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Manager Customer Service

Location:
Vancouver, WA
Salary:
55,000
Posted:
March 07, 2018

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Resume:

Sandy Ferguson

**** ** **** *****

Vancouver, WA 98662

Cell: 503-***-**** Home: 360-***-****

ac4qfh@r.postjobfree.com

I am a detail-oriented, independent self-starter who believes deeply in organization's mission and have a proven record of achievement in challenging and fast-paced situations. I have extensive experience in Healthcare administration and College level instruction. I have earned a Bachelor of Science degree in Business, (Healthcare Administration), and an Associate’s Degree in Marketing and Management. I have Teaching Diplomas in; ESL and TEFL, Certifications’ in’; Practice Management, Dental Assisting and Dental X-ray, Medical Transcription and as a BLS/CPR Instructor.

EMPLOYMENT SUMMARY

Operation Director and Office Manager

Providing first-line implementation of all HR responsibilities for staff; interviewing, training and support of medical and Dental staff. Ensure operation efficiencies and compliance to all mandated regulations. Establishing and maintaining billing rules, business logic, workflows, fee schedules, payer and credentialing settings, EDI and ERA management. Identifying and articulating unmet patient needs to service and operations management for resolution.; Responsible for the management of accounts receivable. This would include the analysis of accounts receivable, directing follow up team to work with payers and determine status of unpaid claims and taking the necessary actions to ensure prompt claim payment; Monthly reporting of operational results and identification of issues and recommended actions to improve results.

Dental Clinic Administration and Assisting, Medical Billing and Practice Administration and College Instructor

Provide information and instruction to students enrolled in the Healthcare Administration program. Provide accurate and current information on the rules and regulation pertaining to ICD-9 and CPT coding and billing procedural protocols. Provide instruction on filing all types of insurance claims, (fee for service, workman comp, Medical billing and coding procedural protocol, HIPAA rules, and regulations. To create a logical progression of learning and ability to apply skills when assessing codes and processing an encounter form for data entry in a Healthcare environment. Prepare and provide all lecture, laboratory and clinical instruction according to the required curriculum. Follow current course outlines, objectives, and evaluation mechanisms for the program and/or develop such when indicated by the President. Maintain a lesson plan of daily instructional events. Monitor student attendance and retention.

Claims Analyst

Provide quality customer service to external and internal customers. Respond to inquiries regarding dental, workman comprehension, vision and individual health claims and policies in an accurate manner. Resolve claims issues by taking appropriate action. Provide timely resolution to questions and issues by using available systems and by involving department staff and external resources and contacts. Accurately and appropriately provide comprehensive and legally defensible documentation. Utilize time proficiently to offer optimal service, secure and analyze information pertaining to claimants' condition, history, insured status and other policy provisions to accurately determine eligibility for, and entitlement to dental, vision and individual health benefits. Communicate claim/pre-determination resolution to insurers, providers, and authorized representatives by providing the benefit determination or exception after the adjustment has been completed. Research and evaluate new or revised member eligibility, benefit plans, or provider data to make appropriate reconsideration of denials, pre-determinations, or payments based on applicable policy limitations and provisions. Investigate and apply contract benefits; provide claims processing, evaluate formation ensure it consists of clarity, accuracy and validity, issue payment for processed claims.

EMPLOYMENT HISTORY

Tutor Specialist December 2016-current

2700 NE 95th Court, Vancouver, WA 98662 360-***-****

Norton Sound Healthcare Corporation May 2013-July 2016

NSHC Dental Clinic Manager, Patient Hostel and Pre-Maternal Home Administrator

PO Box 966, Nome AK 99762 907-***-****

Clinicient April 2011-January 2013

Medical Office Account Manager

1515 Fifth Ave, Portland, OR, 97217 503-***-**** EXT. 149

College Instructor April 2008-December 2012

Advantage Point Tutoring September 2009-current

Peter Ogden School 81st Street, Vancouver, WA 98663, 360-***-****

Charter College, 17200 SE Mill Plain Blvd, Suite 100, Vancouver, WA 98683, 360-***-****

Everest College, 120 NE 136th Ave., Suite 220, Vancouver, WA 98684, 503-***-****

Pioneer Pacific 8800 SE Sunnyside Road, Clackamas, OR 97015, 503-***-****

Operations Director March 2007-January 2008

Comfort Care Mobile Dental, 3245 SE Campbell Street, Milwaukie, OR 97222, 503-***-****

Claims Analyst October 2005-January 2007

Regence Blue Cross, 100 SW Market Street, Portland, OR 97215, 503-***-****

Office Manager October 2001-January 2005

Constant Lu, D.D.S., PC, 616-C NE 81st Street, Vancouver, Washington 98665, 360-***-****

Office Manager June 1991-May 2001

Edward Barnes, D.M.D., 1832 N Lombard Street, Portland, Oregon 97217, 503-***-****

Office Manager July 1989-May 1991

Edward Ward, D.M.D., 627 SW Alder, Portland, Oregon 97205, 503-***-****

Office Manager July 1987-April 1989

Ronald Snyder, D.M.D., 712 Swift Blvd. Suite 8 Richland, Washington 99352, 509-***-****

EDUCATION

Serious Teachers Inc. TEFL Education ESL & TEFL Certificate Diplomas March 2011

Dental Assisting National Boards Certification in Dental X-ray Technician December 2010

American Heart Association BLS/CPR April 2015

Concordia University Bachelor of Science in Healthcare Administration June 2005

Concorde Institute Medical Transcription December 2000

Mt. Hood Community College Medical Coding and Terminology December 2000

Blue Mountain Community College Associate Degree in Marketing and Management June 1981

Dental Assisting National Boards Certification in Dental Assisting October 1989

Dental Assisting National Boards Certification in Practice Management June 1988

PERSONAL REFERENCES

Edward Barnes, D.M.D., PC

1832 N. Lombard, Portland, Oregon 97217

503-***-****

Rhonda Schneider, THRP

Recruitment & Staffing Manager, Norton Sound Health Corporation

P.O. Box 966, Nome, AK 99762

907-***-****

Professor Mark Jaeger, Professor of Healthcare Administration

Concordia University Chair, Department of Health, and Science

2811 NE Holman Street, Portland, OR 97211

503-***-****

Rochelle Ferry, Licensed Dental Therapist

Norton Sound Healthcare Corporation

PO Box 966, Nome, AK 99762

360-***-****

Christine Schultz, LCSW, DCSW, Director of Social Services Norton Sound Healthcare Corporation,

PO Box 966, Nome, AK 99762

907-***-****

Leslie Cooper, RRT, RPsgT, Clinical Coordinator of Respiratory Services

St. Vincent Medical Center

9205 SW Barnes Road, Portland, OR 97225

503-***-****

Jenny Valentine, Daimler Trucks North America, Forecast and Inventory Optimization

Portland, OR 97217

503-***-**** or 360-***-****

Lana Pope, Expanded Functions Dental Assistant

Paynter Dental, Portland, OR 97217

971-***-**** or 503-***-****



Contact this candidate