Manager Data Entry
Resume:
Nancy Cato
Colorado Springs, Colorado 80903
719-***-**** (c) *********@***.***
OBJECTIVE: A career opportunity that draws upon my organizational,
analytical and communication skills, problem-solving strengths, and my
diverse business background.
SUMMARY OF QUALIFICATIONS:
. Reimbursement Operations Manager
. Program Manager
. Database Report Writer
. Data Analysis, Trouble Shooting
. Auditing, Forecasting and Trending (Excel)
. Gather, Record, Track and Verify Data
. Compile, Review and Analyze Data
. Computer Literate, Software Packages
. Generate Reports
. Statistics, Timelines, Tables and Graphs
. Excellent Written and Communication Skills
. Process Improvement
. Problem Solving
. Policies and Procedures
. Financial Reconciliation (Access)
. Month End Accruals (Access)
. Time Management Scheduling
. Diverse Background
. Staff Management
. Staff Motivation
. Contract Negotiation
. MS Office Suite
. Contract Analyst
. Medical Coder
EXPERIENCE AND CAPABILITIES:
. Auditing of contractual revenues, report writing for the Business
Office, auditing of any data requested, and responsible for updating
staff with insurance and Medicare updates.
. Auditing of financial contracts through analysis of extensive amounts
of data utilizing both Excel and Access. Identifying, and following
through to collect, missed and/or unpaid payments.
. Coding of Cardiology, Oncology, Orthopedics, Rheumatology, ENT,
Surgery, Internal Medicine, Nuclear Medicine, Radiology, and
Laboratory. Data analysis of denials w/improvement of coding
practices and insurance guidelines. Created a spreadsheet that holds
over 3,000 diagnoses, and many other tabs that hold quick efficient
methods of finding information.
. Oversaw quality and production for twenty-two employees through data
analysis, positive management, and process improvement which reduced
data entry lags by 75% allowing for staff reductions and increased
cash flow.
. Front end manager over coding, data entry, and payment posting for a
thirty-two physician radiology group.
. Charted employee and location (hospitals and imaging centers)
production through graphs and pivot tables using Excel.
. Contributed to the implementation of the HIPAA Privacy Regulation by
participating in the beta project of a national health care company.
. Participated in the Clinical Operations / Reimbursement Operations
work group, designed to improve cash flow through process design.
. Worked with month end accruals.
. Trended payers (by timely filing and accuracy) and appeals (by carrier
and procedure) to reduce the amount of payment lags and errors.
. Negotiated higher rates with insurance carriers upon contract
renewals.
. Captured data for analysis, trouble shooting, and auditing by writing
reports to pull information from the database and manipulating that
data through filters and pivot tables to extract and address
discrepancies and possible problems.
. Participated in the integration of Harris Methodist (100,000 lives) as
a liaison between Marketing, Benefit Operations, and Claims to ensure
the product being offered would be functional within all system
tables.
. Forecasted future claim impact of Harris Methodist by contract type
and age for the Director of Claims and the Vice President of our
PacifiCare region.
. Forecasted future FTE's from the additional claim impact, inclusive of
space planning and system requirements.
. Reconciled outstanding claims of bankrupt medical groups with Finance
using Access.
. Program Manager, Audit Supervisor, Auditor, Claims Examiner.
PROFESSIONAL HISTORY:
HEALTH LANGUAGE CONTRACTOR, Health Language Inc, Denver, CO 2009-Present
Part-time telecommuter creating medical phrasing for software
projects including SNOMED, ICD-9, and procedural codes.
CONTRACT ANALYST, CSHP, Colorado Springs, CO 2009-2010
Ad hoc reporting, auditing of contractual revenues, report writing for
the Business Office, and responsible for updating staff with insurance
and Medicare updates.
MEDICAL CODER, CSHP, Colorado Springs, CO 2005-2009
. Coding of Ophthalmology, Oncology, Rheumatology, ENT, Surgery,
Internal Medicine, Nuclear Medicine, Radiology, and Laboratory. Data
analysis of denials w/improvement of coding practices and insurance
guidelines. Created a spreadsheet that holds 2,800 diagnoses, and
many other tabs that hold quick efficient methods of finding
information.
VOLUNTEER PUPPY RAISER, Canine Companions for Independence, Plano, Texas
2002-2005
REIMBURSEMENT OPERATIONS MANAGER, M&S Imaging Partners, San Antonio, Texas
2001-2002
. Oversaw quality and production for twenty-two employees through data
analysis, positive management, and process improvement which reduced
data entry lags by 75% allowing for staff reductions and increased
cash flow.
. Front end manager over coding, data entry, and payment posting for a
thirty-two physician radiology group.
. Charted employee and location (hospitals and imaging centers)
production through graphs and pivot tables using Excel.
. Contributed to the implementation of the HIPAA Privacy Regulation by
participating in the beta project of a national health care company.
. Participated in the Clinical Operations / Reimbursement Operations
work group, designed to improve cash flow through process design.
. Worked with month end accruals; filed electronic transmittals.
INSURANCE SPECIALIST, Dr. Calvin Day, San Antonio, Texas 2000-2001
REPORT WRITER / ANALYST, PacifiCare, San Antonio, Texas 1997-2000
. Captured data for analysis, trouble shooting, and auditing by writing
reports to pull information from the database and manipulating that
data through filters and pivot tables to extract and address
discrepancies and possible problems.
. Participated in the integration of Harris Methodist (100,000 lives) as
a liaison between Marketing, Benefit Operations, and Claims to ensure
the product being offered would be functional within all system
tables.
. Forecasted future claim impact of Harris Methodist by contract type
and age for the Director of Claims and the Vice President of our
PacifiCare region.
. Forecasted future FTE's from the additional claim impact, inclusive of
space planning and system requirements.
. Reconciled outstanding claims of bankrupt medical groups with Finance
using Access.
Program Manager, Audit Supervisor, Auditor, Claims Examiner
EDUCATION:
Organizational Psychology, University of Incarnate Word, San Antonio, Texas
Biology, Florida Keys Community College, Key West, Florida
General Studies, University of Maryland, Heidelberg, Germany
Music Theory / Piano, Valencia Community College, Orlando, Florida
MILITARY:
US Army, E-4, 1981-1984, Honorable Discharge
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