Quality Assurance Manager
Resume:
Terri Breaux
**** *** ****** **** **********, TX. 76065 972-***-**** ************@*****.***
March 28, 2014
Dear Hiring Manager:
I am submitting my resume in response to the recent advertisement for the Administrative Assistant
employment opportunity available in your company. For more than 15 years I have worked in the
Healthcare Operations with significant accomplishment in the areas of:
Development of Managed Care Strategies
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Integrating process improvement and business practices into the healthcare setting
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Improving Quality & Reimbursement Management programs through monitoring EOB’s and
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payer reports
Increased cash flow and reduced days in receivables by 30% through streamlining processes on
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the front end by using data analysis and reports on the back end process
Improvement in claims processing, turnaround times through denials management review
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resulting in fewer claims being rejected
Through the use of data analysis and reporting methods I have a proven ability to increase revenue,
maximize collections, and reduce bad debt. I am a self-directed professional with excellent
communication, interpersonal, and problem solving skills. I am working toward my coding certification
so that will add value to my experience and knowledge.
I would welcome the opportunity to discuss my resume details and my background further. If you have
any questions I can be reached at 469-***-**** or 972-***-****. Thank you for your consideration and
I look forward to hearing from you.
Sincerely,
Terri Breaux
Enclosure Resume
Terri Breaux
3781 Joe Wilson Road Midlothian, TX. 76065 972-***-**** ************@*****.***
Objective
I am seeking a challenging position for opportunities with career advancement and a position where I really can use my healthcare
experience and my knowledge.
Skills & Abilities
Implementation of process improvements methodologies though the use of data analysis and workflow tools.
Proficient in Microsoft Office, Windows and Electronic Medical Records Systems.
Ability to effectively use presentation and project management tools.
High level of quality time management and managing a large work load.
Demonstrated analytical, problem solving, and multitasking skills in my previous positions.
Training experience in the areas of HIPPA, Compliance, and Healthcare Best Practices
Related Experience
Regional billing supervisor emcare inc. 04/2009-06/2011
Mentored employees, conducted performance evaluations, counseled and provided disciplinary actions when needed.
Worked to facilitate individual and team development that drove positive results.
Maintained a good working relationship with other physicians, hospital administrators and medical records directors.
Monitored 20 Billing Coordinators and 20 Hospitals Production and Quality Standards to meet the department’s metrics.
Performed hospital startups, implementations of procedures, identification and resolution of problems related to chart flow and provided feedback,
counseling, and retraining when appropriate.
Monitored the workflow for all my designated hospitals to ensure the budget for the administrative functions were being managed per the contract.
COMPLAINCE AUDIT COORDINATOR KAISERPERMANENTE 06/2006-
02/2009
Developed, implemented, and maintained a Comprehensive Compliance Program, including a Compliance Privacy & Security program.
Worked with our regional offices and provided strategic direction on Kaiser Principles of Responsibility.
Responsible for training new employees on HIPPA and Compliance Practices for the Ft. Worth Service Training Center.
Point of contact at the center for all of our regional offices in issues related to incident management and our compliance program.
QUALITY ASSURANCE ANALYST/TRAINER AMERIPATH INC. 06/2003-
02/2006
Coordination and implementation of the Quality Assurance Program
Conducted daily and monthly audits for all departments in billing.
Performed monthly Medicare and Managed Care audits to identify overpayments, underpayments, under billing, and claims errors
Managed internal and external coordination of Provider Agreements and communications of new agreements to the RBC.
Collected and compiled the work performance metrics in report form for the Billing Director as an indicator of metrics for individual and team
performances.
BUSINESS OFFICE MANAGER NEXTCARE HOSPITAL 01/2000-
04/2003
Supervised and coordinated the overall functions of patient billing and collections.
Performed the day to day accounting functions to include month end closing.
Responsible for credentialing, insurance verification, and contract administration.
Tracked and analyzed all billing functions from Medicare, Medicaid, or Commercial Payers to ensure we are being reimbursed at contracted rates.
Set-up and maintenance of patient files, fee schedules, and the Charge-Master by accurately identifying systems and operational issues
capturing over $400,000.00 in lost revenue.
Contact this candidate