Melissa Griffin

Practice Manager - Medical Billing - Credentialling - Retail Manager

Atlanta, GA 30309

acse24@r.postjobfree.com - 678-***-****

Accomplished and determined Practice Manager with a solid history of achievement in defining goals and strategies, increasing positive online presences for practices and identifying immediate places for cost savings. Motivated leader with strong organizational and prioritization abilities. Areas of expertise include budget spending, EHR implementation, Meaningful use attestation. Highly adaptable to change within the healthcare environment. Authorized to work in the US for any employer

WORK EXPERIENCE

Practice Manager

Buckhead Ear, Nose and Throat - Atlanta, GA - March 2006 to Present Human Resources: Design, communicate, and monitor the recruiting strategy and establish a formal standard screening, interview process, and decision making appraisal process. Provided stability into a practice that had 80% turnover within 90 days. Currently the turnover rate was less than 10%. Created and executed employee recognition program thereby increasing employee retention rate. Implemented written policies and procedures to ensure compliance and to improve overall efficiency of employees and practice. Accounting: Accounts receivable and accounts payable, produce payroll, prepare payroll compensation for physicians, prepare and pay state and federal taxes, reconcile bank statements, reconcile merchant accounts, prepare profit and loss statements using QuickBooks, daily tracking and charting of receivables, prepare refund to payer's and patients.

Managed Care: Perform contract negotiations. Reimbursement analysis. Monitor PQRS reports.

Legal: Comply with all state, local and federal laws and guidelines including OSHA, EOE, FMLA, HIPAA, Stark, Crash Carts, ensure entire staff are current on licenses and certifications. Billing: Revamped billing and collections system which resulted in a 100% increase in income to physician by auditing records and billing for unbilled services, refilling unpaid claims, properly coding and capturing charges, and successfully collecting unpaid balances by both insurance and patients.Credentialed providers with network providers. Performed internal compliance audits. Loaded new RBRSV values, new CPTs, ICD-9's and ICD-10's annually. Monitor PQRS reports. Successfully implemented Meaningful use stage 1 and 2.

Marketing: Introduce new physicians, new locations and new services to the community. Track referral sources. Recommend use of radio, magazine ads, direct

mail, news letters, email and social media. Organized open house events for new locations and new Med spa.

Strategic Planning: Prepare ROIs for new physicians, new services, new locations and forecast potential effects of Medicare cuts and ICD-10

implementation. Create plans for capital expenditures such as EHR/EMR, ancillary services, physician recruitment and replace and add new equipment. Medicare and Medicaid Account Manager

Radiation Oncology Services - Riverdale, GA - May 2003 to March 2006 Collect, post, and manage Medicare and Medicaid patient account payments. Set up and maintain ERA's (Electronic Remittance Advice) and EFT's (Electronic Fund Transfer). Translate patient information and into alphanumeric medical code Submit claims to insurance. Prepare and review patient statements. Review delinquent accounts and call for collection purposes. Process payments from insurance companies. Maintain strict confidentiality. Code patient services and enter into computer. Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding. Use computers to read and organized charts. Follow up to see if a claim is accepted or denied. Monitor claims for denial trends. Billing and Coding Specialist

Buckhead Ear, Nose and Throat - Atlanta, GA - February 2000 to March 2006 Improved revenue for provider over 40% with same patient load. Ensure claims are entered and submitted with 48 hours of receipt. Accurately apply payments to patient accounts. Post and reconcile insurance and patient payments. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts. Insure accuracy of insurance claims. Verify correct ICD-9 and CPT codes for a variety of specialties. Set up new patient accounts. Assign ICD-9 to physicians diagnosis and insure correct level of service and various other CPT codes. Work with clearinghouse to resolve file compatibility issues. Retrieve Electronic Remittance Advice (ERA's). Send secondary claims upon processing of primary insurance as well as crossover claims. Monthly processing of Patients billing statements. Answer and resolve patient billing inquires. Follow up on Insurance and patient aging. Re-submit insurance claims as necessary. Knowledgeable in timely filing restrictions, Medicare and Medicaid Billing. EDUCATION

ICD-10 Implementation

AAPC - Atlanta, GA

2014 to 2015

Allied Health Administration in (not complete)

Clayton State College and University - Morrow, GA

1998 to 2000

Certificate in Medical Assisting

Clayton State University - Morrow, GA

1995 to 1997

SKILLS

Allscrips EMR (10+ years), Tiger medical managment software (10+ years), Athena Health EHR (Less than 1 year), Quickbooks Pro (10+ years), HIPAA Compliance (5 years)

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