Supervisor Of Medicaid Billing Team Resume Example Columbus Regional Healthcare

SUPERVISOR OF MEDICAID BILLING TEAM

Summary

I am a driven and compassionate healthcare professional with over 10 years hands-on experience in a hospital environment. I have experience in managing all activities related to billing, follow-up, scheduling/pre-registration, and monitoring accounts receivables. I am a strong problem-solver with excellent time management skills and comprehensive understanding of the Revenue Cycle.

Experience

Columbus Regional HealthcareFebruary 2013 to CurrentSupervisor of Medicaid Billing Team
Columbus, GA

Monitor all activities related to billing, follow-up, and monitoring account receivables.
Develop and arrange continuing education opportunities for all staff to increase knowledge and skills.
Revise policies and procedures in accordance with changes in local, state and federal laws and regulations.
Regularly evaluated employee performance, provided feedback and assisted, coached, and disciplined staff as needed.
Carefully selected, developed, and retained qualified staff as well as trained new staff when needed.
Assist with submitting appeals and working denials.
Review accounts for discrepancies in adjustments and payments.

Columbus Regional Healthcare SystemsDecember 2009 to February 2013Manager
Columbus, GA

Directed and managed the activities related to registration, which included admissions, pre-registrations, insurance verification, pre-certification and financial counseling to ensure payment from insurance carriers and patients.
Served as liaison between management, clinical staff, and the physician's offices.
Provided department statistical data to upper management.
Monitored schedules to ensure procedures were scheduled correctly according to departmental policy and procedures.
Jumped in to fill gaps when needed.
Implemented Ultra call monitoring system to provide coaching, training, and support to staff to ensure excellent customer service are fostered.
Created tools to measure and report productivity using the Avaya system, bench marks and scorecards.
Obtained authorizations, researched denials, and submitted appeals.
Increased POS collections and pre-registrations by 95%.
Regularly evaluated employee performance, provided feedback and assisted, coached, and disciplined staff as needed.
Assigned appropriate CPT codes and checked for medical necessity using 3-M according to the Medicare guidelines.
Responsible for building relationships with physicians' offices which resulted in an 3% increase in patient referrals.
Reduced patient no-show rate by 2% Instrumental in assisting registration to reduce wait times Maintained the budget and cost control Assisted in interviewing applicants for openings within the department.
Monitored overtime, sick, and vacation time to ensure adequate staffing.

Columbus Regional Healthcare SystemsFebruary 2006 to February 2010Supervisor
Columbus, GA

Supervised the day-to-day operations of the Insurance Billing and Follow-up Departments.
Monitored all insurance claims activities and the productivity of all insurance postings, and accounts receivables.
Maintained 98% account receivable for accounts 120 days and less.
Reviewed patients' bills for disputed charges.
Ensured compliance with governmental and payer rules Assisted in interviewing applicants for openings within the department.
Monitored overtime, sick, and vacation time to ensure adequate staffing.
Regularly evaluated employee's performance and provided feedback.
Assisted, coached, and disciplined staff as needed.
Researched and followed up on denials and assisted with filing appeals.
Responsible for effectively communicating with patients, physician's offices, and departments to resolve issues when needed.

New HorizonJune 2003 to March 2006Job Coach
Columbus, GA

Instrumental in training newly hired mentally challenged consumers how to perform their job duties.
Arranged or transported consumers to and from work.
Provided assistance to help consumers complete their tasks when needed.
Tracked and documented the mental and physical progress of the consumer in their medical record.
Counseled and prepared residents for their transition back into the community.
Scheduled meetings with Case Manager and guarantor to provide assistance with scheduling appointments.
Served as a advocate for the consumer.
Set goals for the consumer and tracked them daily.
Administered patient's medication as needed.
Coordinated site visits for consumers.
Developed workable solutions for recurring problems for individuals and families.

Columbus Regional Healthcare SystemsOctober 2001 to March 2006Registrar/Insurance Follow-Up Specialist
Columbus, GA

Aggressively pursed payments from third parties on unpaid insurance accounts.
Researched and analyzed accounts to ensure that all possible sources of reimbursement have been maximized.
Ensured that all information required for prompt claims adjudication have been submitted according to payer requirements.
Answered inbound customer service calls related to insurance.
Submitted appeals based on payer requirements.
Obtained and entered demographic/insurance information, and verified eligibility on all patients.
Researched and resolved denials to ensure prompt payment from payers.

Cash Posting The Columbus Clinic, PCJanuary 1999 to October 2001Team Leader
Columbus, GA

Supervised the daily operations within the posting and filing department.
Daily monitored the smooth functions of posting payments and write-offs to patient accounts.
Assisted in training new employees.
Ensured all work is completed by the deadline.
Assisted in interviewing applicants for openings within the department.
Monitored overtime, sick, and vacation time to ensure adequate staffing.
Verified balances for assigned batches to ensure balancing.
Resolved unidentified payments daily.
Assisted with charge posting as needed.

Hughston Clinic, PCFebruary 1997 to March 1999Insurance Interviewer/Account Receivable Team Leader
Columbus, GA

Registered patients and verified eligibility on all patients.
Daily monitored the smooth functions of posting payments and write-offs to patient's accounts.
Assisted with charge posting as needed.
Assisted in training new employees.
Ensured all work is completed by the deadline.
Assisted in interviewing applicants for openings within the department.
Monitored overtime, sick, and vacation time to ensure adequate staffing.
Verified balances for assigned batches to ensure balancing.
Resolved unidentified payments daily.
Maintained the credit balance report.
Effectively communicated with patients and departments to resolve issues when needed.

Dr. Magdi HanafiApril 1996 to March 1999Office Manager
Columbus, GA

Managed the daily operations within the department.
Interviewed applicants for openings within the department.
Monitored overtime, sick, and vacation time to ensure adequate staffing.
Assisted with patients check-in, check-out, and cash posting.
Verified patient's insurance and pre-certification according to the surgery schedule.
Assisted with the scheduling of patients.
Oversaw claim billing and account receivable report.
Assisted with coding and medical necessity verifications.
Regularly evaluated employee performance, provided feedback and assisted, coached, and disciplined staff as needed.
Responsible for effectively communicating with patients and departments to resolve issues when needed.
Developed relationships with physicians' offices resulting in a increase in patient referrals.

Blue Cross Blue Shield of GADecember 1991 to March 1996Claims Examiner/Customer Service Representative
Columbus, GA

Coded and processed claims using the CPT and ICD-9 coding books.
Researched and resolved inquiries from patients, physicians' offices, and insurance companies in writing or over the telephone.
Maintained the claims suspense report.
Filed claims with other insurance companies.
Coordinated benefits with Medicare, Medicaid, and commercial payers to expedite claim payments.

Education

Southern Union Community College2006Certified Patient Account Representative 2007 Healthcare Financial Management Association Columbus, GA Certification: Leadership Development 2007: NursingColumbus Opelika, GA ALNursing

Columbus State University2003Associate of ScienceColumbus, GA

Chattahoochee Valley Community College1989Diploma: Information and Office TechnologyPhenix City, ALInformation and Office Technology

Columbus Technical CollegeColumbus, GA

Work History

Centralized Scheduling Department

Skills

accounts receivables, Avaya, balance, benefits, Billing, budget, coaching, Conflict resolution, contracts, cost control, counseling, CPT, credit, Critical thinking, excellent customer service, customer service, filing, Financial, Financial Management, ICD-9, imaging, Insurance, Kronos, team building, Leadership Development, Medical Terminology, meetings, 98, policies, POS, coding, progress, Scheduling, SSI, Staff training, staffing, telephone

Resume Overview

Companies Worked For:

Columbus Regional Healthcare
Columbus Regional Healthcare Systems
New Horizon
Cash Posting The Columbus Clinic, PC
Hughston Clinic, PC
Dr. Magdi Hanafi
Blue Cross Blue Shield of GA
Centralized Scheduling Department

School Attended

Southern Union Community College
Columbus State University
Chattahoochee Valley Community College
Columbus Technical College

Job Titles Held:

Supervisor of Medicaid Billing Team
Manager
Supervisor
Job Coach
Registrar/Insurance Follow-Up Specialist
Team Leader
Insurance Interviewer/Account Receivable Team Leader
Office Manager
Claims Examiner/Customer Service Representative

Degrees

Certified Patient Account Representative 2007 Healthcare Financial Management Association Columbus, GA Certification: Leadership Development 2007 : Nursing
Associate of Science
Diploma : Information and Office Technology

Supervisor of Medicaid Billing Team Resume Example

Resume Score: 90%

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