Performance driven Management professional with strong leadership and relationship-building skills. Organized and diligent, with excellent written, oral and interpersonal communication skills.
Bookkeeper with key strengths in planning, problem solving and customer relations. Familiar with financial reconciliations, general ledgers and financial reporting.
Education
Centene Corporation, Expected in 2015 – –Certification:Management Training - GPA:
Coursework in Seven Habits of highly Effective People
Chicago State University Chicago, ILExpected in 2013 – –Bachelor of Arts:Business Administration - GPA:
, Expected in 2012 – –:Illinois Notary Public - GPA:
Skill Highlights
Staffing management ability
Proven patience and self-discipline
Patient-oriented
Personal and professional integrity
Sound decision making
Critical thinking proficiency
Relationship and team building
Financial aptitude
Staff training and development
Claims analysis and review specialist
Professional Experience
Cdw - Supervisor/Member & Provider Services Call Center Palo Alto, CA, 11/2014 - Current
Addressed customer service inquiries in a timely and accurate fashion.
Participate in interdepartmental communication meetings to resolve gaps in communication and resolve inefficiencies
Reviewed and approved time cards for processing by payroll department.
Perform call observations and evaluations for quality control
Formulated and enforced Service Center policies, procedures and quality assurance measures.
Assisted with the development of the call center's operations, quality and training processes.
Trained staff on how to improve customer interactions.
Processed sensitive grievance and Appeals complaints with DOI department for resolution
Provided thorough supervision for day-to-day operations of rep's in accordance with set policies and guidelines.
Jumped in to fill gaps for weekend coverage rotation when necessary.
Regularly evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed.
Diligently monitored the QA (Quality Assurance) program to improve performance and maintain high standards of customer service.
Minimized staff turnover through appropriate selection, orientation, training, staff education and development.
Organized and led weekly staff huddles meetings with 20 team members.
Built customer loyalty by placing follow-up calls for customers who reported product issues.
HCR Manor Care - Administration/ Business Office Manager City, STATE, 10/2005 - 11/2014
Direct the overall Business Office activities in accordance with current applicable federal, state, and local standards, guidelines and regulations
Consult daily with Department Heads and Administrator regarding any financial or customer service issues resulting in Involuntary Discharge Planning
Led the Reception staff, Account payable and Payroll clerks
Conduct monthly A/R reviews for updated status on all collection efforts concerning Private pay, Medicare, Insurance and Medicaid billing
Main contact for maintaining Internal Audit policy and procedures
Consistently maintaining company goal in leading cash collection goals 95%
Managed all necessary overall bookkeeping logs for accuracy and compliance
Assure proper administrative procedures are maintained with focuses on legal and residents rights Resident Trust Fund
Reconciler Review and provide private pay refund checks
Cooperated with other health related agencies and organizations in community activities.
Provided thorough supervision for day-to-day operations of facility in accordance with set policies and guidelines.
Jumped in to fill gaps for on call rotation when necessary.
Established and maintained positive relationships with government regulators, residents, families, other area health care providers, physicians and community at large.
Developed and managed budget and revenue expectations while actively seeking ways to eliminate or reduce expenses.
Observed strict confidentiality and safeguarded all patient-related information.
Reviewed and approved time cards for processing by payroll department
.Maintained accounts receivable documentation electronically and on paper.
Processed bank reconciliations and financial reports to verify practice of proper due diligence.
Handled cash and deposits using the proper accounting procedures and documentation.
Researched and resolved collections and billing disputes with tact and efficiency.
Illinois Collection Service - Medical Collection/Insurance Biller City, STATE, 07/2003 - 10/2005
Arrange and set acceptable payment plans on non-insurance holders medical bills
Execute and bill for co-insurance and out of pocket deductibles due the hospital
Perform skip tracing duties and retrieve credit reports on bad debt accounts making decisions on reporting adversely to credit bureaus
Process accounts for legal action that show ability for suit or liens
Maintained billing duties to various insurance carriers to process HCFA/UB92 for payment
Post payments via credit cards and checks by phone
Addressed low income and hardship debtors with charity programs offered by the hospitals
Consistently achieve group $850,000 goal and individual goals of $50,000 per month.
United Healthcare - Contract Analyst City, STATE, 09/2000 - 10/2002
Handled provider related inquiries Resolved claim processing issues and prepared status reports
Prepared tracking graphs for complex fee schedules Investigated and evaluated activities performed by the claim processing unit
Collaborated with Senior Network Account Managers to identify potential load issues and recommend corrections Tracked audits on unpaid check issues
Communicated key provider disruption issues utilizing the Network Change Database.
United Healthcare - Provider System Specialist City, STATE, 08/1998 - 09/2000
Created provider records in all systems for all physicians and ancillaries
Maintained the data entry of physician re-accreditation applications
Updated physician demographic and contract information on internal database to assist with provider directory
Communicated/educated internal staff of appropriate information needed to complete the data entry process
Responsible for maintaining provider directories and other marketing tools Responsible for assisting supervisor with unit production updates.
Skills
Windows, Microsoft word, Power Point, Excel, Word, Word Perfect, Administrative, Medical Manager, Medicare DDE, Kronos, Trucare, Portico, Emdeon, Medicaid Rev System, Ability Medicare, Resident Fund Management System, Allscripts, Matrix, Wound Rounds, HSSI, ADP E-Time, Billing, Bookkeeping, Call Center , Coaching , Credit Collections, Customer service, Data entry, Database Management, Discharge Planning, Financial , Graphs, Insurance Internal Audit, legal, marketing, Team meetings, Networking, Payroll, Quality control, reporting, Supervisor
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