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Customer Service Medical Billing

Location:
Las Vegas, Nevada, United States
Posted:
September 06, 2018

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Resume:

Kathy Burke

**** ******** ***** *** ***** NV. ***29

401-***-****. ac6ydw@r.postjobfree.com

Experience managing multiple clinics centered on enhancing physician and patient satisfaction while driving growth to meet corporate goals and meeting TJC, and CMS initiatives

Experience

QueensCare Los Angeles, CA 12/2015 to 6/2018

Director of Operations

Responsible for budget in excess of 4 million dollars, including the build out of a 1.3 million dollar six chair mobile dental clinic

Oversee five distinct departments with differing goals and opportunities (Mobile Programs, Mental Health, QueensCare Health & Faith Partnership and Chaplaincy)

Build an “all for one” team atmosphere across departments to increase collaborative efforts and continuous improvement

Establish strong relationships with other departments and community partners

Mentor and support managers and staff to reach their department and individual goals

Maintain audit and compliance records for areas of the organization I was responsible for

Created a customer service focused environment while maintaining a fiscal responsibility

Healthcare Consultant 4/2011 to present

Create operations related policy and procedures to conform to standard operating practices

Oversee the successful processing of health care claims, including the transition to ICD 10

Led the creation of meaningful use compatible forms

Developed and implemented forms numbering system to ensure clinic branding across organizations

Provide expertise and oversight on the creation of Human Resource policies and project coordination

Mentorship and guidance to newly appointed practice managers across the country

Standardized the interview and hiring process for all positions in the practice

Hired, trained,,mentored and scripted call center employees to meet established metrics

Created a customer service training program

Train staff on proper billing techniques, including pre authorization, appeals and electronic submission

Fresenius Medical North America, Waltham, MA (corporate office) 4/2013-7/2014

Director of Operations, Los Angeles Central

Responsible operations in seven dialysis treatment centers in the Greater Los Angeles area

Coordinate revenue cycle management

Developed budgetary goals and track performance

Supervise credentialing of medical staff

Grew market development through outreach to physicians

Provide oversight for corporate and CMS Quality Assurance Initiatives

Implement performance improvement plans to optimize best practices and outcomes

Successfully built rapport with patients to promote overall satisfaction

Train and mentor center staff to their full potential and ensure adherence to standard operating procedures

Accountable for Total Area Productivity (TAP) and EBIT success metrics

Personnel management

The Center For Wound Healing, Inc., Tarrytown, NY (corporate office) 7/2011 – 4/2012

Director of Center Operations, Nationwide, based in CA (left due to corporate downsizing)

Educate wound center staff and clinicians to ensure full implementation of business model including EMR, reimbursement, and clinical and administrative responsibilities

Wrote policy and procedures related to operations of facility

Provide implementation guidance and oversight for new centers.

Collaborate with other senior staff to improve center implementation and ongoing management

Provide guidance and support for all aspects of the revenue cycle

Audit documentation to ensure appropriate coding

Implement and manage performance improvement plans as they relate to data base management and operational compliance

Audit centers to ensure compliance with policies and procedures, as well as TJC requirements

Interview candidates for center based positions

Develop and implement center workflow and time line for new contracts

Train and mentor all members of the team

Diversified Clinical Services, Inc., Jacksonville, FL (corporate office) 2005-2009

Quality Department, Database Auditor based in Redondo Beach, CA

Assisted with data collection and provided clinical outcome database support to wound care team via group training sessions and videoconferences

Measured compliance of wound care practices within 300 national programs

Responsible for training employees on database policy and procedures and assisting with best practice policies

Ensured employee competency, TJC compliance and provided ongoing retrospective compliance reviews to guide quality improvement

Area Program Director, Nationwide based in CA

Primary liaison between designated center partner hospitals and corporate headquarters on all aspects of center operations and management

Provided organizational support for operational, financial and clinical overview

Developed, executed new signings and maintained contractual agreements with partner hospitals.

Program Director, Attleboro MA

Maintained profitability of the wound care center through marketing programs

Monitored productivity on an ongoing basis and intervened as needed to ensure cost-effective operation of center

Ensured regulatory compliance with JACHO and other various accrediting and regulatory agencies

Guaranteed compliance with the clinical pathway and the appropriate usage of new wound healing technologies

Occupational Health + Rehabilitation, Hingham, MA 2004-2005

Operations Director, Pawtucket RI

Responsible for the daily operation of a for-profit occupational health and rehabilitation clinic

Recruited, trained and provided motivation for a team of sixteen employees

Oversaw budget with gross annual revenues of 2.9 million

Explored and analyzed new business avenues while ensuring profitability

Coordinated marketing to key and large-client accounts. Resolved client issues and acted as liaison between the medical and marketing departments to ensure productivity

Provide oversight on coordination of revenue cycle management

Worked with physicians, mid-level practitioners as well as senior-level physical and operational therapists to ensure proper staffing and adherence of clinic goals

Established and maintained the lowest DSO in the company

The Claims Game, Inc., Warwick, RI 1993-2003

President

Built a successful medical billing company from the ground up.

Grew company from zero clients to 21 in a ten year period.

Provide guidance and oversight on all aspects of revenue cycle management for physician partners

Clients included mental health, durable medical equipment, internal medicine, and chiropractic clinics

Managed the medical billing needs of healthcare professionals while providing a high level of customer service to medical professionals and their patients

Developed a successful marketing plan to promote business growth and development

Managed accounts receivable and payable

Education

California State University, Northridge May 1990

Training –Achievements-Skills

Certified Professional In Patient Safety, anticipated August 2018

Received Certificate of Achievement in Occupational Health Practice Management from the National Association of Occupational Health Professionals (NAOHP).

Completed BASE and IMPAX Marketing training.

Passed Wound Care and Hyperbaric Medicine Course.

Fluent American Sign Language

Microsoft Office

References

Available Upon Request



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