Manager Medical

LANCE C. HARDAWAY

**** ******* ***** *** *****, Ca. 94565

***********@*****.***

949-***-**** Mobile

OUALIFICATIONS

Experienced and responsible revenue recovery professional seeking a management/director or team member role utilizing friendly interpersonal skills, attention to detail, and team leadership attributes; which will contribute to an effective, orderly and care focused operations.

HIGHLIGHTS OF QUALIFICATIONS

20+ Years of Billing and Revenue Cycle Recovery Experience

Strong Knowledge and Application of various EMR software such as EPIC; IMS; Medix Prime etc.

Team oriented: Work well with other staff; able to lead and take initiative when needed

Interpersonal Skills: Listen attentively; Seek understanding and respond appropriately

Professional: Prompt Reliable; Responsible; Enthusiastic and ability to work cross cultural with sensitivity and respect

Proficient in the Application of California Case Law; Labor Code and OMFS. Also working understanding of CPT. ICD, DRG and HCPC codes. Lastly, HIPPA compliant to regulations and rules

PROFESSIONAL EXPERIENCE

SENIOR REIMBURSEMENT SPECIALIST 06/2017 – 06/2018

UCSF MEDICAL CENTER

Manage the billing/reimbursement work ques {WQ} in APEX (EPIC) on a daily basis.

Minimizing edits by working request and deficiencies in WQ

Work & communicate effectively with co-workers & external coders to resolve reimbursement/billing capture related issues

Demonstrate competency in the APEX (EPIC) system

Contact insurance companies directly on accounts in need of additional follow up for claim resolution and contractual pay rates between provider and payor

GENERAL OPERATIONS MANAGER OF REVENUE RECOVERY

ANTIOCH MAGNETIC IMAGING 03/2017-06/2017

Developed operational Policy & Procedure.

Managed Front Office Staff and Technicians in diagnostic patient services.

Trained in effective Authorization and Eligibility from Insurance coverage.

Also overseeing clean billing and effective AR Recovery from Commercial and Work Comp Carriers.

MANAGER OF CLINIC BUSINESS & OPERATIONS

PALMER CHIROPRACTIC CLINICS (ACCOUNT TEMPS) 11/2016 – 02/2017

Responsible for oversight of all business operation involving College & Clinic.

Provided support and direction to Interns & Clinicians along with front desk support staff.

Responsible for monitoring, addressing and reporting daily and monthly posting of AR and AP. Staffed computer application. Financial reporting of patient billing, collections and managing all clinic business operations.

REVENUE RECOVERY LIEN SPECIALIST

PACIFIC PAIN INSTITUTE – Dr. TOUFAN RAZI 06/2015 – 11/2016

Workers Compensation Revenue Recovery through professional and aggressive collections and lien litigation.

Educated and training staff on current Work Comp policy & procedure.

Monitoring physician MPN status, with various TPA payers.

Reported actual and projected revenue recovery derived from applied metric system.

MANAGER OF BILLING & REVENUE CYCLE RECOVERY

H.E.L.P. PAIN MANAGEMENT – DR WILLIAM BROSE 01/2014 – 05/2015

Managed two billers and four collectors in recovery of Workers’ Comp Pain Management Liens

Training of staff & measuring reimbursement of AR efforts utilizing metric system to report actual vs projected revenue recovery.

LIEN LITIGATION SPECIALIST

BEVERLY HILL SUNSET SURGERY CENTER 11/2007 – 12/2013

Collected &/or litigated Workers’ Comp Surgery Bills both professional and facility charges.

Filed appeals to inaccurate EOB’s & EOR’s for appropriate reimbursement.

Filed timely liens & DOR’s to defend compensability of medical services.

LIEN LITIGATION SPECIALIST

INNOVATIVE MEDICAL MANAGEMENT 08/1998 – 01/2007

Recovery of Workers’ Comp A/R with various multi-specialty charges.

Appearance at the WCAB interfacing with Defense Attorney’s and Adjustor’s negotiating and/or litigating Work Comp liens.

Accurately reviewing & appropriately appealing underpaid/unpaid medical services and recovery of reasonable compensation.

Filing DOR’s and scheduling WCAB appearances as required.

COLLECTION MANAGER-LITIGATION SPECIALIST

GARY MICHELSON-ORTHO SURGEON 02/1992 – 07/1998

Managed/ Implemented / Delegated / Training of Staff - Fee Schedule & DRG

Proficient in Application of Calif. Case Law, Labor Codes & ACOEM Guidelines.

Daily collection of Work Comp Accounts Receivables for various specialties.

Trained and Developed of Staff in Work Comp Collection and Billing - Litigation and Negotiation of Work Comp Liens on the phone &/or at the WCAB.

Prepared Trial Briefs; Petitions for Reconsideration/Appeals, D.O.R.’s etc.

Successful Competent and Professional when interfacing with Defense Attorneys and Insurance Adjustors via telephone and/or at the WCAB

Ability to recover the highest percentage of Work Comp liens and/or Commercial Billing on a case by case basis and predicated upon Case in Chief and appropriate lien or claim filing.

EDUCATION: Doctorate Degree – Strategic Leadership & Expository Communication. 2013 FAITH EVANGELICAL COLLEGE & SEMINARY TACOMA, WA

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