Energetic, organized, and detail oriented proactive hands on Manager. Adaptable team player seeks to obtain a challenging, and responsible position within a successful Health Care organization. To utilize my exceptional follow through and customer service skills, fast pace leader with strong multi-tasking ability. Consistently meeting and exceeding profitable growth in sales revenues through positive planning, while focusing on customer service.
Medical Billing Specialist
- Leadership/Communication
- Employee Development and Training
- Conflict resolution
- Patient-oriented
- Staffing management ability
- Maintains strict confidentiality
- Strong work ethic
- Effectively influences others
- Sound decision making
- Employee Relationship and Team Building
- Personal andPprofessional Integrity
- Strong planning skills
- HIPAA compliance
- Team player with positive attitude
Working toward Associate degree in Health Information Technology
Staff Development:
- Created and implemented departmental training program for all new employees.
- Organized and led monthly personnel meetings with team members.
- Mentored and coached employees resulting in a 10% - 15% increase in weekly productivity scores.
Process Improvement:
- Introduced new and revised departmental procedures regarding POS collection processes, Direct Admission and Transfer policies and updated insurance verification methods, all in accordance with health system objectives and with changes in local, state and federal laws and regulations.
Fairfax, VA, 03/2015 - 10/2015
- Provided oversight management of 20+ employees, to include hiring, training, scheduling, payroll, and performance reviews.
- Monitored Patient Access performance to ensure timeliness, accuracy, and compliance with industry and organizational policies and standards, including (but not limited to) HIPAA, EMTALA, and Joint Commission requirements.
- Identified and implemented process and company compliance policies, and timely staff education.
- Practiced and promoted following of organization mission, vision, values, and promise.
- Conducted probationary and annual performance evaluations of all nursing staff.
- Assigned staff to meet patient care needs and address productivity standards, while adjusting for census, skill mix and sick calls.
- Reviewed and approved time cards for processing by payroll department.
City, STATE, 06/2006 - 03/2015
- Obtained demographic and insurance information.
- Obtained pre-certification or authorization for procedure.
- Oversaw the daily activities of the registration area to insure department standards were met.
- Assisted Manager in educating Patient Access staff of any changes pertinent to their roles.
- Performed point-of-service collections in a professional manner Acts and communicates in a professional manner, appropriate for the health-care setting.
- Strictly followed all federal and state guidelines for release of information.
- Directed patient flow during practice hours, minimizing patient wait time.
- Acquired insurance authorizations for procedures and tests ordered by the attending physician.
- Arranged and assisted with hospital admissions.
- Completed registration quickly and cordially for all new patients.
- Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
- Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
- Confirmed patient information, collected copays and verified insurance.
- Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
- Efficiently performed insurance verification and pre-certification and authorization functions.
City, STATE, 08/2004 - 03/2015
- Provided excellent customer service to patients
- Wrote clear and detailed clinical phone messages for physicians.
- Directed patient flow during practice hours, minimizing patient wait time.
- Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
- Acquired insurance authorizations for procedures and tests ordered by the physician
- Completed registration quickly and cordially for all new patients.
- Scheduled radiology exams for patients.
- Reviewed diagnostic and procedural terminology for consistency with acceptable medical nomenclature.
- Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
- Consistently informed patients of their financial responsibilities prior to services being rendered.
- Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
- Efficiently performed insurance verification and pre-certification and authorization functions.
- Provided excellent customer service to patients
- Reviews and evaluates patient's insurance coverage.Called private insurance companies, Medicare, Medicaid and Tri-Care to obtained benefit information.
- Completed appeals and filed and submitted claims.
- Responsible for training.
Bilingual in Spanish-English
•More than 14 years of customer service experience
•Basic knowledge of medical terminology
•Good written and verbal communication skills
•Knowledge of ICD-9, CPT coding, with insurance terminology and ability to read Explanation of Benefits.
•Excellent organizational skills, and able to manage multiple priorities and responsibilities
•Proficient in Syngo, Invision, Medical Manager, Siemens, Right Fax, Scheduler Maximizer, Advance Visualization, Ahiqa, Pacs Cube CD burner, Kronos, EDM, Microsoft Word and AS400
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School Attended
- DeVry University
Job Titles Held:
- Patient Access Manager
- Outpatient/ER Team Lead
- Radiology Coordinator/Insurance Liaison
Degrees
- Associate Degree
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