Marie A. Barney

Home Address

*** ****** *********

Florence, Alabama 35630

Home: 256-***-****

Cell: 912-***-**** ac18u3@r.postjobfree.com

Summary of Qualifications

Effective Management. Recruited, trained, evaluated, developed and implemented procedures;

Detailed- oriented/multi-task. Demonstrated history of producing accurate timely reports and meeting deadlines. Thrive in deadline driven environment and able to balance competing priorities;

Exemplary Communicator. Accustomed to handling sensitive, confidential records and delicate situations that require discretion and tact. Performed tasks with professional and non-professionals at all levels.

Identify needs, tactfully answer questions, and solve problems;

Creative thinker. Enjoy developing policies and procedures to benefit the organization and public health.

Good written and verbal communication skills.

Professional Experience

Wayne Medical Center (Maury Regional Hospital), Waynesboro, TN, (November 2007 to Present), Director of Business Office/Director of Admission/Liaison for RAC’s)

My experience and knowledge include correct coding principles of CPT/HCPCS and modifier selection as well as, UBO4 revenue codes and 1500 billing requirements. Experience working with medical record to bill and review charge-capturing accuracy. Knowledge of CMS and state coverage and payment methodologies. Working knowledge of professional billing company operations; ability to plan, implement and evaluate systems and procedures; ability to manage multiple priorities; ability to communicate effectively; ability to establish and maintain working relationship with a wide range of staff including outside vendors; skilled in use of Microsoft applications such as word, excel, and powerpoint. Excellent analytical and critical thinking skills. Completion of reports for documentation of issues in Word and Excel spreadsheet formats. My skills also include knowledge of medical billing operations, hospital department charge capturing, revenue cycles services and CMS regulations.

Ensure appropriate bottom line targets are developed and met relative to financial performance through revenue enhancement and cost containment, including but not limited to, maintenance of current volumes and increasing volumes through new service offerings. Ensure appropriate bottom line targets are developed and met relative to quality of care through the hospital's quality assurance program; assure development and implementation of outcomes management and associated performance targets, including but not limited to patient satisfaction surveys, enhance effectiveness and efficiency of as well as satisfaction with patient care delivery; develop recommendations on appropriate care, redesigning as necessary, and coordinate implementation. Identify and communicate service line needs; coordinate with clinical and non-clinical hospital departments to develop supplier contracts.

Inspire staff to be creativity and innovated in the work group. Build relationships with individuals and teams. Hold self and others accountable to the same high standards. Grow leaders by mentoring, modeling, and teaching. Evaluates competence and initiates performance improvement plans to develop staff. Support staff in the delivery of care and/or resolutions of issues at the point of service. Utilizes skills of team to reach desire outcomes. Take a pro-active role in setting up task force meetings to implement new procedures to assure a smooth workflow between hospital departments. Review and evaluate the department budget. Evaluate and justify equipment and supply needs. Project the department’s growth and needs for future planning. Maintain complete and accurate documentation of monthly expenditures for FYI budget.

Monitor production statistics and performs assigned audit to assure billing accuracy, timelines and compliance to the billing standards. Reports any possible compliance issue to director, and system compliance officer immediately. Takes the lead role in coordinating payer audits, assuring timely and accurate data submission. Acts as liaison between payer and departments to assure facility reimbursement is whole.

Responsible for the day-to-day operation of revenue cycle departments including patient access, business office, patient accounts and financial counseling. Duties include scheduling, registration, billing, and collection functions. Responsible for all managed care contracts as well as vendor billing. Developed a process for POS Collections for all departments including the ER.

Accomplishments: Conducted internal audits on chart review for accuracy on correct charges and codes. Ensure that charge master charges were current for all departments. Audit revenue reports for charge accuracy and coordinating discrepancies found. Knowledge of Medicare and Medicare billing to ensure accurate utilization of HCPCS/CPT codes.

As a result of dedicated efforts, the hospital experienced over a 25% increase in fees received in the first nine months of the fiscal year, resulting in more fees being collected through billing in nine months than were collected in the entire previous fiscal year. Developed and implemented in house collection letters to help reduce bad debt. Prepared claims for services and submits to appropriate sources for payment. Tracked outstanding claims. Research and resolve claim issues. Utilize the patient care management system to review charged medical procedures and prepare billings. Identify training needs, providing guidance with an action plan business office, patient access, and physical therapy. Created and maintain a high performance environment characterized by positive leadership and a strong team orientation.

Strong knowledge of per diem, per case, DRG and APC reimbursement methodologies and clear understanding of Medicare and claims processing guidelines. Experience applying pricing, financial analyses, hospital bill audits results and contract standards and negotiation strategies. Problem solving skills, including the ability to systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement appropriate solutions calmly. Proficient in speaking in both individual and group settings. Ability to multi-task, shifting back and forth effectively among multiple activities. Possesses good interpersonal skills, establishing rapport and working well with others.

Developed a training manual for Meditech since the goal live date of July 1, 2007 to ensure the Business Office and Admitting staff has the necessary equipment to perform their duties with accuracy and efficiency. The manual will be utilized to assist with new staff training as well as ensuring the current staff has a resource for review at hand.

Additional accomplishment that has been implemented for the Business Office was a cost saving study on bringing the outsourcing of patient statements back as an in-house task. This has save the hospital approximately 25,000 per year with no additional cost of hiring additional FTE to complete this task. With the condition of the economy and searching for ways to save money a 90 day cost study was performed with the admitting department by implementing a 12 hour shift for all staff. This has allowed for 16 hours per pay period of FTE savings for this department and as well as for the hospital.

Coastal Health District, (Health Department), Savannah, GA, (Promotion), August 2005 – November 2007) Consultant/ Billing Director.

Responsibilities include: Analyze electronic data files. Coordinate findings with clinical nurse managers and program manager to ensure missed charges are billed. Create and maintain excel files and submit quarterly reports to departments and manger. Assist in recommending action plans to reduce missed revenue opportunities. Compile and coordinate rules with vendor to update the software used in compiling our data files. Audit revenue reports for charge accuracy and coordinate discrepancies found. Perform charge master maintenance and validate entries. Knowledge Medicare and Medicaid billing to ensure accurate utilization of HCPCS/CPT codes.

Conducted and managed internal audits and reports with conclusion about the adequacy of the internal audit controls, accuracy of financial transactions. Directly issue reports to the leadership team on State guidelines and proper procedure and protocols with an action plan. Additionally, I was given six (6) additional counties to develop an action plan and increase fees and revenue.

Accomplishments: Conducted numerous billing sessions and arranged for several training sessions by the state and the agencies, which processed Medicaid and Medicare claims, to increase the billing knowledge of the billing staff and to enable them to resolve billing issues. Introduced billing through the internet (Web Portal) and actually worked many hours to submit old claims for assurance that the health departments did not lose funds. Established a detail review of the status of claims in programs, such as Family Planning, Infectious Diseases, Children Services, Primary Care Services, Dental, and other programs in both health departments. From this I was able to review problems and incorrect billing and denial processing procedures. As a result of dedicated efforts, both health departments experienced over a 27% increase in fees received in the first nine months of the fiscal year, resulting in more fees being collected through billing in nine months than were collected in the entire previous fiscal year. Coordinated all the documents for the new Case Management Organization (CMO) credentialing process for all Nurse Practitioner, Physicians, Nutritionist, and Dentist. Completed the credentialing walk through process for all eight (8) counties with 100% pass rate. Set up training for all eight (8) counties with the new CMO’s for open forum discussion in April 2006 with much success on discussing health department programs and services rendered to the community. Trained staff on new software M&M for electronic data collection and billing.

Coastal Health District, (Health Department), Savannah, GA, (Chatham and Effingham), July 2004 – July 2005), Accounts Receivable Billing Manager

Prepared claims for services and submits to appropriate sources for payment. Tracked outstanding claims. Research and resolve claim issues. Utilize the patient care management system to review charged medical procedures and prepare billings. Provided technical assistance to Board of Health center staff in the utilization of the patient care management system billing operation. Identify training needs, providing guidance with an action plan for each health department. Created and maintain a high performance environment characterized by positive leadership and a strong team orientation.

Accomplishments: Conducted and managed to improve the billing operations in other areas related to public health by offering ongoing clerical and clinical training. Worked closely with District Administrator to revise an outdated fee schedule for the services provided and coordinated with appropriate staff to implement the new fees. Worked with Chatham County health department staff to establish their dental fee schedule and to properly bill for dental services.

Health Management, Westview Nursing and Rehabilitation Center, Port Wentworth, GA, (September 2003 – June 2004), Business Office Manager

Establishes and maintains financial files for all residents related to admission, billing, and collection of accounts receivable. Completes all necessary documentation and updates applicable system data related to cash receipts, account research and adjustments, transfer of depository cash, and daily census activity. Coordinates, performs, and documents the collection of accounts receivable and past due accounts. Reviews payment policies and procedures with new admissions and their responsible parties. Prepares billing for routine and ancillary services to state agencies, Medicare, veterans, and other billing agents. Administers and reconciles resident trust accounts and petty cash. Performs month-end close procedures and prepares and submits all required reports. Provides supervision and assistance to the Payroll and Benefits Coordinator and other business office staff. Utilized Quickcare software to maintain all financial information. Administer and reconcile resident trust accounts and petty cash. Prepared billing for agencies, such as Medicare, Medicaid, Veterans Benefits and other billing entities. Prepared month end closing reports.

Accounts Payable, oversee all aspects of the Accounts Payable function which include:

Processing invoices for payment according to the guidelines outlined in the Purchasing / Accounts Payable section of the Business Office Manual.

Ensuring that we are only paying for purchases that were properly authorized.

Documenting receipt of goods / services. Each payment must be stamped with the A/P stamp and completed as documentation that goods / services were received.

Reconcile payments to vendor statements to ensure payments are made in accordance to the vendor's terms.

Manage facility petty cash fund. Document all purchases accurately and request reimbursement as needed.

Ensure that all invoices are submitted weekly to Accounts Payable to ensure accurate financial statements.

Payroll, oversee all aspects of Payroll which include:

Completing Employee Information Set-Up and Change Form as changes and terminations occur. Ensuring they are sent by fax or e-mail daily with original sent in next federal express packet to Support Office Payroll Department.

Completion of the Bi-Weekly Payroll Transmittal, balance and forward to Support Office Payroll Department.

Ensure accuracy and timeliness of Daily Labor Hours Report.

Ensure accuracy of Weekly Overtime Report.

Assist Support Office with quarterly, annual reporting as needed.

Accomplishments: Primary objective was to oversee the collection of outstanding account balances in a timely manner, which included filing Medicare, Medicaid, and Commercial Insurance claims. Implemented a standard policy and procedure to effectively improve in the collection process to reduce outstanding balances for residents in the Long Term Facilities. Worked closely with DFCS on proper completion of paperwork in a timely manner as well as working closely with discharge planners in hospitals prior to admission. Utilized a communication action form for incoming and outgoing resident for hospital admission as well as Hospice admissions.

Supervision of Business Office Staff:

Develop plan for the operation of the Business Office. Continually review position responsibility, staffing levels, and processes to facilitate gaining efficiencies and streamlining paperwork.

Delegate work and provide training to staff as needed / warranted to improve department functioning.

Provide performance reviews communicating to staff strengths, and areas of improvement in current positions. Obtain input from various sources that interact with staff being interviewed.

Kindred Healthcare, Savannah Rehabilitation Nursing Center, (April 2003 – September 2003), Savannah, GA, Business Office Manager

Setup and maintain financial files for residents, which included billing, admission papers, and state and Medicare reimbursement documents. Coordinated the collection process on accounts receivable and past due accounts. Review payment policies and procedures with new admission and their responsible parties. Reduce and maintain A/R at pre-determined reasonable goal.

Monitoring / processing Medicaid Pending applications with documentation of the following:

Follow-up with Local County Caseworker and resident designee on a weekly / bi-weekly basis.

Advise Executive Director and Support Office of potential problems.

Collecting account receivable with emphasis on the 60 plus accounts utilizing the following techniques:

Delinquent collection calls with letter reiterating conversation.

Document all activity in Departmental Notes.

Advise Support Office of payments not received timely indicating late

payment fees to be allocated.

Resolve balance disputes as needed / requested from responsible party.

Analyze balances and communicate necessary adjustments to appropriate area / staff member, document in Departmental Notes.

Credit balance reviews with resolution noted and communicated to appropriate areas with action needed such as adjusted / void claims or prepare refund by checks for any overpayments or duplicate payments.

Prepare plan of action for follow-up on accounts with recommended collection action. Include referral recommendation following collection policy.

Prepare and submit applicable write off requests per collection policy.

Completion of pre-bill reconciliation for resident statement generation approximately the 23r of the month. Upon reconciling days and cash receipts, run statements, review for errors, and mail.

Prepare and participate in facility aging reviews monthly or as needed with Support Office staff.

Responsible for Handling of Cash Receipts Including:

Preparation of daily deposits.

Ensure deposits are taken to the bank daily.

Processing payments in appropriate A/R or Trust Fund system.

Review and sign off on verification reports for accuracy and balancing to deposit receipt and source document.

Responsible for Managing and Reconciling Resident Trust Fund Accounts,

including but not limited to:

Deposits and disbursements are appropriately authorized, accurately, and processed timely.

Monitor and take action of accounts that fall into credit status.

Supervise the daily balancing of Resident Trust Fund Petty Cash and weekly replenishment.

Monthly Reconciliation of checking account and balancing to Resident Trust Fund detail trial balance.

Ensure allocation of monthly interest completed after reconciliation.

Assist with processing of 1099-INT at year-end.

Maintain Resident Trust Fund Authorization files.

Accomplishment: Worked closely with DFCS on admission policies and procedures with a reduction in loss time of completion of appropriate forms. Increase revenue by developing a policy and procedure on collection and working all outstanding balances with properly generated the aging reports and working all accounts. Trained staff on HPAS software as well as proper approach to reading the report and sending correct data to corporate office at month end closing.

Supervision of Business Office Staff:

Develop plan for the operation of the Business Office. Continually review position responsibility, staffing levels, and processes to facilitate gaining efficiencies and streamlining paperwork.

Delegate work and provide training to staff as needed / warranted to improve department functioning.

Provide performance reviews communicating to staff strengths, and areas of improvement in current positions. Obtain input from various sources that interact with staff being interviewed.

Role Responsibilities — Interpersonal Skills:

Is aware of, and adheres to, Resident's Bill of Rights and Confidentiality of Resident

Information.

Interacts with residents, family member, co-workers, clinical and ancillary staff in a non-

judgmental, supportive, and calm manner.

Addresses family satisfaction issues immediately and assists in resolving the matter in a

professional manner.

Is aware of the Resident Abuse Reporting Law.

Compliance with all facility dress code requirements.

Participates as assigned in the orientation of new staff and demonstrates a positive, helpful,

and enthusiastic attitude.

Role Responsibilities — Safety:

Demonstrates ability to locate emergency equipment (i.e. fire extinguisher).

Understands and demonstrates knowledge of role in Fire and Disaster drills.

Demonstrates ability to identify and respond appropriately to potential behavioral outbursts.

Uses facility equipment safely.

Recognizes, removes, and/or reports potential hazards.

Role Responsibilities — Resident Dignity:

Ensures understanding of and compliance with all rules regarding residents' rights.

Addresses residents in a respectful manner.

Discusses confidential resident information in appropriate areas only.

Davlong Business Solutions, Savannah, GA, (June 2002 – March 2003), Clinical Software Support/EDI Coordinator/Sales

Effectively train users and super users to use Patient Medical Records (PMR) and Electronic Medical Records (EMR) software at physician offices throughout the United States. Effectively clarify and resolve product or service issues presented by clients.

Accomplishments: Managed all training aspects of PMR and EMR project (s) from beginning to end, with an emphasis on customer service and pre-determined deadlines. Work successfully with various EDI vendors to send test files and specs for testing data for transmission. Gather and generated testing information for Hippa compliance in all states that uses Medinformatix software in conjunction with Medicare, Medicaid, and BCBS compliance specifications. Successfully deliver training presentations and respond to questions from small and large groups, which may include physicians, managers, and clerical or clinical staff.

Medical Infusion Technology, Savannah, GA, (March 1999 – June 2002),Director, Durable Medical Equipment/Billing Specialist

Managed intake process on new and established clients. Managed and developed the insurance verification worksheet for processing new and established clients. Duties included verification of insurance information, coordinating with discharge planners on patients needs for home care setups. Billing and coding claims for reimbursement. Follow up with patients in the home setting on equipment usage and delivery pickups. Market potential doctor’s offices and hospital on medical equipment, supplies, and infusion services.

Accomplishments: Negotiated contracts with commercial insurance carriers on medical equipment, supplies, and infusion services. Developed and managed a program with the ICU Pediatric doctors on Ventilators for children and adult trach patients. Developed a wound management program and Hyperbaric Oxygen for clients to utilize in a home setting with BCBS and United Healthcare. Developed a flow comparison chart to demonstrate options to clients to receive this service in a home setting. Worked closely with a Plastic Surgery clinic on this process with much success and improvement in DRG’s. Managed and developed a program for CPAP and BIPAP clients to receive equipment after hours and on weekends with initially setup. Initial setup required watching a teaching video and meeting the client needs with correct sizing of mask and setting the correct parameters requested by the Pulmonologist. Downloaded the data monthly with a printout to be sent to the doctor for review and any changes per request.

Education

Armstrong Atlantic State University, Savannah, GA BS Health Science, 2005

Brunswick College, Brunswick, GA AS Nursing, 1996

St. Louis College of Health Careers, St. Louis, Mo Diploma Respiratory Therapy and Cardiology, 1991

References

References are available upon request.

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