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Manager Quality Assurance

Location:
Stormville, NY, 12582
Posted:
March 09, 2010

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Resume:

Cynthia Objective

Friedbauer

*** ******

Road

Stormville

NY 12582

845-***-****

jfriedbaue@a

ol.com

Having numerous years working within practice management,

revenue cycle management, patient accounting and

reimbursement, I have had exposure to inpatient as well as

outpatient billing practices within surgical, specialty and

primary care environments. I carry strong organizational,

written and interpersonal skills. Under my belt is a proven

track record of minimizing loss while maximizing

reimbursement and efficiencies. My goal is to secure a

rewarding administrative position, which would allow me to

utilize as well as build on my experience while offering

growth, challenge and stability.

Work Experience

Manager of Accounts Receivable

8/2005 - 9/2008 The Jewish Guild For The Blind, New

York, NY

Major responsibilities include the total hands on management

of billing and payment (in excess of $28M each month), and

all accounts receivable functions for five separate and

distinct health care service corporations providing

multi-site adult day health care programs, rehabilitative

service and NYS OMH & OMRDD medical clinic (D&TC) which

includes various specialties as well as primary care, a

multi-site Article 31 Clinic offering behavioral health

services, continuing day treatment program, day treatment

program, Medicaid Service Coordination services as well as

NYS's premier Long Term Medicaid Managed Health Care

Organization (LTMC). Duties also include system

administration for multiple practice management or billing

systems, training and supervision of all billing staff as

well as collection efforts and claiming/follow-up for NYS

and MA Medicaid, Part B Medicare, 3rd party payors, Early

Intervention, CACFP program and state contract billing.

Performed all system management pertaining to HIPAA

initiatives for electronic claiming, ICD-9 and CPT-4 coding

compliance, and liaison to Agencies non-A/R staff with

respect to training for front office functions at service

locations. Performed reconciliation of G/L functions with

senior accounting staff, internal auditing functions,

interactions with software vendors and state agencies to

meet federal and state regulations. This position reports

directly to the VP of Finance for all related corporations.

Director of Accounts Receivable

4/1997 - 7/2005 Jewish Board of Family & Children's

Services, Inc., New York, NY

Successfully managed A/R and Collections Departments

performing centralized automated mental health billing and

collection for 14 out-patient clinic sites as well as back

office billing for all RTF, RTC, ICF, Intensive Support

Apartment Programs, HIV, Community Residences, CDT, IRA and

Waiver Programs to NYS Medicaid with annual revenues

totaling $85M+. Centralization of Managed Care Payment

Posting Department for management reporting and maximization

of HMO, Medicare and 3rd Party Reimbursements. Oversee J/E

preparation, cash receipt reconciliation and claim

follow-up. Ongoing reconciliation of subsidiary ledgers to

G/L, Policies and Procedures, liaison to Medicare and NYS

Medicaid and outside recovery agents. Training of all

off-site billing staff. Responsible for all credentialing

and provider relations issues related to HMO entities,

Managed Care, Medicare and private insurance billing and

collection functions and system file maintenance.

Coordination of MSO including complete patient accounting

functions for 2 separate agencies.

Director of Administration/Practice Manager

11/1995 - 4/1997 Butterfield Prompt Care Center/HVHC

Physicians PC, Cold Spring, NY

Responsibilities include planning, start-up and operations

of Article 28 D&TC as well as multi-site/multi-specialty

private medical practice. Performed start up planning,

physician credentialing for Managed Care, established

policies and procedures for Article 28 Diagnostic &

Treatment Center, on-site Human Resource functions including

staff recruitment and training, set-up and maintenance of

management information and patient accounting system.

Set-up of Medicaid Rate Code Billing System, liaison for NYS

DOH and parent hospital (reporting to VP Administration & VP

of Finance), preparation and maintenance of payroll records,

on-site inventory and purchasing system, medical records

system, quality assurance plans, process improvement plans

and telephone systems. Total staff compliment 47.

Revenue Manager

9/1994 - 11/1995 Planned Parenthood of New York City, Inc.,

New York, NY

Supervision of Revenue Accounting and Data Entry Departments

as well as indirect training and supervision of Clinic

Business Managers, Cashiers and Patient Service staff in 3

large off site clinic locations. Revenue Cycle Management,

completion of Medicaid Cost Report, A/R analysis, HMO

contracting and provider credentialing. Also responsible

for Medicaid and 3rd party claims submissions and follow-up.

Liaison to NYS Medicaid and Department of Health. Performed

research and implementation of automated patient accounting

system for 3rd party billings. Maintenance of fee

schedules, ICD-9 and CPT-4 system tables and negotiations

with Managed Care entities.

Billing and Collections Supervisor

6/1990 - 9/1994 Ossining Open Door Health Centers,

Ossining, NY

Responsibilities included supervision of fully automated

patient accounts/billing system, statistical support, system

table maintenance if ICD-9 and CPT-4 update, collections,

HMO contract negotiations, monitoring utilization of

capitated plans, ongoing training and support of billing,

cashiers and clinic patient service staff.

Patient Accounts Manager/Bookkeeper

10/1979 - 7/1986 Cardiovascular & Thoracic Surgical Group,

P.C., Roslyn, NY

Direct supervision of accounts payable and accounts

receivable functions, medical and surgical claims submission

through payment application and review/appeal. Performed

bi-weekly analysis of accounts receivable balances and

initiated claims follow-through procedures to maximize

revenue. Responsible for maintenance of O/R and conference

schedules, manual payroll for 16 persons as well as

recruitment and training of all office support personnel.

References Provided Upon Request



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