Customer Service Management
Resume:
Objective
I am searching for a challenging position where strong organizational
skills, detail accuracy, interpersonal skills and my previous experience in
the industry will be an asset. My experience includes developing processes
for clean claims, increasing cash flow and reducing DSO. I would appreciate
an opportunity to discuss my qualifications with you.
Profile
Motivated, personable business professional with a successful track
record of delivering financial results and excellent customer service.
Talent for quickly mastering new software programs. Demonstrated history
of excellent revenue management and meeting stringent billing regulations
for state and federally funded programs.
Flexible and versatile - able to perform under pressure. Problem-solver.
Thrive in deadline-driven environment. Respected as a team leader and
able to motivate team to produce expected results.
Skils
Leadership Financial/Regulatory Marketing/Sales
Accounts Receivable Audits Payroll
management Time Management Purchasing
Patient assistance Customer Service Software development
program management Training and testing
Professional Experience
Accounts receivable management
o ABLE TO MEET REVENUE MANAGEMENT EXPECTATIONS:
o Consistently able to meet and exceed expectations for DSO < 15 days
o Seek ways to improve efficiency, productivity and reporting
results.
o Develop and implement electronic billing and remittance processes
to expedite payment and improve DSO
o Experience with Medicare Part B appeal process with favorable
outcomes.
o Experience resolving billing issues with Texas Medicaid.
o Able to manage day-to-day operations:
o Use time management skills to adjust daily expectations and
processes based on customer demand
o Experience managing telephone triage and call resolution
o Able to restructure operational processes as needed to meet both
revenue and EBITDA projections
o Share passion and a "can do" attitude with staff
o Support needs of operation and promotes teamwork between
departments
Customer Service
o ABLE TO CONSISTENTLY DELIVER QUALITY CUSTOMER SERVICE IN A FAST-PACED
ENVIRONMENT:
o Committed to excellent Customer Service
o Implement processes to continually improve customer service based on
internal and external customer needs
o Organize and conduct weekly team meetings to address customer service
needs
o Able to promote a sense of urgency and teamwork to implement new
processes and meet deadlines
o Consistently able to meet less than 1% call abandonment expectations
o Able to develop and implement strategic marketing plan for business:
o Participate in strategic planning and implement marketing plans
o Host promotional events including purchasing, set up and
marketing materials
o Organize and promote corporate fundraising events to support
charitable organizations
safety/COMPLIANCE
o ABLE TO IMPLEMENT BILLING, COLLECTION AND PATIENT ASSISTANCE PROCESSES TO
ENSURE FULL COMPLIANCE WITH FEDERAL, STATE, DEA, HIPAA, AND STARK
REQUIREMENTS AND DEADLINES.
o Use scheduled reviews, audits and ongoing training to ensure compliance.
SOFTWARE DEVELOPMENT AND TESTING
o Experienced liaison between software development team and business
users
o Able to analyze system supported processes, identify improvement
opportunities and make effective suggestions for improvement.
o Experience creating data tables and list of values for software
development team.
o Experience defining appropriate data source and validating source
data during data migration
o Able to understand, document and share issues found within
application or data migration
o Experience testing software applications in both SAT and UAT
environments.
Employment History
October 2010 - August 2013
Reimbursement Manager
Amerita, Inc.
8080 TriStar Blvd, Suite 120
Irving, TX 75061
Responsible for billing, cash application and accounts receivable
management for 5 pharmacies in Texas and Oklahoma. Duties
included leadership, training, primary and secondary billing including
commercial, government and Medicare Part B.
Responsible for all aspects of electronic claims submission and claims
editing, analysis of pending revenue and A/R, billing and
collection procedures, management of write offs due to lack of prior
authorizations, coverage limitations and billing errors,
weekly cost of goods analysis and monthly accounting close process.
Successfully managed billing to a 48 hour turnaround and
ending revenue to less than 25% over 14 days. Responsible for knowledge
and monthly training of DMEMAC billing
requirements and completing billing timely, accurately and according to
NHIA guidelines. Evaluated performance against goals
and made process changes as needed to consistently meet and exceed goals.
June 2006 - June 2010
Associate Director
OncologyRx Care Advantage Pharmacy, US Oncology
13501 Park Vista Blvd, Suite 150
Fort Worth, TX 76177
Responsible for day-to-day business operations, billing, collections,
customer service and administration of patient assistance
Programs. Duties included leadership, training, primary and secondary
billing, analysis of A/R, collection procedures, bad debt
projections and monthly financial reports. Responsible for knowledge of
Medicare Part B and Part D billing requirements,
including STARK law, and completing billing timely, accurately and within
regulations at all times. Managed triage of all
incoming calls, intake of prescriptions, validation, data entry and
shipping confirmations. Developed and managed the patient
assistance program and obtained over $20 Million in co-pay assistance for
oral chemotherapy. Evaluated performance against
goals and made process changes as needed to consistently meet and exceed
goals.
January 2005 - May 2006
Accounts Receivable Manager
CVS Caremark, formerly Caremark Specialty Pharmacy
909 E Collins Blvd
Richardson, TX 75081
February 2004 - December 2004
Financial Analyst for CVS Caremark, formerly Caremark Specialty Pharmacy
CDI Corporation
1703 N Plano Road
Richardson, TX 75081
Responsible supervision of A/R department, billing and collections of
1,200 specialty pharmaceutical claims per month and
customer service department. Duties included leadership and training,
analysis of A/R, primary and secondary billing, collection
procedures, bed-debt projections and monthly financial reports.
Responsible for communicating business needs to IT team during
development of pharmacy billing software and testing all reimbursement
modules. Successfully converted from CPR+ to
AmosRx, retired 90% of A/R, and manually posted transactions to transfer
remaining 10% within 10 months.
March 1998 - July 2003
Accounts Receivable Supervisor
Accredo, formerly Gentiva Health Services
1620 Century Pkwy, Suite 101
Memphis, TN 38134
Responsible for supervision of A/R transactions including cash posting
and reconciliation, collections, appeals, month-end
reporting, sales and demographic reports to partners, A/R analysis and
processes to reach monthly collection goals.
Responsibilities also included analyzing and improving collection
procedures, training, coaching, and team meetings to provide
weekly objectives and feedback.
References available upon request.
Contact this candidate