Medical Manager
Resume:
LORI SITTON
* * ******* **** **, Milan, TN ***** • Cell: 731-***-**** • abn1i3@r.postjobfree.com
O BJECTIVE
A ccomplished leader seeking a challenging career opportunity where expertise in strategic planning,
p roactive project management, decisive leadership, dynamic client relations, and targeted marketing
a nd business development can be effectively applied towards defining and achieving company
o bjectives.
WORK HISTORY
M edical Practice Consultant Milan, TN
Self Employed J an 2011 to Present
Provide services for West TN Providers, including clinic start up, software set up for EMR and billing,
A /R recovery, consulting on fee schedule, managed care contracts, hiring staff, employee evaluations,
p ayroll and policies and procedures.
Increased single provider income from $6,000 to $80,000 monthly.
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A dministrator, Specialty Medical Practices J ackson, TN
West TN Healthcare Jan 2007 to Jan 2011
Directly supervised 5 specialty medical practices, 4 trauma/general surgeons, 12 neurologists, 4
n eurosurgeons, 1 neuro psychologist, 5 cardio thoracic surgeons, and 100 supporting clinic
e mployees. P rimary responsibilities included day to day operations, marketing, employee evaluations,
h iring, payroll, physician and employee staff support, creating and maintain policies and procedures,
a nd maintain compliance with all state and federal regulations.
Involved in the purchase of specialty medical practices by the hospital and transition all billing
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t o hospital system, setting up policies and procedures, and transition of paper medical records to
EMR (electronic medical records).
Project Management of building of Medical Office Building for Specialty Clinics, managing all
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c ontractors and sub-contractors.
Responsible for recruitment and hiring of specialty physicians and annual evaluations.
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Initiated marketing for West TN Heart Network with the Cardiothoracic Surgeons.
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O perations Manager J ackson, TN
S emmes Murphey, Neurology & Neurosurgery Practice Jan 2006 to Jan 2007
Managed all day to day operations and billing for Neurology Clinic with ancillaries including sleep study
lab, EMG, EEG, MRI and CT Scans.
Transition of billing system and EMR for efficient maintenance of Accounts Receivables.
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P hysician Billing Manager J ackson, TN
West TN Healthcare Dec 2002 to Jan 2006
Managed billing operations for 150 physicians, staff included 80 employees with functions of payment
p osting, demographic entry, insurance follow up, managed care credentialing, medical coding and
c ustomer service.
Accounts receivable in excess of 8 million per month.
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Developed and maintained database for tracking and analyzing insurance denial data for trending
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a nd educational development.
Maintained all training for staff individually and in classroom settings.
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Met with ancillary departments and insurance payers to develop relationships and address
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o utstanding issues.
P roject Manager, Physician Billing J ackson, TN
West TN Healthcare Mar 2002 to Dec 2002
Organized the transition of hospital based physicians from the Business office to the Physician Billing
D epartment in accordance with timeliness set aside by Quality Council.
Transitioned 8 million in A/R to new billing system, changing physicians compensation to real
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r eimbursement.
Worked with Information Systems Department to retrieve data from multiple systems and
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c onsolidate to one by electronic methods.
Developed presentations to explain physician change in reimbursement.
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S enior Provider Contract Analyst J ackson, TN
West TN Healthcare May 1998 to Mar 2002
Functioned as a liaison between West Tn Healthcare affiliated physicians and managed care groups
i ncluding credentialing, contracting and application process. C oordinated all activities for the
c redentialing employees and contracting/credentialing for over 500 physicians.
Developed electronic method in order to process applications and contracts more efficiently.
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Educated Physicians and their clinic staff regarding managed care contracts and compliance
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r egulations.
Negotiated and maintained contracts for physicians.
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Audited physician claims to verify correct reimbursement according to the contract.
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Participated in promotion of WTH by completing full financial analysis for clinics in West TN.
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P art Time Instructor J ackson, TN
West TN Business College Jan 2000 to Dec 2000
Taught classes including Introduction to Accounting I & II, Computerized Accounting and Introduction
to Information Systems.
A ccounts Payable Representative J ackson, TN
West TN Healthcare A ug 1996 to May 1998
Responsible for accounts payable for Jackson Madison County General Hospital and five affiliate
h ospitals. B alanced end of month A/P reports, completed capital equipment ledger for depreciation.
A ssisted external and internal auditors and completed payroll for over 5,000 employees.
E DUCATION
U nion University J ackson, TN
Masters of Business Administration, GPA 3.8 Aug 2002 to Dec 2004
Union University J ackson, TN
B achelors of Science, Accounting Aug 1997 to Dec 2000
MEMBERSHIPS
H ospital Employee Fund Committee, Hospital Quality Plus Committee, Hospital Policy and Procedure
C ommittee, MGMA
SOFTWARE/SYSTEM SKILLS
Microsoft Office (Word, Excel, Access, Power Point, Outlook), Filemaker, Global and ESI (Accounting),
AS400 (Series), DOS, Quickbooks, Goldmine (Sales), RIS (Radiology), Paperwise (Imaging), Horizon
Plus, Centricity, Kareo (medical billing), Midas (Hospital Credentialing & CPI), ESI, MDStaff, Practice
Fusion (Medical EMR)
Developed Access Database for Physician Billing in order to analyze and trend data for claim
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d enials and employee productivity.
Set up and maintained software for physician clinics, included medical billing and electronic
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m edical record (EMR) software.
REFERENCES
G eorge Austin
f ormer Executive Director Physician Services
West TN Healthcare
Stephanie Daniels
Director Business Office
C ommunity Health Services, Regional Hospital
Kristi Johnson
S ales Representative
V olunteer Home Services
M ichael McAdoo, MD
p hysician
Milan Medical Center
( 731) 686-1 5 0 5
R onnie Coleman
p astor
I mmanuel Baptist Church
P ace, FL
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