Manager Insurance
Resume:
Denham Springs, LA *****
***********@*****.***
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
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