Medical Assistant Manager
Resume:
Management/Billing and Coding/Finance/Medical Collections/Medical Assisting
Seeking Growth!
My name is Jayne Cambas, I am bilingual, computer savvy, EMR knowledgeable, HEDIS tool knowledge, Microsoft proficient, aware of quality measures, business oriented and interested in assuring the highest quality of patient care. I am very ambitious and enjoy watching numbers grow through proper coding and collection tactics. I am very dedicated to exceeding in all areas within my work and educational space. I am a responsible notably fast learner, organized, team player, ambitious and self-motivated in my actions. I am always looking to learn more, develop skills and find better ways to operate and grow in my professional environment. I am good at developing strategies to set achievable goals, to achieve a set goal and I excel in problem solving. I recently completed my Bachelor’s degree in Public Safety Management/Criminal Justice. I have over 7 years of experience in the medical field, 3 of which have mainly consisted of running the finance department, insurance authorization department, billing and coding in inpatient and outpatient mental health. I also have knowledge in billing for skilled nursing facilities, spine and orthopedic specialty. I had the opportunity to work per diem inpatient psych as a behavioral health technician, so I have inpatient experience. I have extensive expertise in all the inpatient and outpatient billing and coding, insurance verifications, authorization requests, denials and appeals, patient/insurance accounts receivables, collection lay outs and staff overview & directing balance collection. I am looking to obtain a position where I can grow professionally. I am certified through NCCT as a National Certified Insurance and Coding Specialist, ID # 882229. I have my BLS active for healthcare providers and I am registered as a medical assistant in the state of Florida, AMT ID # 2702808. I am currently a member of the AAPC and I am looking into testing for the CPC in January. I am also a member of the ARHPC and will receive my RH-CBS certification by the 17th of December. For the new year I would like to get certified through the AAPC in medical auditing and medical compliance. I am willing to take any training necessary in order to obtain a position that I can grow with. I am currently in the process of attaining my MBA in Health Care Administrations pending admission at F.I.U.
References:
Patrick Joyce: (Director) 305-***-****
Elizabeth Tapanes: (Practice Manager) – 954-***-****
Dr. Ignacio Bobes: (Provider) – 305-***-****
Vicky Garcia: (Professor) – 786-***-****
Maria Cardozo – (Professional) 305-***-****
Objective: Growth!
Professional
Experience:
Care Resource
1/17/2017-Present
Edith Clark Manager
Medical Coder
Review records for coding
Charge entry
Denial review and correction
Collections
Insurance verifications
Excel creation for tracking
Contracting development and adjustment
Training staff
Provider communication for clarification
Event staff for fund raisers
Spine & Orthopedic Center, S.O.C.
07/17/2016-10/25/2016
Odalys (Manager) & Jennifer (Assistant Manager)
Coding Specialist
Charge Entry
Assuring that charge ticket matches notes and fulfilled exams
Patient Demographic verification
Phone calls
Appeals
Participate in projects as they come
Weekly/Monthly reconciliation
Request information as needed.
Find proper codes if needed
Insurance verification as needed
Victoria Nursing Home
04/2016-06/2016
Gerrald Piccorneli
Medical Biller
Prepare all charges for charge entry. Pharmacy, room and board, therapy, x-ray and ultrasounds as provided by the facility
Account reconciliation reports
Appeals
Payment posting
Monthly balancing
Coinsurance collections
AHF Kinder Medical Group
03/2016-04/2016
Marcelo Escobar
Medical Assistant/Referral Coordinator/ Medical Records
Medical Record abstraction and preparation
Room prep
Copayment collection upon admission
Vitals
Ekg’s
Appointments
Handling phone calls
Referral preparation for all specialties and patient needs
Alico Capital
Patrick Joyce
*******@************.***
10/2015-Present
Regional Account Manager-Contract personnel
Handle Commercial accounts for region
Collect information for loan closing
Follow up with account supervisors as needed
Answer calls from supervisors and assist in inquiries
Delegate and prioritize accounts by loan closing dates and cash amounts.
Pay roll distribution for sub-contracts
Serve as administrative assistant to Directors of operations
Research properties
Serve as first hand contact and advisor to regional account supervisors
Supervise and review all work from account supervisors to assure maximum function
Train and improve function of regional supervisors
Serve as goal motivator to all regional supervisors and employees
Try to advance in delegated states for maximum closing outcome
Mercy Hospital
3663 South Miami Avenue
Giselle Asst. Director and Dolores Director
5/2015 to 8/2015
Position: Behavioral Health Technician – Per Diem
●Assist patients
● Maintain ordinance on floor
●Executed on case management and HEDIS measures
●Admissions
● Room check
● Patient 15 minute monitoring (rounding)
● Patient activity observation
●Fall prevention
●Prevent accidents and any other unwanted situation
● Assist nurses in medication administration when patients are disorderly or non-compliant
● Vitals
● One to One observation if needed.
● Assist in emergency code situations.
● Assure patient safety
● Assure staff safety
● Prevent elopement and self-injury
● Serve patient snacks, breakfast, dinner and lunch.
● Clean after meals and maintain a clean floor.
● Monitor patient visitation.
●CPI – Crisis Prevention Intervention
HCA Mercy Behavioral
2150 Coral Way Suite 5D Miami FL. 33145
Maria Del Sol MD/Ignacio Bobes MD
Practice Manager – Iliana Garcia-Barbon
Nov. 2014 – Oct. 2015
Position: Medical Assistant/Coder
●Answer calls, Assist in patient services, call in refills, assist to emergency calls, check and respond to messages, scan and upload documents, screen phone calls for physician referral.
●Assuring patient payments were received.
●Preparing notes for front office to enforce patient balance collections.
●Train new employees as needed to enter charges, Develop lists or power point presentations for staff training, phone etiquette, scheduling instructions, hours and more, call handling, prescription writing, insurance verification process, lab ordering, referral creation, information that must be obtained at front desk, phone calls etc.
●Insurance verifications - Billing and Coding – Authorization requests – IET/Denial review, correction and resubmission – Run and prepare billing reports for charge entry – enter charges, charge entry reconciliation, prepare reports for provider records, create portals and update passwords as needed to make the verification process more efficient and quicker.
●Enter office charges and hospital charges.
●Verify staff entered charges for errors.
●Upload missing documents and correct errors.
●PHP/hospitalization referrals – Baker Acts – therapy – sleep testing – ADHD testing –as needed
●Assist in filling out forms for patients.
●Prepare letters requested by patients for Dr. Signature and approval
●Fill out form for patients
●Respond to attorneys requesting court appearance from providers.
●Assist in prior authorizations
●Prepare medical records for appeals, charge submission or payment reconsiderations.
●Follow up to manager with employee as needed and suggest new ways or solutions to current issues.
●Assist and train new staff or front desk
●Inpatient billing and coding, insurance verifications, authorization requests and denials.
●Assure proper documentation completion for submission.
●Executed on case management and assured PQRS quality measures were met.
Maria J Del Sol MD PA/Ignacio Bobes MD
2150 Coral Way Suite 5D Miami Fl. 33145
(Manager- Elizabeth Tapanes)
February 2013 – June 2013
Position: Receptionist/Front Desk
●Greet patients, provide sign-in sheet, prepare and provide new patient packages (consents)
●Scan rx’s, insurance cards, identification cards, records, provide excuse letters
●Answer phones
●Verify insurances
●Copayment and past due balance collection
●Payment plan arrangements
Maria J Del Sol MD PA/Ignacio Bobes MD
2150 Coral Way Suite 5D Miami Fl. 33145
(Manager- Elizabeth Tapanes)
June 2013 – Office Staff/Back Office / Medical Assistant/Office Coordinator
●Office Duties
Answer phones
Take messages for the doctors
Assist patients with inquiries, emergencies, confusions etc.
Provide refills, letters, forms etc.
Assist with any emergencies or side effects reported
Assist doctors with any requests
Assist manager with any requests
Front desk
Assist with prior authorization Assist with patient referral
Attend to possible interactions or medication abuse reports from insurances
Enter lab requests into Quest 360 for patients to get labs
Lab Orders
Make lab orders on ICA Notes to give to the patient in order for them to get labs elsewhere
●Assisted Living Facility Patients (ALF’s) – All request from ALF’s are handled by me or reported to me at some point.
Appointment dates given to the groups. (Block out partial or full days in order to have ALF patients come in.)
Side effects reported by ALF’s and doctor responses or changes to medications. Fax all changes on a prescription for these patients
Annual reports
Discharge summaries
Assure optimal patient care and proper provider documentation.
●Insurances
Verify insurances for next day patients or walk in patients
Review, correct, appeal and resubmit denied or unpaid claims
Mail or fax reconsideration forms for claims which are not able to be appealed
Submit claims (If needed)
Request authorizations for patients which require authorization
Submit treatment plans for insurances which require treatment plans
Insurance inquiries such as new process or changes within the provider insurance relations department (If needed)
Update portal passwords (If needed)
●Patient Balances
Verify, correct, log and review patient balances daily
Collect patient balances
Mail out balance statement
Log all patient balances, claims corrected or submitted, items faxed, labs ordered, voice messages etc.
Create collection plans for front office, review outstanding balances daily and assure we were meeting our daily goals as logged in daily patient lists
1/2013-2/2013 – Dr. Kendall – Dermatology – 305-***-****
318 Alhambra Circle Coral Gables FL 33135
Medical Assistant
●Answer phones
●Prepare rooms
●Assist in patient procedure prep.
●Insurance verification
●Copayment collection
● Procedure assistance
●Skin test preparations
6/2013-12/2013 Motel Bianco –
5250 Biscayne Blvd Miami FL. – 305-***-**** – Owner – Jose Licata or Jaray 786-***-****
Receptionist
●Answer Phones
●Greet clients
●Assist clients with directions, translations, finding rooms or local entertainment, restaurants, etc.
●Customer service
●Briefing & Logging
●Assuring the right amount of cleaning staff is on duty to assure the guests are covered.
5/2010 – 12/2012 – Office of Dr. Zoilo Rafael Abad & Francisco Padron
10621 SW Kendall Drive Miami FL 33156 Suite 230
RN – Yanaisy – 786-***-****
Medical Assistant
●Order lab work and x-rays
●Prioritize patient daily care according to acuity and scheduled patient procedures
●Assist patients with patient care, take vital signs, prep for procedures, draw blood and obtain specimens
●Maintain, clean and set up patient rooms
●Patient intake/discharge
●Assist with patient and family education
●Assist R.N. with sterile and non-sterile dressing changes
●Prepare for EKG’s
●Utilize PC and retrieve patient data
●Answer Multi-line phones, operate fax and copy machine
●Prepare records for charge entry
●Authorization requests
●Super bill preparation
●Copayment and insurance payment collection
Super Yellow Cab – Manager: Arturo - 305-***-****
I do not recall exact times and dates I worked here. I was with the company back and forth, while I worked with Dr. Abad and Padron and in between jobs as well.
Position: Phone Operator/Full-time PRN
●Answer phones
●Take accurate information from callers
●Relay messages to dispatcher
●Follow up if needed
Education:
Miami Lakes Educational Center (2009-2010) Prof. Vicky Garcia – 305-***-****
Basic Health Care Worker
Administrative Medical Assisting ‘
Anatomy & Physiology
Billing/Coding
Clinical Medical Assisting
Medical Lab. Techniques
Phlebotomy – Theory/clinical
Electrocardiography- Theory/Clinical
Radiography – Theory/Clinical
Pharmacology/Drug Administration- Theory/Clinical
Externship –
North Dade Center (Jackson North)
Miami Jewish Home for elderly
Miami Dade College – 2010 – 2013
Associates of Arts – Criminal Justice Administration
Miami Dade College 2013 – April 23, 2016
BAS - Criminal Justice/ Public Safety Management
Certifications
Registered Medical Assistant
BLS - 2010 to 2013
Renewed 2015 exp. 2017 – pending renewal
CCS - Certified Insurance and Coding Specialist 8/2015
CPC – pending test
CH-CBS – pending test 12/17/2017
Affiliations
HOSA
AMT
ARHPC
AAPC
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