Manager Project
Resume:
Title:Manager
******@*******.***
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NAME:,
ADDRESS:
ADDRESS2:
CITY:
STATE: TX
ZIP:
CANDIDATE ID: 2909682
US CITIZENSHIP:
EDUCATION:
EXPERIENCE: 0
WILL RELOCATE: No -
JOB WANTED:
RATE NEEDED:
TELEPHONE: 972-***-****
EMAIL: ******@*******.***
HOMEPAGE:
HOTTEST SKILLS: health, medical, patient, lien, healthcare, claim, claim, product,
clinic, billing, budget, payment, proposal, clinical, emergency, surgery, financial,
market, presentation, strategic
REVISION: 08-SEP-02
RESUME:
SDTechForce
ARLENE F. BARIL
7200 RANDALL WAY
PLANO, TX 75025
******@*******.***
EDUCATION
University of Scranton,
Scranton, PA Master of Science- Health
Administration,
GPA 3.85, August 1991
State University of New York at Binghamton
Bachelor of Science-
Applied Social Science,
summa cum laude, May 1990 Concentrations:
Business and Health Systems
Broome Community College,
Binghamton, NY Associates in Applied
Science- Medical Record Technology,
cum laude, May 1980 Accredited
Records Technician, September 1980
EXPERIENCE
1/97
-presentCampbellWilson Healthcare Consulting Dallas, TX 75231
Manager
Manage day to day operations of HIM product line Evaluate, train,
supervise, discipline, and delegate assignments to Senior and Staff
consultants Serve as Project Manager for HIM assignments; Coding and
billing audits, DRG Validations, Charge Description Master reviews,
Medicare Fraud and Abuse Issues, Teaching Physician Regulations, and
other pertinent topics Write proposals, develop timelines, and prepare
budgets for all projects in HIM line See under "Senior Consultant
responsibilities" for remaining tasks and responsibilities
8/95
-1/97CampbellWilson Healthcare Consulting Dallas, TX 75231 Senior
Consultant
Initiated development of HIM product line Perform a multitude of
ICD-9-CM/CPT coding reviews-physician, hospital, DME, HMO, substance
abuse, psychiatric, mental health/mental retardation clients Perform
billing/claims review for multitude of clients Assist in multiple
Charge Description Master review projects- serve as Project Director
Develop educational materials on various subjects for both individual
client and national presentations
Knowledgeable of Medicare, Medicaid, and other various payer
regulations Develop forms/superbills for client facilities National
lecturer in APG readiness and CPT coding Perform market analysis,
utilizing DRG/discharge data Perform research on a multitude of topics
and act as resource person for client facilities Proficient in
Proposal and Report Writing Proficient in Excel, Word, Power Point and
other various software applications Assist in other projects on an "as
needed" basis
3/92
-7/95Mercy Health Systems-Northeast Region Wilkes Barre, PA
Director, Medical Records
Managed day to day operations for 303 bed acute care hospital with
responsibilities for inpatient, outpatient, psychiatric, emergency
room, ambulatory surgery and clinic records. Administered $700K
budget. Accountable for Medical Records Department of 91 bed long term
special care sister hospital, and served as medical records consultant
for affiliated 110 bed skilled nursing facility. Supervised, trained
and delegated assignments to 25+ medical records personnel; managed
department staffing. Upgraded computerized coding, abstracting and
data collections systems for Mercy Hospital and initiated automated
abstracting system for sister facility. Introduced cross-training
program resulting in maximization of department productivity and
improved coverage for vacation and sick leaves. Originated coding
focus review program resulting in increased DRG reimbursements. Worked
cooperatively with third party payers and peer review organization in
coordinating insurance payments; possess knowledge of New York State
and Pennsylvania reimbursement regulations. Developed a "coding
hotline" providing coding and billing assistance to Mercy Med-Care
physicians' office staffs. Streamlined job procedures and reduced
staff by 5.20 FTE's. Converted physician box system to terminal digit
system to reduce incomplete and delinquent records. Selected and
implemented digital dictation system, October 1992. Developed
strategic plans, budget, floorplan, and new file room for new
department, opened Fall, 1993. Served on system-wide Information
Systems Task Force, responsible for the selection of a Corporate
computerized patient clinical record system.
1990
-1992Moses Taylor Hospital, Scranton, PA Coding Manager/Assistant
Director
Directed coding processes for 230 bed acute care hospital with
responsibilities for inpatient, outpatient, emergency room and
ambulatory surgery records. Implemented ICD-9-CM and CPT-4/HCPCS
coding procedures. Supervised, evaluated, trained and delegated
assignments to staff of 11. Conducted in- service training on coding
updates. Interviewed and hired qualified medical records personnel.
Oversaw medical record analysis, assembly, abstracting, coding, tumor
registry, Medisgroups, and quality assurance ensuring compliance to
state, federal and hospital regulations. Monitored physician
compliance to timely completion of records; issued notices and
coordinated disciplinary action. Effectively managed DRG
reimbursements to receive optimal payments. Achieved 98% and 100%
ratings during external reviews for receipt of optimal insurance
reimbursements. Participated on review team resolving payment
discrepancies. Served on task force designing and implementing
Critical Pathways. Served as Co-system Manager of computerized coding
and abstracting system. Initiated installation of CADCARS 3M system,
including training staffs of Coding, Utilization Review, and Medical
Social Work departments. Researched and selected systems for other
hospital divisions.
1981
-1990Lourdes Hospital, Binghamton, NY Coding and Clinical Data
Supervisor
(11/86-10/90)
Supervised coding and abstracting staff for 267 bed acute care
hospital; evaluated, trained and controlled work flow of 9 employees.
Interfaced with physicians and other health care professionals to
provide and verify data.
Abstractor
(3/81-11/86)
Collected patient data; developed indices and statistical studies;
maintained related logs and summaries. Performed back-up medical
records coding of inpatient/outpatient records.
1980
-1981Blue Shield of Western NY, Upstate Medicare Division,
Binghamton, NY Claims Representative
Investigated claimant inquiries; researched records and communicated
with providers and beneficiaries in resolving claims; processed
appropriate reimbursement adjustments.
PROFESSIONAL ACTIVITIES/ASSOCIATIONS
Member: American Health Information Management Association Section
Member
AHIMA:
Coding, Quality Assurance, Long Term Care Texas Health
Information Management Association Dallas-Ft. Worth Health Information
Management Association Healthcare Financial Management Association
Healthcare Financial Management Association- Lone Star Chapter
National Association of Female Executives Advisory Board member of
Medical Record Technology program at Broome Community
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