Manager / Director, Medical Billing Operations and Quality Assurance

R.Daniel Panarella, MS.

I have two objectives; First as a Manager I will set the bar and make customer

service my highest priority. Secondly, it is my funtion as an employee on any level to

ultimately generate income for my employer. These two attributes will bring about a

return on your investment. ME.

San Diego, CA

********@*****.*** - 619-***-****

From every position that I have held. I have left each one as an expert in the industry. Do yourself a service

and simply just ask. Always.

WORK EXPERIENCE

Manager, Billing and Quality Assurance Operations

University of Pittsburgh, University Physicians Medical Group. ( UPMG, inc. ) - Pittsburgh, PA - January

2007 to March 2014

Responsibilities

● This position was to oversee the departments of Medical Billing, Contracts, Quality Assurance, Benefits,

Data Entry, and Practice Management. It's composition was made up of, seven supervisors, five technical

support advisors and nearly thirty five non-management personnel with varying levels of functionalities and

technical abilities. Also I had a personal Administrative Assistant assigned to my supervision as well. I managed

the governmental and commercial insurance products which includes federal and state programs such as

Medicare and Medi-Cal/Medicaid, Workmans Compensation and other varying third party payers.

● Duties entailed direct billing, coding, and charge captures with the maintenance of a General Ledger.

● I have the capabilities to decipher any EOB, summary plan description and any contractual agreement,

along with the billing practices of that group or individual doctor. I am considered a subject matter expert.

● I believe in providing the upmost exceptional customer service both to internal and external customers.

ALWAYS.

● I am well versed in medical terminology and the ability to utilize the CPT and ICD-9 & 10 value system.

● I poses a considerable amount of understanding of the managed care delivery system, the analysis and QA

and the quantitative properties of that system.

● I am experienced at handling a Workmans Compensation claim, the subrogation and the case management

process thats affiliated with thoes billing processes and their collection procedures. HMO and PPO products

are easily understood along with their contractual agreements. This includes any Stop Loss and Capitation

agreements that are either entire practice or individual doctor specific and the billing practices therein.

● I have provided Quality Improvement in a system conversion to the IDX system.

● I have developed and adapted policy and procedure.

● I was nominated for Pittsburgh's " Executive of the Year " 2012.

● I performed employee evaluations on time all the while maintaining a 8.25m a year operations budget. I am

proud of always preserving the integrity of the Quality Assurance and Total Quality Management expectation.

Claims Analyst and Quality Assurance Auditor.

HEALTHAMERICA inc. - Pittsburgh, PA - August 2001 to November 2006

Responsibilities

● I began my endeavor with HealthAmerica inc. as a medical claims examiner. I adjudicated medical claims

at the rate of nearly 150 per day with nearly 98 to 99 percent accuracy. This is where I began to understand

the managed care delivery system and how exactly an HMO and a PPO functioned. I learned how to read

contracts and decipher a summary plan description. I had a solid understanding of how the EOB was broken

down and how it's definition drove payment for medical services.

● I was soon promoted to QA Auditor where I examined and reported the individual statistics for the employees

of the Claims department to the Director of the Claims Administration. I occupied this position for over three

years and my level of expertise was exceptionally advanced along with my case management and reporting

techniques.

High School Teacher, Tenured.

Belle Vernon Area School District. - Belle Vernon, PA - September 1993 to May 2001

Responsibilities

● I was the instructor of 8th grade General Science, 10th grade Biology, Anatomy, Physiology and 12th grade

A/P Microbiology. This made up seven periods a day with one scheduled prep period. I was granted tenure

in 1996 only three years in to my career. My principal informed me that in all of BVA history no teacher prior

to nine years has ever been granted tenure.

● I was " Teacher of the Year " 1999.

EDUCATION

MS Masters of Science degree in Clinical Counseling Psychology and Healthcare

Administration

Duquesne University - Pittsburgh, PA

2002 to 2005

Bachelor of the Arts and A Bachelor of Science degree obtained. in Liberal Arts and

Secondary Science Education.

Harvard University - Cambridge, MA

1988 to 1993

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