Manager Medical Billing
Resume:
Nancy Jayne Cooper
Reno, NV. 89509
**********@*****.***
Profile Summary:
Medical Office Manager, with 20 years of high quality experience in
managing a full spectrum of both medical and home care services. Time
acquired knowledge, practice and expertise in office management which
includes: efficiently managing the daily operations of the office, payroll,
medical billing, collections, credentialing, insurance contract review and
negotiation, creation of fee schedules, front office management, management
of monthly office accounts receivables, hiring/terminating, resolution of
office issues, staffing/scheduling, office budgets, creation of benefits
packages, employment and medical laws, marketing, compliance to HIPPA,
JCAHO, Medicare compliance issues, CPT and ICD- 9 codes.
Competencies:
Meticulous and precise with details and following through, highly
conscientious, intellectually quick, and accurate - assuring precision and
excellence in all projects and areas of responsibilities
Collections - Extremely skilled at collecting past debts. Able to
negotiate, delegate, and collect accounts receivable where others have
failed. Increased A/R income in the first year to it's highest level in the
twenty-seven year history of a prolific medical practice
Reliable and responsible - 20 years experience in office management and
supervisory roles, including payroll, medical billing, accounts
receivables, hiring, scheduling, and supervision of fifty employees
Deadline proficiency - works well under pressure, and possesses excellent
time management and efficiency skills
Self-Starter - takes the initiative, foresees what needs to be done
including possible problematic issues, accomplishes work without prompting
or cuing in an efficient manner
Excellent interpersonal, conflict resolution, and negotiating skills;
pragmatic and creative problem solving abilities
Strong knowledge of Medicare, Medicaid, commercial insurance coverage,
creation of fee schedules, billing requirements, contract review and
negotiation, collections and labor laws
Excellent computer skills - Access, Word, Excel, AdvancedMD, and Medical
Manager
Legal ~ Proficient in writing appeals, filing liens, and credentialing.
Excellent verbal and written communication skills; strong command of the
English language.
Nancy Jayne Cooper ~ continued, page 2
Experience:
PanTerra Health, LLC
316 California Ave.# 330
Reno, NV 89509
Account Manager
Dates of Employment: March 2010 - January 2011
Responsibilities Included:
Provided Consulting Services during the formation of the company, which
included creating a business plan, market analysis and consulting
information/advice of medical billing and medical office management.
Assisted in the creation of Sales and Marketing materials
Sales & Marketing calls throughout Reno's medical community including
presentation meetings of company's services
Insurance Contract Review and Negotiations with insurance carriers
Physician Fee Schedule set up
Assisted with Medical Billing utilizing AdvancedMD
Account Management and quality assurance oversight
Credentialing physicians
Acquiring and closing sales, contract presentation
Sierra Internal Medicine Associates
865 Tahoe Blvd. Suite 306, Incline Village, NV 89450
Office Manager/ Billing & Collections Manager
Date of Employment: June 2005 - August 2007
Responsibilities Included:
Medical Office Management, which included supervision of the billing
department, back office and front desk staff.
Physician credentialing with hospital and insurance companies
Insurance contract review and negotiation with commercial insurance
companies
Recruited, hired, counseled, managed and terminated office staff
Responsible for all new patient intakes, verification of insurance coverage
and eligibility, pre-authorizations.
Assisted in the scheduling of patient appointments, referrals,
and helped reception answer phones as needed
Billing & Collections Management -Billed and collected current and past due
amounts, which included writing appeals to insurance companies, filing
liens, writing letters to patients and insurance companies, phone calls,
and most often, a face to face meeting with patients; explaining and
resolving their statement issues, working out a payment plan, or collecting
the full amount due.
Nancy Jayne Cooper Resume Page 3 ~ continued
Resolved patient issues and concerns with the front desk and billing office
Data Entry - Entering all demographic and insurance information on
patients, including documentation of patient and insurance transactions
Directed office meetings to discuss and resolve issues and changes
Evaluated, analyzed, responded and resolved denied claims, billing
problems, and denied claims
Corrected procedure codes, and diagnosis codes for resubmission of claims
and appeals, account adjustments, and collections.
Proficient in most aspects of Medical Manager, and prolifically
knowledgeable of Medicare, Medicaid, Blue Cross Blue Shield billing and
payment stipulations and protocols.
Assisted the Doctor with legal issues concerning the practice, including
contracts and insurance laws.
Utilized careful written documentation in recording all conversations and
transactions with patients and insurance companies.
Evaluated, responded and resolved patient and employee's concerns, requests
and needs.
Responsible for processing payroll
Sparrow Home Care Network
2909 East Grand River Avenue, Lansing, MI 48906 517-***-****
Title: Staffing Coordinator/Department Manager
Dates of Employment: October 1986 - August 2003
Responsibilities Included:
Managed all payroll and billing, and past due accounts receivables,
specializing in difficult and stale accounts
Created, maintained, staffed and coordinated master schedule for employees
and patients, including Medicare/Medicaid, private pay, and commercial
adjusters with over 1800 hours of staffing in private homes, assisted
living centers, nursing homes, and in hospitals.
Implemented and processed all patient intakes; verified coverage;
coordinated patient home care needs with case managers, hospital discharge
planners, physical therapists, physicians and insurance adjusters.
Responsible for processed all department payroll ( over 50 employees)
Oversight of the front office and medical records staff
Creation and oversight of department budget
Evaluated, analyzed, resolved and responded to client and employee
concerns, requests and needs.
Recruited, hired, oriented, and supervised department employees. Oversight
included: compliance to organizations policies and procedures, patient care
plans, evaluations, disciplinary actions, terminations, creation and
maintenance of employee files, records, and employee scheduling
Nancy Jayne Cooper Resume Page 4 ~ continued
Documented agency activities, service coordination, and patient/ office
communications, which included oversight of all patient charts for JCAHO
standards compliance and written documentation requirements
Marketed agency's home care and DME services to physicians offices and
surrounding area community hospitals
Participated in weekly multidisciplinary staff meetings and patient chart
reviews
Performed and supervised after hours on-call coordination and triage.
Participated in the Ethics Committee monthly meetings
Education:
Lansing Community College, Lansing, Michigan 1976-1978, and 2004 (G.P.A
3.45 Pre-Nursing )
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