
Bookkeeping
Responsible
Education
Professional Career CollegeVictorville, CA, Expected in 07/2002 – –Medical Billing And Coding Diploma:Medical Billing And Coding - GPA:
Completed professional development in Medical and Coding Specialist.
Medical Transcription
Front Office Administration
Hippa Certification
Relevant Coursework Completed: Medical Billing & Coding Specialist
Job-related courses: Medical Terminalogy and Front office Administration
Professional development completed in [Subject]
Accomplishments
Documented and resolved CMS Mipps takeback final decision no appeal rights which led to Audit takeback overturned and full refund plus interest fully refunded back to Practice .
Resources and respect on applying skills to better Patient care.
Work History
Deaconess Health System - Heathcare Administrator Evansville, IN, 04/2021 - Current
Managed bi-weekly payroll employees, as well as insurance matters, workman's compensation and compliance reporting.
Entered and maintained departmental records in company database.
Devised and implemented improvements to reporting procedures.
Conducted in-depth troubleshooting of program problems and employee concerns and recommended corrective actions to resolve issues.
Managed payroll, transactions, invoicing and budgeting to decrease financial inconsistencies.
Networked with industry professionals to foster partnerships and identify new and improved solutions.
Adapted to workflow changes and implemented continuous process improvements to overcome obstacles.
Computerized office activities, maintained customer communications and tracked records through delivery.
Drove workflow improvements by streamlining processes.
Developed revisions for systems and procedures by evaluating operational practices and identifying improvement opportunities.
Managed agendas and calendars, boosting productivity and improving organizational initiatives.
Aided colleagues, managers and customers through regular communication and assistance.
Screened and transferred incoming calls, took down messages and transmitted information and documents to internal personnel.
Billing Specialist Professional Fees and Appeals paid at 95%
Direct Patient care
Critical problem solving and and investigation to get correct information to decrease Balance billing.
Confirmed accurate completion of forms and reports for admission, transfer or discharge of each program participant.
21 years of Practice Insurance verification and Patient liaison,HIPAA Compliance Requirements.
Provider and Practice Credentialing.
Medication Authorizations.
Professional Authorizations.
Handled calls daily to address customer inquiries and concerns
Worked with chronic and terminally Patients to understand needs and provide excellent service
Worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately
Worked flexible hours; night, weekend, and holiday shifts
Adhered to social distancing protocols and wore mask or face shield at all times
Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
Increased customer satisfaction by resolving insurance and billing issues.
Performed duties in accordance with all applicable standards, policies and regulatory guidelines to promote safe working environment
Conducted research, gathered information from multiple sources and presented results.
Oversaw daily operations to ensure high levels of productivity
Actively listened to customers, handled concerns quickly and escalated major issues .
Improved operations through consistent hard work and dedication
Exceeded goals through effective task prioritization and great work ethic
Led projects and analyzed data to identify opportunities for improvement
High Desert Nephrology - Medical Biller and Coder City, STATE, 10/2002 - 04/2009
Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
Accurately selected proper descriptive code when more than one anatomical location was indicated.
Verified signatures and checked medical charts for accuracy and completion.
Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
Reviewed patient charts to better understand health histories, diagnoses and treatments.
Coded Observations and Inpatient Professional Services at average rate of 15 claims per hour.
Initiated, performed and documented quarterly coding audits for physicians.
Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Data verification and entry
California Villa Retirement/Shea Convalecent - Patient Care Technician City, STATE, 03/1996 - 03/1998
Attended to patient and family's immediate needs and concerns by acknowledging and providing required attention.
Recognized and reported abnormalities and/or changes in patients' health status to case manager.
Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
Obtained patient vital signs and reported results to staff nurse or physician, noting changes from prior measurements.
Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
Planned, prepared and served meals and snacks according to prescribed diets.
Monitored and assisted residents through individual service plans.
Determined specific needs and provided most appropriate level of services for patient well-being.
Monitored ongoing care and proactively corrected problems.
Helped enhance unit operations by continuously delivering accurate, efficient care and maintaining performance objectives.
Reassured patients by explaining medical practices and processes in easy-to-understand terminology.
Answered over light or bell calls per shift to respond to patient requests and needs.
Updated documentation and reports detailing patient activities, care actions and hospital determinations.
Documented residents' behavior in terms of mental status, sleeping and eating patterns in medical record books.
Facilitated communication between all hospital departments.
Liaised between hospital departments to facilitate effective communication.
Evaluated patients to identify and address wounds, behavioral concerns and medically relevant symptoms.
Maximized patient satisfaction by helping individuals carry out personal tasks such as dressing and walking.
Reported any unusual or urgent circumstances in patients' condition or environment immediately to nurse supervisor.
Remained alert to problems or health issues of clients and competently responded.
Scheduled and accompanied clients to medical appointments.
Contributed to efficient unit operations by keeping patient and facility paperwork current and accurate.
Supported patient mobility needs with correct assistive devices and proper body mechanics to prevent injuries.
Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
Upheld confidentiality requirements and regulatory compliance guidelines in all areas.
Completed documentation of care, hospital actions and patient activities.
Monitored and maintained cleanliness, sanitation, and organization of assigned station and service areas.
Transported food trays and aided with feeding.
Furthered skills by actively taking part in employee trainings and taking classes in subjects to improve skills.
Maintained confidentiality of patient data and condition at all times to safeguard health information.
Reviewed each step of patient care and made proactive adjustments to avert issues.
Provided subject matter expertise in case management and related procedures.
Recorded vital signs such as temperature, blood pressure, pulse, or respiration rate as directed by medical or nursing staff.
Maximized preventative care utilization to reduce hospital burden and help eliminate readmissions.
Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
Coached patients and caregivers on treatment processes, hospital policies, medication hazards, specific diets and doctor advice.
Connected patients with available community and charitable resources
Assessed patients to gather medical information including weight and height measurements and vital signs to assist LVN and caregivers with patient care initiatives.
Aided Physicians in wound care, patient assessments, discrepancy reporting and additional treatments to enhance productivity.
Worked with patients and families to develop future plans and discuss care actions.
Answered over 25 light or bell calls per shift to respond to patient requests and needs
Organized and replenished unit supplies to maintain team readiness for expected demands.
Supported patient admissions, discharges and transfers to promote team productivity.
Helped patients maintain healthy skin by checking wounds, assessing integrity and bathing bedbound individuals.
Assembled admissions pages and added new pages to patients' charts.
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