Darilyn Johnson

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

Fort Worth, TX 76134

acvujk@r.postjobfree.com - 817-***-****

To secure a position as an Account Receivable Manager where I may utilize my billing, collection, auditing, and leadership skills. My goal is to join a company that will help me grow personally as well as professionally.

Summary of Qualifications and Skills:

Word Processing, Spreadsheets Production, Processing EOB, ICD-9, CPT coding, Managed Care Reimbursement Procedures (Medicare and, Tricare, and Workers Compensation), Universal Claim Form Filing, and Medical Records Management. Medical Manager, Access, Word, Excel, Power Point, Lytec, Chiro 7,000, Medrium, Mutual Omaha, Meditech, Matrix, E Permis, SimpleLTC, Protouch, CPSI, SSI, Quick Care, Passport, Centricity, HMS, Fast Track, Path Comp, IMACS, On demand, I Suite, Quick, Completed CPC Exam, and CPR Certified

WORK EXPERIENCE:

Regional Financial Hospice Consultant

Senior Living Properties Corporate Office - Fort Worth, TX - June 2014 to May 2016

Conducting month end close for eight facilities. Collecting on old Medicare AR 120 days and older.

Training Business Office Managers at the facility level.

Billing/Collecting on Hospice Medicaid for thirty-four facilities. Processing Occupancy Reports. Reconciling all financial cash for eight facilities. Medicare A auditing, hospice billing and collecting for thirty nursing homes. Assisting the CFO with policies and procedures

Billing and collecting for over fifty different hospice companies and thirty-four nursing homes in the DFW area. Loading Pharmacy Invoices and Occupancy Reports

Independent Business Consultant, Nonprofit Management, and Facilitator

Johnson's House of Hope Developments - Fort Worth, TX - May 2008 to December 2015

Nonprofit management and grant writing/proposal development.

Mediator assists with resolving conflicts with staff, families and youth.

Implement strategic plans for organizing nonprofit organizations and early childhood environments.

Facilitate seminars for employees in developmentally appropriate practices.

Facilitate training in budgeting, grant writing, funding, operating a high quality early childhood environment.

Facilitate trainings on Non Profit documenting of records, and assisting with business documents

Perform on site training upon request of small businesses, organizations, and conferences.

Medicaid Biller & Collector

Vibra Healthcare - Irving, TX - August 2013 to May 2014

Billing and collecting for eleven different hospitals from California to Texas.

Processing refunds and Medicare bad debt adjustments.

Monthly AR calls and reports.

Appealing Medicaid claims electronic and on paper.

Training other employees as well as implementing new processes for the CBO Office.

Reviewing coding and billing issues.

Claim Analyst & Auditor (Consultant)

Halcoyn Search Solutions - New Jersey - October 2012 to January 2013

Develop and implement claims auditing policies and procedures.

Run audit data, perform medical records audits, claim audits, and research and resolve billing and payment issues

Perform commercial and Medicaid audits on a quarterly basis and complete required reporting

Review and make decisions on claims appeals. Identify fraud and abuse

Medicare Consultant

Frasier Healthcare Consulting - Arlington, TX - August 2011 to November 2011

Processing payments and reviewing adjustments for seventy-two hospitals.

Auditing over three- hundred accounts per day, including research overpayments.

Rebilling late charges and claims that were under paid by the insurance

Oversee all roll forwards accounts for seventy-two hospitals, along with auditing Medicare claims before billing electronic. Processing and posting contractual adjustments and bad debt write offs.

Commercial Biller/Collector

Fundamental Healthcare - Dallas, TX - September 2009 to September 2010

Billing and auditing Hospice, Blue Cross Blue Shield, Humana, VA, Secure Horizon, Care Improvement Plus, Lovelace, Medicaid, Amerigroup, and Worker man's Compensation claims for seven hospitals. Oversee all roll forwards accounts for over ten hospitals, along with placing collection calls to insurance companies.

Processing and posting contractual adjustments and bad debt write offs.

Assisting hospital business office managers with entering of department charges and month end close.

Updating collection control log and not billed spreadsheet for seven hospitals, along with assisting the Coding Director with coding issues.

Private billing for self-pay patients and reviewing 80 accounts per day. Processing and preparing admission checklist and updating in house patient logs.

Claim Auditor/ Consultant

Conexis - Irving, TX - November 2008 to April 2009

Auditing and processing medical flexible spending accounts, alone with DCAP(Dependent Care FSA) Commuter Benefits (Transit & Parking) Health Reimbursement Accounts HRAs

Managing case studies on FSA account to assure claims are processed and reprocessed correctly. Processing over one hundred claims per day along with processing cases.

Enhancements and process improvements to increase annual revenue. Provide leadership in managing and monitoring an escalation list/process.

Business Office Liaison Manager

Regency Hospital Company - Fort Worth, TX - April 2008 to November 2008

Oversee all daily operations in accordance with the business office best practices maintain appropriate internal controls related to business office functions.

Deal with all business office financial goals as published annually provides accurate and timely financial data as required by the CEO.

Enforce and participate in all required billing and coding education Maintain legal and regulatory compliance Support center efforts to provide exceptional customer service and increase case volume.

Reviewing patients charges on a daily bases and verifying patient Medicare days; along with loading patient contracts and Medicare days.

Process CMI numbers for patient's length of stay and complete all procedure logs. Report facility census daily and enter all charges for departments.

Medicare/Medicaid Biller

Kindred Hospital Southwest - Fort Worth, TX - March 2006 to April 2008

Collecting payments on Worker Comp, Medicare A & B, Aetna, Blue Cross, Self-Pay and all other commercial insurance.

Following up on short paid accounts and processing insurance verification.

Updated insurance information and loading contracts. Monitoring accounts to make sure accounts are final coded and updating cash.

Writing up adjustments and preparing bad debt accounts. Also processing refund request for commercial accounts and self-pay accounts.

Correcting Medicare days in meditech and calculating carveouts. Processing insurance verification and loading contracts.

Billing Medicare No pay claims (Bill Type 110). Billing 60 day interim claims and exhaust claims.

Processing Medicare adjustments and bad debt, along with overseeing billing and collections for two hospitals.

EDUCATION:

Healthcare Administration

Grand Canyon University

May 2013 to Present

Certification in Healthcare

Concorde Career College- - Arlington, TX

2004 to 2005

AWARDS

Yellow Rose of Texas Award

October 2014 Received it for my Non Profit Johnson's House of Hope Development

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