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physician practice manager resume example with 12+ years of experience

JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
Summary

Healthcare Administration professional with proven business acumen for operational management in patient centered medical clinics. Strategic planning and program implementation focused on CQI; improving health care management and prevention strategies. Proven problem solver and excellent communicator. Strong organizational skills, superb understanding of data collection and performance metrics. Successfully oversees budgeting, human resources, supply management,providers, interns and patient services. Develop and lead productive and efficient clinic staff.

Skills
  • Policy and procedure development
  • EPIC/Cerner
  • HIPAA and Joint Commission
  • Performance metrics
  • Budget oversight
  • Diversity and Inclusion Management
  • CMS/Press Ganey
  • EMR/ EHR
  • Microsoft Office Advanced Proficient
  • Occupational medicine
  • New Hire Training
  • Employment Performance Evaluations
Experience
01/2018 to Current Physician Practice Manager Amita Health | Vernon, CT,
  • Maintained and revised policy procedures for general operation of compliance program.
  • Worked with small and medium enterprises to draft documents, monitor attendance and conduct audits.
  • Conceptualized, developed and implemented safety system improvement initiatives.
  • Trained interns and newly hired team members on office procedures and computer system.
  • Oversaw accounting, budgeting and financial reporting.
  • Developed policies and procedures for effective practice management.
  • Boosted staff morale by offering constructive feedback and specific direction.
  • Developed and maintained electronic record management systems to analyze and process data.
  • Addressed and remedied all patient or team member issues.
  • Communicated closely with patients, ensuring medical information was kept private.
  • Supervised team of 52 office personnel and 38 Providers.
  • Carefully maintained and circulated filing documents and records to department heads.
  • Assisted with regulatory issues such as compliance.
  • Assessed processes and procedures, complying with Joint Commission and HIPAA regulations.
  • Developed organizational methods and policies, implementing training initiatives to deliver ongoing awareness of and compliance with established procedures.
  • Direct day-to-day administrative and operational functions for 7 specialty clinics, providing guidance and leadership to over 52 employees across more than 7 departments.
  • Enforced safety and regulatory adherence throughout client projects and training programs.
  • Collaborated with leadership to devise strategies to improve processes and risk controls as well as implement new systems and best practice guidelines.
  • Produced monthly financial reports like income statements, balance sheets and cash flow statements for presentation to board of directors.
  • Scheduled surgeries, managed pre-certifications and verified insurance coverage.
  • Enforced regulations by reviewing federal and state laws to confirm compliance.


01/2017 to 01/2018 Field Analyst Manager Aln Medical Management | Lincoln, NE,
  • Under minimal direction, works directly with each Plan's external providers to educate, advocate, and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving upmost highest level of customer service.
  • Conducted over 15 monthly provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet, or exceed each individual MCO Plan's monthly site visit goals. Proactively engage with each assigned provider and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess non-clinical quality of customer service provided to Molina members.
  • Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining positive working relationship.
  • Independently troubleshoots problems as they arise, making assessments when escalation to Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between providers and MCO Plan whenever possible. Handled questions, issues or problems that may emerge during visits are unpredictable and may range from simple to overly complex or sensitive matters.
  • Initiates, coordinates, and participates in problem-solving meetings between each assigned provider and Molina stakeholders, including senior leadership and physicians. Such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding, for example.
  • Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of each health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multi-specialty groups or health systems, executive level decision makers, Association meetings, and JOC's).
  • Trains other Provider Services Representatives as appropriate.
01/2016 to 01/2017 Medical Billing Manager Aln Medical Management | Los Angeles, CA,
  • Reviewed billing problems, researched issues and resolved concerns.
  • Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
  • Worked with customers to develop payment plans and bring accounts current.
  • Directed operations in busy 30-person billing group managing $850,000 in monthly funds.
  • Conducted performance reviews and implemented improvement plans.
  • Created new standard operating procedures improving billing accuracy and cash flow.
  • Performed testing for billing modules, enhancing new functionality and process improvements.
  • Trained and mentored staff on procedures, compliance requirements and collections techniques.
  • Worked cross-functionally with customer service, inventory and finance teams for conflict resolution.
  • Improved overall financial reporting by streamlining control processes and reporting structures.
  • Established and enforced internal controls, workflows and policies for tracking, reconciling and reporting on accounting activities.
04/2010 to 12/2015 Medical Billing Manager Louisiana Urgent Care Brusly/Opelousas | City, STATE,
  • Reviewed billing problems, researched issues and resolved concerns.
  • Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
  • Worked with customers to develop payment plans and bring accounts current.
  • Directed operations in busy 40-person billing group managing over 1 Million in monthly funds.
  • Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
  • Prepared internal and regulatory financial reports, balance sheets and income statements.
Education and Training
Expected in 01/2023 Master of Science | Healthcare Adminstration Southern New Hampshire University, New Hampshire, OH, GPA:
Expected in 12/2020 Bachelor of Science | Finance Southern New Hampshire University, New Hampshire, OH, GPA:
Expected in 05/2000 High School Diploma | Baker High School, Baker, LA GPA:
Accomplishments
  • Led team to achieve 100% SAFETY COMPLIANCE, earning recognition from upper management and financial reward.
  • Created highly effective new ACCOUNTABILITY PROGRAM that significantly impacted efficiency and improved operations.
  • Realized TO AUDIT PAR LEVELS AND ADUIT BILLING in ongoing effort to boost revenue while reducing costs.


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Resume Overview

School Attended

  • Southern New Hampshire University
  • Southern New Hampshire University
  • Baker High School

Job Titles Held:

  • Physician Practice Manager
  • Field Analyst Manager
  • Medical Billing Manager
  • Medical Billing Manager

Degrees

  • Master of Science
  • Bachelor of Science
  • High School Diploma

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