Manager Quality Assurance
Resume:
Robin K. Suggs
Atlanta GA 30338
Dear Human Resources,
Perhaps I am the experienced Professional with strong clinical skills you
are searching for. I have the solid experience you specify as well as the
strong patient care skills you desire. I am presently affiliated with a
highly regarded home health care agency with whom I am sure will give me an
excellent recommendation . The details of your advertisement suggest to me
that the position will involve many of the same responsibilities that I am
currently performing. In addition to the back office and front office
skills that I have, please note that I am currently working on my Associate
of Arts in Healthcare Administration.
As promised, my resume states my thorough experience in insurance
verification, pre-certifications, data entry, ICD-9 coding, payroll, human
resources, office management, and other secretarial duties. What my resume
doesn't reveal is my professional demeanor. I'm reliable, detail-oriented,
self starter, willing to learn, and an extremely hard working associate-one
who will serve as a model to encourage other staff members to demonstrate
the same high standards of professionalism.
I'd welcome the opportunity to demonstrate these qualities in person. I
look forward to hearing from you I will call you in a few days. Or if you
agree upon reviewing my letter and resume that I am the professional you
need, call me at the home number listed above, or at the number listed
below 202-***-**** during business hours.
Thanking you most sincerely for your time and consideration.
Cordially,
Robin K. Suggs
Robin K. Suggs
633 Preston Woods Trail
Atlanta GA 30338
HYPERLINK "mailto:*********@*****.***" *********@*****.***
Objective: To obtain a position with a dynamic company that has opportunity
for growth and advancement.
Education: Applied Career Training GPA: 4.0 Medical
Assisting Arlington VA
University of Phoenix (presently taking classes) Associate of Arts in
Healthcare Administration GPA 3.67
Computer Skills: Microsoft Word, Excel, Outlook, Power Point, Medical
Manager,
Protomed, Word Perfect, Home Solutions Visitrak, Quick books
Bank Pro, FACTS, Type 65wpm Windows XP
Work History: Amedisys Home Healthcare Agency (Business Office Manager)
College Park, GA
March 2011- Present
Plan,direct and contralto he billing and office support function. Direct
administrative services and operations for the branch including: billing,
purchasing communications systems, space utilization, secretarial support,
and mail services. Coordinate systems and procedures with medical record,
data entry, claims review, and personnel functions to ensure efficiency and
accuracy in operations. Coordinate staff replacement as necessary. Promote
compliance with all fiscal intermediary and/or other third party payers
through education and coaching. Monitor systems, identify problem areas,
and develop and implement action plans. Train and orient new employees.
Payroll processing and preparation. Maintain and update HR files and
information on all staff. Interview and evaluate office support staff.
Coaching staff and disciplining staff according to company regulations.
Supervision of office support staff. Staffing agency employees as well as
scheduling appropriate staff for available jobs. Daily and monthly billing
to ensure compliance with all state and government regulations. Insurance
verification and authorization to ensure to timely and efficient billing of
services. Work state validation reports according to federal and agency
guidelines. Answers the multi-line telephone and gives information to
callers or routes calls to appropriate staff. Serves as first responder on
telephones for the companyGreets visitors, ascertains nature of business,
provides information or conducts visitors to the appropriate
person.Processes, handles, and distributes incoming and outgoing mail and
all other correspondence (including electronic mail.)Collect, compile, and
report data to appropriate committees. (Performance Improvement, Infection
Control, Safety, etc.)Inputs patient visit data into the billing system to
ensure accurate and timely billing and payroll processes.Processes
mileage/payroll activity logs and validates visit with presence of clinical
note to ensure accuracy.
Inputs patient data into Oasis system and transmits accurate and timely
information.
Input/generation of client data to 485/486 Plan of Care/Medical Update and
Patient Information with scrupulous attention to detail and high level of
accuracy for admissions and re-certifications. Also maintains concise re-
certification and admit logs.
Maintains tracking system for physicians' orders (Admissions, re-
certifications, discharges, verbal orders/telephone orders, rehabilitation
evaluations) to maintain compliance in the billing processes. Maintains
the "hold billing" list for claims with outstanding documentation.
Notifies Director or designee as needed when documentation is delinquent
from staff.
Copies and distributes completed 485/486 forms and all signed orders to
appropriate staff.
Responsible for pulling medical records and printing claims for billing
review each billing cycle.
Assists with checking of billing frequencies and presence of orders every
billing period. (Claims review.)
Inputs/edits billing corrections as needed and assist in transmission of
billing data.
Notifies Director and/or Business Office Manager of needed billing
adjustments.
Assembles and organizes forms for admission packets, discharge packets, and
post-hospital admission packets.
Assembles new admission charts.
Maintains security of patient records in locked files.
Filing of medical records, physicians' orders, lab reports, progress notes,
clinical notes, etc. on active and discharged patients.
Thin patient medical records as needed, and maintain thinned information in
an orderly manner.
Conduct clerical audit on discharged charts and process according to
company policy
Tracks and maintains log of Medicaid and funding source records and orders.
Verification and ongoing monitoring of Medicaid authorizations, approvals
and visits as directed.
Pre-certification of private pay admissions. Communicates with Insurance
(payors) and their representatives with updates and assists the Clinical
Supervisor or Designee with generating written correspondence as directed
(Typing, faxing, and generating "Letters of Medical Necessity".)
Assist the Clinical Supervisor or Designee with follow-up with payors as
needed.
Organizes orders and maintains medical supplies on a daily basis, or as
needed by field staff
Responds to supply requisitions for all staff timely and appropriately.
Assists Director and/or Business Office Manager with ordering and
purchasing of supplies by completing forms for review and approval.
Participates in required Inventory Control processes.
Maintaining the ongoing scheduling of patient visits for all assigned field
staff, as well as communication updates, changes and new admissions to
ensure continuity and coordination of patient care services.
Schedules all visits based on patient needs, staff experience, and
geographical location.
Confirms daily assignments with field staff per agency policy.
Adds and/or deletes visits while attempting to maintain a fair and
appropriate distribution of workload.
Receives pertinent reports on patient status affecting scheduling and
completes appropriate agency form on all missed or refused visits.
Maintains communication with all field staff regarding updates and changes
in schedules.
Human Touch Home Healthcare Agency (Payroll Administrator)
Washington, DC 20001
April 2006- March 2011
Update and maintain paper and electronic personnel files of all employees
Participate in the planning, recruitment and retention of employees
Assist in the verification of license, certificates, criminal background
records, references and health requirement documentation
Must assure that the documentation requirements are met for regulatory
bodies and are in compliance with local, state JCAHO standards and federal
laws
Ensure that employee confidentiality is maintained and files are stored in
secured area
Assist in organizing and documenting orientation and monthly in-service
training provided to all employees
Assist in the administration of benefit programs to new employees at the
time of hire and communicate all changes or modifications in benefit
structure or eligibility as needed
Responsible for scanning all documents such as visit information, start of
care, transfers, recertification's, discharge summaries and discharge notes
Reconcile, distribute and schedule all visits
Generate all Plan of Cares's based upon orders from Physicians
Assure that all patient and employee visits are entered for payroll and
billing purposes, before each payroll and billing period
Responsible for sending Plan of Care's that have been approved by Director
of Nursing to all concerned physicians for their signature
Admittance of new patients into the database
Maintenance of personnel data, and reminding clinicians about updating
their certifications and licensures as necessary
Participate in the orientation process of new employees by providing and
arranging in-service training as needed as well as copying in-service
materials and application documents as well as any other documents needing
to be copied
Responsible for preparing, processing and authorizing time cards and
payroll through ADP
Responsible for processing overtime payroll using quick books
Correction of errors on the no-billable reports received from CMS billing
Ensure that all clinical record contain appropriate medical documents
Organize and file all clinical records in a uniform fashion
Endure that clinical record of each discharged patient are retained for a
minimum of 7 years following the discharge of the patient
Participate in the in-service training, regular Quality Assurance and Peer
Review Meetings
Participate in team meetings, Quality Assurance Meetings, and provide
leadership and support to the Manager, Clinical Coordinator, Quality
Assurance Team, Plan of Care Coordinator, and the Administrator
Provide weekly Plan of Care tracking and medical record managerial reports
Responsible for the first line of contact for all phone calls, and make
appropriate response and transfer to relevant people in the office
Responsible for intake and referral processing as well as staffing
Assist in other areas when needed and designated by the Office Manager,
Director of Nursing, and Administrator
Medforce Complete Healthcare Staffing (Medical Assistant/Biller)
Fairfax VA
July 2005 - April 2006
Venipuncture and blood testing
BP Checks
EKG
urine collection and testing
Injections
Cleaning and preparing exam rooms
Collecting patient co-pays
Appointment scheduling
Pulling charts for appointments
Filing
Calling and faxing prescriptions
Inputting services rendered and co-pays into system
Forwarding billing information to billing company
Dr. Janice Arnold MD (Medical Assistant)
Reston, VA
June 2004 - April 2005
Daily cleaning and stocking of exam rooms
Assisting with patients
Preparing exam rooms for surgical procedure
Performing and assisting physician with in office urodynamics testing and
cystourethroscopy procedures
Ordering office supplies
Insurance coding and billing
ICD-9 and CPT coding
Filing electronic and paper insurance claims
Posting receivables and billable to patient accounts
Consolidating patient accounts
Preparing charts for new and existing patients
Sterilizing instruments
Preparing specimens for lab pick ups
Venipuncture
Blood pressure checks and other patient vital signs
Posting surgeries in the office and at the different hospitals
Insurance verifications
Inputting patient information payments charges
Inputting insurance payments
Typing office letters and memos, insurance documents and patient letters
Copying patient records and any other information needed
Calling in prescriptions to pharmacies for patients
Writing prescriptions for patients
Filing
Answering multi-line telephone
Taking messages Checking answering service for messages
Sorting and filing all office mail and bills
Appointment scheduling
Ensuring that all OSHA guidelines are being followed
American Red Cross Collections
Tech Baltimore MD 2/04 - 6/04
Branch Banking and Trust Senior Teller/Teller line
Advisor/Relationship Banker Washington DC Oct 01 - Jan 04
consolidating all branch at opening and closing of each business day
Auditing teller drawer cash
Auditing ATM cash
Auditing vault cash
Auditing TCD cash
Ordering and shipping of cash weekly
Balancing vault and vault sheet as well as teller drawer anadem and TCD
machine daily
Auditing all money orders and official checks daily
Daily consolidation and balancing of all branch cash accounts
Assisting teller with locating differences and helping them fix the
difference if located and if unallocated showing them how to pass
a difference ticket
Teaching tellers how to take one client and one transaction at a time to
eliminate making such errors
Coaching
Training all new tellers and branch policies and procedures and teller
operations
Assisting with teller assessments and PDP as well as teller discipline and
write ups
Assisting clients with all transactions
Preparing change orders for shipment
Assisting clients with opening and closing accounts stop payments, account
holds
Ordering check cards
Ordering checks
Sending national and internal wire transfers
NSF refunds
Placing blocks on overdue accounts
Selling travelers cheques to clients
Selling bank products and services to all clients
Meeting weekly teller line goals
Providing clients with excellent customer service skills
Maintaining a positive attitude at all times and being a team player
Profiling clients to see how we can better serve them and their banking
needs
Keeping track of all signature cards for newly opened accounts
Assisting Area Operations Manager with any additional tasks
Contact this candidate