Medical Support Professional
Resume:
Michelle Ford
Saint Peters, MO ***76
acqspx@r.postjobfree.com
Work Experience
Doucment Funding Center Manager-Medicare Division
Numotion-Hazelwood, MO May 2014-Current Date
Directly supervise 5 Document Funding Supervisor and the Document Funding team of 62 employees in areas of pre-authorization, chart review, document submission and document collection
Performed corrective actions as necessary, and in collaboration with Human Resources.
Independently interview, train, and make hiring decisions.
Develop & execute plans to facilitate achievement of Document Funding Center and Company Goals.
Organize daily work load of team and ensures supervisors organization department daily workloads.
Provide on-going coaching/mentoring to team members.
Respond to internal and external customer in a timely & professional manner.
Drive compliance in accordance with the organization's policies and applicable laws.
Communicates with Contract Manager in regards to contract guidelines and changes to Payer Profiles.
Respond to all internal and external customers in a timely & professional manner
Maintains consistent review of all open orders in DFC including orders on hold.
Collaborates with Director of Reimbursement and Regional Managers when necessary regarding order process flow.
Develop & execute plans to facilitate achievement of Document Funding Center and Company Goals
Employee Payroll submission, vacation time approval, etc
Home Health and Hospice Accounts Receivable Director
Pyramid Home Health Services Inc -Cape Girardeau, MO - July 2004 to April 2014
10 years’ experience in Medicare, Medicaid and Commercial Insurance billing, collections, and insurance regulations in Home Health and Hospice billing
Vast knowledge of CMS's Home Health and Hospice billing guidelines
Proficient use of CMS intermediary
Strong understanding of Coordination of Benefits structure
Knowledge of Medicare Part A and Part B benefits
Preauthorization and Precertification experience
Trained all employees and preformed patient chart auditing, 485 and medical orders required for billing
purpose
Ability to work in an environment of continual change with flexibility and ingenuity
Ability to effectively present information
Ability to communicate in writing relevant insurance regulations
Developed and administered policies and procedures to accomplish department specific and organization goals
Managed electronic claims submission process through claims
Maintained the hospital’s credit and collection policy as it pertained to billing and follow up.
Provided daily supervision of all employees in the area of billing, collections and compliance
Ensured compliance with the regulatory guidelines
Forecasting potential revenue
Creating financial reports on a weekly, monthly, quarterly and annual basis
Process and submit bills to accounts payable for disbursement
Worked with senior leadership and finance teams to identify best practices and produce positive outcomes for the company
Communicated metrics to employees and to senior management on a timely basis
Prepared month end financial statements for the Board of Directors
Regularly monitored company performance metrics
General accounting functions
Effectively managed a billing, collecting and auditing team of 23 employees across 6 offices in the state of Missouri
Commercial insurance contract negotiations
Employee payroll submission, vacation time approval, etc
Assisted Human Resources in performing corrective action as necessary
Quality Coach II
BlueCross Blueshield of MO - Cape Girardeau, MO – February 2002 to July 2004
Responsible for on the floor training and education
Performed quality audits
Take calls management calls and assist Customer Care Associates with questions and difficult calls
Monitor queue and track inbound calls. Keep agents aware of inbound calls, calls waiting, abandonment rate, etc
Motivate and encourage agents through positive communication and feedback
Effectively built call center culture by being responsible for "on-the-floor" activities, assist Customer Care Associates while they are "on-the-floor"
Collaborated with Human Resources and Management in correction action when needed
Customer Care Associate III
BlueCross Blueshield of MO - Cape Girardeau, MO - October 1999 to February 2002
First point of contact for customers
Develop strong customer relationships daily through incoming calls, correspondence and email secured messaging
Intermediary between management and customers
Held all customer account information to the highest level of confidentiality
Assisted with provider contracting, fee schedules and claims pricing
Education
BS in Business Communications
University of Kentucky - Lexington, KY
*References are available upon request*
Contact this candidate