Project High School
Resume:
Ana Montes
** ********* ***** - *** *********, TX 77354 - 713-***-****
acvxez@r.postjobfree.com
https://www.linkedin.com/in/ana-montes-a07a4587
SUMMARY OF QUALIFICATIONS
Solid Professional and Academic experience in Project Coordination and Project Management.
Excellent Leadership and Motivational Skills, as well as ability to Plan and Communicate Effectively.
Experience in Administrative Support, Documentation Management and Resolution of complex issues; demonstrate Professionalism, Attention to detail and Collaborative Nature.
Excellent Communication Skills. Ability to convey Technical Concept to Non-Technical audiences.
Excellent Time Management Skills.
Bilingual (Spanish) Speak, Write, and Read Spanish fluently.
CORE COMPETENCIES / TECHNICAL EXPERTISE
Microsoft Office Suites Expert (Outlook, Word, Power Point, Excel).
Microsoft Visio.
Extensive Knowledge on Data Validation and Project Management.
SSRS Reporting (Design – Building – Deployment).
Bilingual Spanish – English (Fluent in Writing, Reading, and Speaking).
Bilingual Spanish – English (Fluent in Technical Translation).
PROFESSIONAL EXPERIENCE
ALEGIS REVENUE GROUP (formerly Meridian Revenue Solutions) The Woodlands, TX
Appeals and Denials Manager - (2011 - 2015 )
Led and developed full scale project plans and executions. Responsible for more than one cross-company project at a time.
Defined the project scope of work, financial plan, its goals and delivery – Managed all aspects of the project business plan and budget.
Identified resources required, assigned responsibilities and coordinated project staff directly and indirectly to ensure successful completion of the project.
Responsible for establishing, meeting and exceeding operational work flow, and productivity in order to meet the company’s collections goals. Tracked and resolved critical issues to minimize project risk factors:
Developed policies and procedures for processing Insurance Denials and Rejections that were based on coding issues. Developed policies and procedures for requests made to change codes that may have originated from the physicians and/or patients.
Project Staff/Clients:
Responsible for the recruiting, management and career development of staff. Directed, supervised, supported and coordinated the project staff.
Communicated extensively with clients, sub-contractors and vendors to establish cordial/effective working relationship. Followed up with clients to verify satisfaction. Reported on project progress and communicated relevant information to superiors.
Designed project documents to monitor project performance and ease of data retrieval. Responsible for providing matrix reporting relationship to several clients’ Patient Financial Services (PFS) departments. Analyzed data against key performance indicators in order to trend success rates on projects.
Responsible for designing, developing, and deploying trend reports in order to provide monthly QA tools for Alegis, and clients. Responsible for managing the Appeals and Denials Department by designing, implementing, and deploying best-in-class performance metrics in specific categories of revenue cycle (productivity, compliance, accuracy, effectiveness, and efficiency).
Responsible for reconciling reports between client’s inventory and Alegis’ inventory.
MERIDIAN REVENUE SOLUTIONS The Woodlands, TX
Apeals and Denials Supervisor (2009 – 2011)
Responsible for hiring and training of Account Representative Personnel.
Responsible for ensuring that all personnel working for the department have extensive understanding of HIPAA rules and regulations.
Responsible for proving training and skills to allow Account Representative to identify and categorize denial codes.
Responsible for verifying the timely work of assigned inventory.
Responsible for the tracking of all deadlines inventories to ensure that all accounts would be worked accurately, and in a timely manner.
Responsible for providing Account Representatives with all the tools, and training needed in order to keep up to date with the latest collection rules, and regulations.
THE TUREK LAW FIRM, LLP The Woodlands, TX
Legal Assistant (2007 – 2008)
Responsible for interviewing prospectives for Social Security Disability Cases.
Responsible for accurately obtaining all supportive medical evidence to be provided to SSA in order for the approval and payments of all initial, and appeal claims.
Responsible for the application, and appeal of denied claims by the Social Security Administration.
Responsible for preparing all trial binders for Administrative Hearing cases.
Maintained a 98% success rate of all approved cases submitted to the Social Security Administration for benefits consideration.
EDUCATION
Completed 70 credits toward an Associate Degree Associate of Applied Science Computer Science
Rafael Belloso Chacin University (Venezuela)
High School Diploma
Fermin Toro High School
CERTIFICATION
Notary Public, State of Texas
Commission Expires August 31, 2017
PMP Certification (in progress)
PMI Houston Chapter
35 PDU Training Completed
PROFESSIONAL REFERENCES
Micaela Suarez - Director of Appeals and Denials
Alegis Revenue Group, LLC - Formerly Meridian Revenue Solutions, LLC
Justin Myers - Vice President of Operations
Alegis Revenue Group, LLC - Meridian Revenue Solutions, LLC
Douglas Turek - Attorney at Law
Turek DeVore, PC - Formerly The Turek Law Firm, PC
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