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Medical Assistant Manager

Location:
Hialeah, FL
Salary:
Open for discussion
Posted:
April 05, 2018

Contact this candidate

Resume:

Management/Billing and Coding/Finance/Medical Collections/Medical Assisting

Seeking Growth!

My name is Jayne Cambas, I am bilingual, computer savvy, EMR knowledgeable, HEDIS tool knowledge, Microsoft proficient, aware of quality measures, business oriented and interested in assuring the highest quality of patient care. I am very ambitious and enjoy watching numbers grow through proper coding and collection tactics. I am very dedicated to exceeding in all areas within my work and educational space. I am a responsible notably fast learner, organized, team player, ambitious and self-motivated in my actions. I am always looking to learn more, develop skills and find better ways to operate and grow in my professional environment. I am good at developing strategies to set achievable goals, to achieve a set goal and I excel in problem solving. I recently completed my Bachelor’s degree in Public Safety Management/Criminal Justice. I have over 7 years of experience in the medical field, 3 of which have mainly consisted of running the finance department, insurance authorization department, billing and coding in inpatient and outpatient mental health. I also have knowledge in billing for skilled nursing facilities, spine and orthopedic specialty. I had the opportunity to work per diem inpatient psych as a behavioral health technician, so I have inpatient experience. I have extensive expertise in all the inpatient and outpatient billing and coding, insurance verifications, authorization requests, denials and appeals, patient/insurance accounts receivables, collection lay outs and staff overview & directing balance collection. I am looking to obtain a position where I can grow professionally. I am certified through NCCT as a National Certified Insurance and Coding Specialist, ID # 882229. I have my BLS active for healthcare providers and I am registered as a medical assistant in the state of Florida, AMT ID # 2702808. I am currently a member of the AAPC and I am looking into testing for the CPC in January. I am also a member of the ARHPC and will receive my RH-CBS certification by the 17th of December. For the new year I would like to get certified through the AAPC in medical auditing and medical compliance. I am willing to take any training necessary in order to obtain a position that I can grow with. I am currently in the process of attaining my MBA in Health Care Administrations pending admission at F.I.U.

References:

Patrick Joyce: (Director) 305-***-****

Elizabeth Tapanes: (Practice Manager) – 954-***-****

Dr. Ignacio Bobes: (Provider) – 305-***-****

Vicky Garcia: (Professor) – 786-***-****

Maria Cardozo – (Professional) 305-***-****

Objective: Growth!

Professional

Experience:

Care Resource

305-***-****

1/17/2017-Present

Edith Clark Manager

Medical Coder

Review records for coding

Charge entry

Denial review and correction

Collections

Insurance verifications

Excel creation for tracking

Contracting development and adjustment

Training staff

Provider communication for clarification

Event staff for fund raisers

Spine & Orthopedic Center, S.O.C.

561-***-****

07/17/2016-10/25/2016

Odalys (Manager) & Jennifer (Assistant Manager)

Coding Specialist

Charge Entry

Assuring that charge ticket matches notes and fulfilled exams

Patient Demographic verification

Phone calls

Appeals

Participate in projects as they come

Weekly/Monthly reconciliation

Request information as needed.

Find proper codes if needed

Insurance verification as needed

Victoria Nursing Home

305-***-****

04/2016-06/2016

Gerrald Piccorneli

Medical Biller

Prepare all charges for charge entry. Pharmacy, room and board, therapy, x-ray and ultrasounds as provided by the facility

Account reconciliation reports

Appeals

Payment posting

Monthly balancing

Coinsurance collections

AHF Kinder Medical Group

786-***-****

03/2016-04/2016

Marcelo Escobar

Medical Assistant/Referral Coordinator/ Medical Records

Medical Record abstraction and preparation

Room prep

Copayment collection upon admission

Vitals

Ekg’s

Appointments

Handling phone calls

Referral preparation for all specialties and patient needs

Alico Capital

305-***-****

Patrick Joyce

ac41q6@r.postjobfree.com

10/2015-Present

Regional Account Manager-Contract personnel

Handle Commercial accounts for region

Collect information for loan closing

Follow up with account supervisors as needed

Answer calls from supervisors and assist in inquiries

Delegate and prioritize accounts by loan closing dates and cash amounts.

Pay roll distribution for sub-contracts

Serve as administrative assistant to Directors of operations

Research properties

Serve as first hand contact and advisor to regional account supervisors

Supervise and review all work from account supervisors to assure maximum function

Train and improve function of regional supervisors

Serve as goal motivator to all regional supervisors and employees

Try to advance in delegated states for maximum closing outcome

Mercy Hospital

3663 South Miami Avenue

305-***-****

Giselle Asst. Director and Dolores Director

5/2015 to 8/2015

Position: Behavioral Health Technician – Per Diem

●Assist patients

● Maintain ordinance on floor

●Executed on case management and HEDIS measures

●Admissions

● Room check

● Patient 15 minute monitoring (rounding)

● Patient activity observation

●Fall prevention

●Prevent accidents and any other unwanted situation

● Assist nurses in medication administration when patients are disorderly or non-compliant

● Vitals

● One to One observation if needed.

● Assist in emergency code situations.

● Assure patient safety

● Assure staff safety

● Prevent elopement and self-injury

● Serve patient snacks, breakfast, dinner and lunch.

● Clean after meals and maintain a clean floor.

● Monitor patient visitation.

●CPI – Crisis Prevention Intervention

HCA Mercy Behavioral

2150 Coral Way Suite 5D Miami FL. 33145

305-***-**** Fax 305-***-****

Maria Del Sol MD/Ignacio Bobes MD

Practice Manager – Iliana Garcia-Barbon

Nov. 2014 – Oct. 2015

Position: Medical Assistant/Coder

●Answer calls, Assist in patient services, call in refills, assist to emergency calls, check and respond to messages, scan and upload documents, screen phone calls for physician referral.

●Assuring patient payments were received.

●Preparing notes for front office to enforce patient balance collections.

●Train new employees as needed to enter charges, Develop lists or power point presentations for staff training, phone etiquette, scheduling instructions, hours and more, call handling, prescription writing, insurance verification process, lab ordering, referral creation, information that must be obtained at front desk, phone calls etc.

●Insurance verifications - Billing and Coding – Authorization requests – IET/Denial review, correction and resubmission – Run and prepare billing reports for charge entry – enter charges, charge entry reconciliation, prepare reports for provider records, create portals and update passwords as needed to make the verification process more efficient and quicker.

●Enter office charges and hospital charges.

●Verify staff entered charges for errors.

●Upload missing documents and correct errors.

●PHP/hospitalization referrals – Baker Acts – therapy – sleep testing – ADHD testing –as needed

●Assist in filling out forms for patients.

●Prepare letters requested by patients for Dr. Signature and approval

●Fill out form for patients

●Respond to attorneys requesting court appearance from providers.

●Assist in prior authorizations

●Prepare medical records for appeals, charge submission or payment reconsiderations.

●Follow up to manager with employee as needed and suggest new ways or solutions to current issues.

●Assist and train new staff or front desk

●Inpatient billing and coding, insurance verifications, authorization requests and denials.

●Assure proper documentation completion for submission.

●Executed on case management and assured PQRS quality measures were met.

Maria J Del Sol MD PA/Ignacio Bobes MD

2150 Coral Way Suite 5D Miami Fl. 33145

305-***-****

(Manager- Elizabeth Tapanes)

February 2013 – June 2013

Position: Receptionist/Front Desk

●Greet patients, provide sign-in sheet, prepare and provide new patient packages (consents)

●Scan rx’s, insurance cards, identification cards, records, provide excuse letters

●Answer phones

●Verify insurances

●Copayment and past due balance collection

●Payment plan arrangements

Maria J Del Sol MD PA/Ignacio Bobes MD

2150 Coral Way Suite 5D Miami Fl. 33145

305-***-****

(Manager- Elizabeth Tapanes)

June 2013 – Office Staff/Back Office / Medical Assistant/Office Coordinator

●Office Duties

Answer phones

Take messages for the doctors

Assist patients with inquiries, emergencies, confusions etc.

Provide refills, letters, forms etc.

Assist with any emergencies or side effects reported

Assist doctors with any requests

Assist manager with any requests

Front desk

Assist with prior authorization Assist with patient referral

Attend to possible interactions or medication abuse reports from insurances

Enter lab requests into Quest 360 for patients to get labs

Lab Orders

Make lab orders on ICA Notes to give to the patient in order for them to get labs elsewhere

●Assisted Living Facility Patients (ALF’s) – All request from ALF’s are handled by me or reported to me at some point.

Appointment dates given to the groups. (Block out partial or full days in order to have ALF patients come in.)

Side effects reported by ALF’s and doctor responses or changes to medications. Fax all changes on a prescription for these patients

Annual reports

Discharge summaries

Assure optimal patient care and proper provider documentation.

●Insurances

Verify insurances for next day patients or walk in patients

Review, correct, appeal and resubmit denied or unpaid claims

Mail or fax reconsideration forms for claims which are not able to be appealed

Submit claims (If needed)

Request authorizations for patients which require authorization

Submit treatment plans for insurances which require treatment plans

Insurance inquiries such as new process or changes within the provider insurance relations department (If needed)

Update portal passwords (If needed)

●Patient Balances

Verify, correct, log and review patient balances daily

Collect patient balances

Mail out balance statement

Log all patient balances, claims corrected or submitted, items faxed, labs ordered, voice messages etc.

Create collection plans for front office, review outstanding balances daily and assure we were meeting our daily goals as logged in daily patient lists

1/2013-2/2013 – Dr. Kendall – Dermatology – 305-***-****

318 Alhambra Circle Coral Gables FL 33135

Medical Assistant

●Answer phones

●Prepare rooms

●Assist in patient procedure prep.

●Insurance verification

●Copayment collection

● Procedure assistance

●Skin test preparations

6/2013-12/2013 Motel Bianco –

5250 Biscayne Blvd Miami FL. – 305-***-**** – Owner – Jose Licata or Jaray 786-***-****

Receptionist

●Answer Phones

●Greet clients

●Assist clients with directions, translations, finding rooms or local entertainment, restaurants, etc.

●Customer service

●Briefing & Logging

●Assuring the right amount of cleaning staff is on duty to assure the guests are covered.

5/2010 – 12/2012 – Office of Dr. Zoilo Rafael Abad & Francisco Padron

10621 SW Kendall Drive Miami FL 33156 Suite 230

RN – Yanaisy – 786-***-****

Medical Assistant

●Order lab work and x-rays

●Prioritize patient daily care according to acuity and scheduled patient procedures

●Assist patients with patient care, take vital signs, prep for procedures, draw blood and obtain specimens

●Maintain, clean and set up patient rooms

●Patient intake/discharge

●Assist with patient and family education

●Assist R.N. with sterile and non-sterile dressing changes

●Prepare for EKG’s

●Utilize PC and retrieve patient data

●Answer Multi-line phones, operate fax and copy machine

●Prepare records for charge entry

●Authorization requests

●Super bill preparation

●Copayment and insurance payment collection

Super Yellow Cab – Manager: Arturo - 305-***-****

I do not recall exact times and dates I worked here. I was with the company back and forth, while I worked with Dr. Abad and Padron and in between jobs as well.

Position: Phone Operator/Full-time PRN

●Answer phones

●Take accurate information from callers

●Relay messages to dispatcher

●Follow up if needed

Education:

Miami Lakes Educational Center (2009-2010) Prof. Vicky Garcia – 305-***-****

Basic Health Care Worker

Administrative Medical Assisting ‘

Anatomy & Physiology

Billing/Coding

Clinical Medical Assisting

Medical Lab. Techniques

Phlebotomy – Theory/clinical

Electrocardiography- Theory/Clinical

Radiography – Theory/Clinical

Pharmacology/Drug Administration- Theory/Clinical

Externship –

North Dade Center (Jackson North)

Miami Jewish Home for elderly

Miami Dade College – 2010 – 2013

Associates of Arts – Criminal Justice Administration

Miami Dade College 2013 – April 23, 2016

BAS - Criminal Justice/ Public Safety Management

Certifications

Registered Medical Assistant

BLS - 2010 to 2013

Renewed 2015 exp. 2017 – pending renewal

CCS - Certified Insurance and Coding Specialist 8/2015

CPC – pending test

CH-CBS – pending test 12/17/2017

Affiliations

HOSA

AMT

ARHPC

AAPC



Contact this candidate