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Manager Insurance

Location:
Brandon, Florida, United States
Posted:
February 15, 2018

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Angelina Valenti

813-***-****

ac4hhn@r.postjobfree.com

EMPLOYMENT:

DIRECTOR OF BUSINESS AND FINANCE DEPARTMENT JULY 2014- AUGUST 2017

Orthopaedic Medical Group of Tampa Bay Brandon Fl

Responsibilities include direction and supervision of 10 employees which include education and training overseeing and prioritizing workloads.

Payment posting.

Filing and reimbursement of insurance.

Collection.

Analyze and research coding and procedural for optimal payment.

Implementation of Compliance regulation and policy. Osha and Hippa

CPT/ICD – 9 coding ICD-10, insurance billing and reimbursement.

Coding all surgeries and consult for Seven Physician and Seven Physician Asst. Payroll.

Daily balance and Close of Office Books.

Family and Patient correspondence in related to all Insurance and payment issues.

Research and maximize all vendors for the lowest prices.

Oversee all Order and GPO account. Reconciliation of multiply merchant and bank accounts.

Medicare Compliance Officer. Internal Self Audit

Assisting all location with any and all billing and insurance questions.

Schedule all Telephone Conference, Deposition and Trial with Physician and attorney included but not limited to payment.

Insurance verification and authorization.

Credentialing

Oversee all Revenue Cycle Operations

Accounts payable Accounts Recievable

OFFICE MANAGER AUGUST 2007- JULY 2014

Orthopaedic medical group of Tampa Bay Brandon Fl

Grew Practice from a one Provider, one Office to a Seven Provider seven Physician Asst. five location Practice.

Responsibilities include direction and supervision of 45 employees, which include education and training, overseeing and prioritizing workloads.

Overseeing the complete operation of the four offices including but not limited to any building or maintenance problems.

Credentialing of Four Physician and Two Physician Asst.

Implementation of Compliance regulation and policy.

Involved in credentialing, CPT/ICD – 9 coding, insurance billing and reimbursement.

Payment posting.

Filing and reimbursement of 2nd insurance.

Patient billing and collection.

Insurance verification and authorizations

Researches coding and procedural guidelines mandated by multiple insurance companies.

Coordinate and prepare meeting with Multi – Representatives and Physicians to obtain new information on product, procedures and billing.

Payroll.

Marketing.

Daily balance and close of Office Books.

Family and Patient correspondence

DEPARTMENT LIASON SPECIALIST DECEMBER 2006- AUGUST 2007

USF Physician Group Tampa Fl

Provide support between the USF Physicians Group and the Patient Accounts Department.

Reviewing TES workfiles and providing support to clinical area and USFPG faculty in the form of reimbursement and denial analysis.

This also in includes but not limited to the area of correct coding and reimbursement as defined by legislative, regulatory and procedural guidelines imposed by Medicare, Medicaid and WC.

Assist in on-going reimbursement and denial review with clinical departments and help with process improvement.

Work with Patient Accounts staff and Departmental staff, monitoring TES workfile and expediting quick resolutions for A/R management.

This Position is also the primary back up for Tes and Claims Manager software applications.

MANAGED CARE COORDINATOR JUNE 2005 – OCTOBER 2006

Home Health Corporation of America Tampa Fl.

Develop relationship with managed care providers to become a reference provider for home health service. Contacting and maintaining new and old contracts with various Insurance Company to become part of their network.

Verify Insurance benefits and receive authorization, re-authorization and retro authorization for home health care. Credentialing for multi – offices in the Florida area related to the Orthopeadic department. Process the intake of all patient referral from hospital, managed care and physician's office.

Oversee and supervise 12 locations in the Florida area.

OFFICE MANAGER JULY 2003 – JUNE 2005

Orthopaedic Center of Brandon Brandon, Fl

Responsibilities include direction and supervision of 5 employees, which include education and training, overseeing and prioritizing workloads

Credentialing

insurance billing and reimbursement

Researches coding and procedural guidelines mandated by multiple insurance companies

Coordinate and prepare meeting with Multi – Representatives and Physicians to obtain new information on product, procedures and billing

Daily balance and close of Office Books

Payroll. Marketing...

CPT/ICD – 9 coding

Family and Patient correspondence

SURGERY SCHEDULER OCTOBER 1996 – JULY 2003

Orthopaedic Center of Brandon Brandon, Fl

Responsibilities include insurance verification and authorization. Schedule surgery throughout multi facilities.

Obtaining all test and authorization for all surgerical procedures

Patient care as a certified Medical Assistant, X-Ray Technician, Orthopaedic Technician and basic Physical Therapy

Operating multi – phone system. Electronic Data entry of medical record, transcription and patient information.

CPT/ICD- 9 coding

Basic receptionist duties.

schedule appointments and basic billing functions

EDUCATION

Clara Maas School Of Nursing Belleville NJ

Bloomfield College Bloomfield NJ

CERTIFICATION

Notary

SKILLS

Organized, detail oriented and accurate. Creative and flexible in dealing wih multiple tasks. Excellent oral and written communication. Knowledgeable in Greenway, Compugroup, Visionary, Medical Management, Microsoft Word, Microsoft Outlook, Microsoft Windows, Word Perfect, Excel, Quick Book, Availity, ACM, Mozilla Firefox, Paybill, Medi- Tech, Medware, Docpad, Visatrax,Haven. Persona (IDX) TW Scan, Pace, PICS, Claims Manager, PICS Development and Intergy.



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