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Manager Insurance

Location:
Denham Springs, LA
Posted:
May 19, 2019

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Resume:

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

Denham Springs, LA *****

225-***-****

ac9ey4@r.postjobfree.com

Leah McBride, CH-CBS

Objective To obtain a position in which I can utilize my skills to further my career within

the company.

Experience

January 2018 – Current

RKM Primary care-Springfield Location

Front Office Supervisor

Patient registration, billing, coding and claims reconciliation.

Insurance verification, updates and changes.

Collection of copay, deductible, co-ins and balances on accounts.

Assist patients with Slide scales and setting up payment plans.

Mentor/train new employees to the clinic.

Identify and Resolve workplace issues.

Scheduling changes with providers and staff, while maintaining adequate coverage.

Insure that End of Days are posted/balanced.

Daily Deposits are balanced, made and recorded correctly.

April 2014 – December 2017

Mary Bird Perkins

PFR

Introducing and Greeting new patients to the clinic.

Registering and verifying patient information and

Insurance benefits.

Authorizing all Chemotherapy Care plans, medications, injections and

procedures.

Building patient financial responsibility and payment plans.

Assist patients in applying for copay, deductible and foundation programs.

Assist and support the Billing Office in claims, payments and denials.

Provide support to other staff as needed.

December 2010 – May 2013

Our Lady of the Lake

PSR II

Scheduling changes with physicians, some staff issues and ordering

supplies.

Training of new staff in the daily operations of the clinic site. Trainer of the

new EMR system.

Handle patient phone calls concerning billing issues, with knowledge of

insurance denials. Billing both clinic and hospital charges.

Provided other clerical support with referrals, filing and medical records,

credentialing current physicians with Insurance companies.

March 2010-December 2010

Orthopedic & Sports Clinic-Gonzales

Billing Specialist

Collecting Insurance EFT’s from online accounts, including posting

and balance.

Resolve denied claims

Assist patients in account issues

Verify patient insurance, pre-certs, referrals. Work up patient surgery

deposits

Support to other clerical/clinical staff

Reviewing and maintaining clinic A/R

September 2009-March 2010

Baton Rouge Colon Rectal Associates (Part-Time)

* Post and balance insurance and patient payments.

* Review and resolve denied claims.

* Assist patients in resolving account issues.

* Review/Receive patient insurance coverage, pre-certs, referrals, etc.

* Offer support to other clinical staff.

* Credentialing of new and current physicians with Insurance companies.

January 2007 – February 2009

People’s Health-Baton Rouge Office

Mimi Reinbold

Adm. Assist/Recpt/Mbr Srvc Rep/Ins. Spec.

* Greeted/checked in members

* Answered phone calls regarding member questions-claims,auth’s, etc.

* Updated daily hospital census/member authorizations

* Filing, Typing, Faxing

September 2004 – August 2005

Blue Cross/ Blue Shield of Louisiana

Katherine Goudeaux

TPA Claims Analyst

Processed medical claims for 11 different groups

Responded to CSR inquiries regarding claim status

OUR LADY OF THE LAKE RMC

April 1998 – June 2003

Men’s Health Center/Executive Wellness Program-OLOLRMC

Curtis C. Chastain

Practice Manager/Program Coordinator

Oversee the daily operations of clinic. Scheduling patients, obtaining

authorizations for specialist test and visits.

Billing and collections on patient accounts. Daily posting of charges and

payments for both inpatient and clinical visits.

Maintain budget and inventory with effective cost containment.

May 2002 – December 2002

The Family Center/Calais Health-OLOLRMC

Jacquita Stroughter

Billing Department Manager

Oversee the billing department, billing and collecting for patient accounts,

including hospital and outpatient charges. Work denied, pending claims

and posting contractual adjustments. Work aged reports, tracking

payments made by Medicare, Medicaid and other Managed care

companies. Maintained A/R reports.

Provide guidance and support to billing staff.

Provide support to Office Manager

November 1999- May 2002

LAKE PRIMARY CARE PHYSICIANS-OLOLRMC

Myrtha Sanderson

Practice Manager

Oversee the daily operations of primary care site, including customer

service. Billing of both clinical and hospital charges, insurance issues and

processing of invoices for payment.

Provide leadership, guidance and support to physicians and staff.

Prepare and Manage Budget for clinic site.

Maintain inventory control for all supplies with effective cost containment.

Maintain all aspects of practice staff, i.e., interviewing, performance

appraisals, and disciplinary actions. Approved ATM with accurate records

of corrections and leaves of absence. Maintain adequate staffing levels to

support physician productivity.

Credentialing of new and current physicians with Insurance companies,

renewal of licenses, including DEA license.

April 1998 – November 1999

Internal Medicine of Baton Rouge-OLOLRMC

Clerk III

Scheduling changes with physicians, some staff issues and ordering

supplies.

Training of new staff in the daily operations of the clinic site.

Handle patient phone calls concerning billing issues, with knowledge of

insurance denials. Billing both clinic and hospital charges.

Provided other clerical support with referrals, filing and medical records.

EDUCATION

August 2005 – May 2006

Southeastern Louisiana University Hammond, LA

1996 – 1998

Southeastern Louisiana University Hammond, LA

Graduated 1987

Walker High School Walker, LA

SKILLS

Microsoft Word Perfect Promed hu Credentialing of Physicians

Microsoft Excel Medical Manager Participated In Certified Coding Class

Vital Works Rumba Organized startup of the LPCP

Medisoft 10 Key Calculator/Scanning Denham Springs clinic site.

MOSAIQ

Centricity

OTHER .

POINTS * Trainer for the EPIC/Electronic Medical Record System

* Trainer for LPCP to new staff

* Trainer for the Vital Works system

* Substituted for Manager of Shenandoah Medical Associates (3 months)

* Assisted/Trained the Assistant Manager for Pediatric Medical Center (6months)

* Assisted the Financial Supervisor at Central Billing Office (2 months)

Denials, payments and financials Credentialing of Physicians

* Participated In Certified Coding Class



Contact this candidate