Insurance Manager
Resume:
Rachael L. Torres
*** **** ** **, ***********, NM 87105
Objective
S eeking a position in a company where I can use my skills and passion for helping others and give back to the community. Education
ASSOCIATES OF APPLIED SCIENCE DEGREE IN INTEGRATED STUDIES DECEMBER, 2013 CNM
Skills & Abilities
MANAGEMENT
M anaged and analyzed billing and accounts receivables.
R esponsible for hiring and firing employee.
C ompleted yearly employee reviews – Established short and long term goals for employees as well as myself and my department.
D eveloped daily/weekly employee goals to ensure department and individual effectiveness.
D emonstrated knowledge of company’s policies and procedures.
F ollowed and maintained such procedures/policies.
C ompleted employee write up’s and disciplinary action when appropriate.
R eview, Corrected, and approved employee time cards and vacation requests.
A bility to delegate and to depend on subordinates.
A bility to organize, plan, and communication with subordinates for effectiveness use of resources.
P romoted being proactive rather than reactive.
M aintain positive and good relationships with subordinates, upper management, and other healthcare professionals.
D eveloped training material and conducted staff and upper managerial trainings.
C ompleted chart audits and compliance assessments to ensure proper billing procedures are being followed.
R an weekly, monthly, quarterly, and yearly financial reports.
I mported appropriate data Analyzed Reports.
R eported findings to CEO daily.
W eekly, monthly, meetings with facility manager and CEO to ensure that operations of the company’s goals are being met.
D eveloped good strategies and welcomed change in the billing department as well as within myself to ensure the company’s success.
A bility to appraise subordinates and one’s performance objectively.
P romote self-motivation and self-control.
P ossess well-defined personal and professional goals.
E ncourage subordinates to maintain and strive for the same.
E ncourage wiliness to compromise and embrace subordinates ideas and suggestions.
P ossess emotional maturity and the internal resources to cope with frustrations, disappointments, and stress with subordinates.
P romote and acknowledge that one will keep on growing, improve one’s performance, and continue to develop.
A bility to problem solve and make decisions.
I have the ability to act upon them, and accept responsibility for them.
ACCOUNTS RECEIVABLS MONTHLY GOALS:
S trived and maintained monthly billings of $250,000.00 or more.
S trived and maintained Accounts Receivables 31-60, 61-90, 91-120 to be less than 30% combined.
S trived and maintained 120+ to stay under 10% of the total Accounts Receivable.
S trived and maintained monthly income revenue of $200,000.00 or more
COMMUNICATION:
S hort daily meeting to ensure that the department was running as efficient as possible
W eekly individual employee meetings. Review work load, expected goal, answer any questions, and be a continued resource for my employees.
LEADERSHIP:
R esponsible for teaching and leading billing department of 15 employees.
Experience
OFFICE MANAGER ACCENT ON VISION EAST APRIL 2014 – MAY 2016 Managed six employes’s and all management responsibilities Managed and analyzed accounts receivables and billing. Completed insurance and patient billings for the company. Analyzed Account Receivable accounts from 0-120+. Worked and collected on outstanding insurance and patient accounts. Posted insurance check payments and EFT payments.
Analyzed EOB’s and patient payments to ensure proper and prompt payment. Completed bank deposits and took to the bank. Requested insurance authorizations for New Mexico
Completed prior authorization appeals for patients. Answered phones, addressed patients’ needs or complaints. Scheduled appointments.
Verified patients insurance and benefits.
Complete knowledge on Medicare’s LCD’s and Articles to ensure compliance
Received zero payments.
Analyzed the denial, submitted corrected claims when appropriate. When appropriate created and completed appeals to insurance companies for incorrect denials.
Assisted in the optical as a back-up Optician when needed. Analyzed and completed insurance and patient refunds when appropriate. BILLING MANAGER CPOD AUG 2012 – APRIL 2014
Managed and analyzed Accounts Receivables and Billing. Completed insurance and patient billings for the company. Billed over 500 claims per month.
Analyzed Account Receivable accounts from 0-120+. Worked and collected on outstanding insurance and patient accounts. Accounts Receivable 300,000 dollars.
Posted insurance check payments and EFT payments.
Analyzed EOB’s and patient payments to ensure proper and prompt payment. Completed bank deposits and took to the bank. Requested insurance authorizations for New Mexico
Requested OON authorizations.
Negotiated workmans compensation authorizations.
Completed prior authorization appeals for patients. Answered phones, addressed patients’ needs or complaints. Scheduled appointments.
Verified patients insurance and benefits.
Complete knowledge on Medicare’s LCD’s and Articles to ensure compliance
Received zero payments.
Analyzed the denial, submitted corrected claims when appropriate. When appropriate created and completed appeals to insurance companies for incorrect denials.
Analyzed and completed insurance and patient refunds when appropriate.
BILLING MANAGER ACTIVE LIFE, INC. AUG 2008- JUNE 2012 Managed and analyzed Accounts Receivables and Billing. Completed insurance and patient billings for the company. Billed over 500 claims per month.
Analyzed Account Receivable accounts from 0-120+. Worked and collected on outstanding insurance and patient accounts. Accounts Receivable 300,000 dollars.
Posted insurance check payments and EFT payments.
Analyzed EOB’s and patient payments to ensure proper and prompt payment. Completed bank deposits and took to the bank. Requested insurance authorizations for New Mexico
Requested OON authorizations.
Negotiated workmans compensation authorizations.
Completed prior authorization appeals for patients. Answered phones, addressed patients’ needs or complaints. Scheduled appointments.
Verified patients insurance and benefits.
Complete knowledge on Medicare’s LCD’s and Articles to ensure compliance
Received zero payments.
Analyzed the denial, submitted corrected claims when appropriate. When appropriate created and completed appeals to insurance companies for incorrect denials.
Analyzed and completed insurance and patient refunds when appropriate. References:
See letters of recommendation attached
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