Participants Record Specialist resume example with 19+ years of experience

(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
Professional Summary
Highly motivated Sales Associate with extensive customer service and sales experience. Outgoing sales professional with track record of driving increased sales, improving buying experience and elevating company profile with target market.
Core Qualifications
Computer Literate (Microsoft Word, PowerPoint, Excel, Outlook Express, QuickBooks, Medical Assistance/ Private Insurance Billing)
University of Phoenix Online Phoenix, AZ Expected in August 2012 Master's : Accountancy - GPA : Accountancy
University of Phoenix Online Phoenix, AZ Expected in August 2006 Bachelor's : Business Accounting - GPA : Business Accounting
Community College of Philadelphia Philadelphia, PA Expected in June 2000 Associate's : Accounting - GPA : Accounting
Us Lbm Holdings - Participants Record Specialist
Silsbee, TX, 10/2012 - Present
  • Manages all information related to services provided to individuals as it pertains to administration and billing.
  • Accurately and completely registers all individuals in the agency's computer system; and processes all data/ forms related to registrations per agency policies and procedures on a daily basis.
  • Verifies insurance coverage with insurance carriers for each individual on the agreed cycle of verification determined by the program needs Clears suspense and rejected billings by working cooperatively with clinical personnel and the Billing Department.
  • Accurately schedules initial intake appointments in a manner that maximizes daily service delivery.
  • Uses internal reports to identify, troubleshoot and resolve suspense and rejection problems on a timely basis.
  • Provides supervisor with an accurate accounting of all monies collected and turned in on a daily basis.
  • Prepares and sends routine individual information and billing related correspondence as authorized by supervisor or clinical staff in accordance with agency policies on confidentiality and HIPPA requirements.
  • Assists Managers in preparing weekly and monthly accountability reports.
  • Drafts analysis and responses to inquiries related to such.
  • Compiles data, as requested.
  • Proactively analyzes and assesses participant information to discern trends and early warning on emerging issues.
  • Maintains all administrative and billing data and information throughout the life cycle of a participant's tenure with the agency, including but not limited to: authorizations for service that are current at all times, status of insurance eligibility assessments, and other information required for complete, accurate and timely billing of services for assigned participants.
Good Fortune Physical Therapy LLC - Office/Billing Manager
City, STATE, 01/2008 - Present
  • In charge of all daily internal tasks Updating Client databases Scheduling interviews and company meetings Manage bill payment, invoicing to other agencies, and receipt of reimbursements Complete quarterly budgets, monthly payroll, and Medical Assistance Billing Submissions Assist Director in projects, data collection, and decision making Monitor all subcontractors' progress, paperwork, licensure, certificates, and trainings Handle any family, agency, subcontractor, employee, and other company complaints.
Consortium Incorporated - Administrative Assistant
City, STATE, 12/2008 - 10/2012
  • In charge of monitoring daily tasks and assisting supervisor Check emails, phone messages, and mail daily; file documents as needed Make sure all forms are copied and accessible for staff Keep caseloads and addresses updated/ Give Case Managers new copies quarterly Update all kids' information into the data entry system and the census Send welcome and discharge letters to the families Complete and turn in timesheets report, doc report, outcome and expense report.
  • If supervisor isn't present, complete weekly and productivity report Check Liability and 271 reports for errors Type evaluations and addendums Report maintenance of all vehicles.
Sunshine Therapy Club Incorporated - Fiscal/Billing Clerk
City, STATE, 01/2001 - 01/2007
  • Responsible for assisting the Director in setting goals and priorities Manage the administration of specific projects, programs, or activities as assigned Review and provide feedback on employee performance Assist in determining assignment of tasks to staff Direct the day-to-day operations of the department including, but not limited to, supervision of financial matters and assignment of work Recommend various personnel actions including, but not limited to, hiring, performance appraisal, promotions, transfers, and vacation schedules Determine fiscal requirements; prepare budgetary recommendations; monitor, verify, and reconcile expenditure of budgeted funds Dedicated to running full capacity of accounts receivable and accounts payable departments Knowledgeable of paying all company bills, updating invoices, completing budgets, preparing payroll, lowering company expenses, and raising company profits Monitored training, subcontractors, employees and overall performance of the company.
accounting, accounts payable, accounts receivable, administrative, agency, Billing, billings, budgets, Computer Literate, Client, data collection, data entry, databases, decision making, delivery, financial, forms, funds, hiring, Insurance, invoicing, letters, Director, Medical Assistance, meetings, Excel, mail, Outlook Express, PowerPoint, Microsoft Word, payroll, performance appraisal, personnel, policies, processes, progress, QuickBooks, Scheduling, supervisor, supervision, phone, troubleshoot, Type

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Resume Overview

School Attended

  • University of Phoenix Online
  • University of Phoenix Online
  • Community College of Philadelphia

Job Titles Held:

  • Participants Record Specialist
  • Office/Billing Manager
  • Administrative Assistant
  • Fiscal/Billing Clerk


  • Master's
  • Bachelor's
  • Associate's

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