Management/Sales
Resume:
Phoenecia Houston
Douglasville, Georgia 30134
acwhl2@r.postjobfree.com
HR OPERATIONS AND ADMINISTRATION MANAGER
Accomplished and dedicated professional with highly visible senior management accountabilities with experience in business, financial planning, organizational development, personnel management, laboratory business integration, contract review, and project management. Recognized as a leader in the company based on my ability to professionally implement goals that improve business efficiency and corporate revenue. Based on my abilities and hard work, I have been rapidly advanced in my career. I now seek a challenging and varied position that will enable me to capitalize on my professional experience with opportunities for personal and professional growth.
Key Successes
Managing professionals with diverse backgrounds
Efficient implementation of company goals as a liaison between senior management team and staff
Improved business efficiency and revenue of a multimillion dollar corporation through careful assessment of issues, proposal of innovative approaches, and implementation of constructive solutions
Key Skillsets
Employee Management
oTeam Leadership
oProblem Solving and Conflict Resolution
oEmployee Mentoring
Business Management
oAccounts Receivable Analytics
oProcess Analysis
oContract Review
oSupplies Management and Cost Control
PROFESSIONAL HISTORY
HR Operations and Administration Manager November 2011 – July 2016
Medical Neurogenetics, LLC Atlanta, Georgia
Lead company initiatives to improve team member engagement via strategies and programs endorsed by the CEO and key managers.
Ensure the company has clearly written policies that have been endorsed by the CEO and leads the organization in abiding by those policies; delivers unbiased reports to key management for action.
Create, oversee and coordinate business and HR metrics reports, as well as project management plans, in coordination with other departments.
Coach employees for success consistent with HR policies and practices.
Develop and coordinate delivery of all training and approved educational assistance for employees as per company policy, and supports development of educational assistance policies consistent with business goals.
Draft communication plans to support the CEO and management for a variety of company announcements. Issues announcements on behalf of the CEO and other executives as directed.
Document and provide tools and input to management on a wide variety of employment decisions with the goal of supporting performance management. Sources training and HR consulting for leaders as appropriate.
Support management and employee training and compliance with equal employment opportunity policies and other HR policy and legal requirements, receives complaints of non-compliance and recommends courses of action to resolve such HR complaints.
Recruit and work with external recruiters as appropriate, first line interviews and extends offers to candidates.
Plan and conduct new employee on-boarding and, as applicable, sources and manages external resources retained to perform on-boarding.
Prepare employee separation notices and related documentation, and conducts exit interviews.
Generate, support and maintain records of, and reporting functions related to, all employment life cycle records, such as hires, promotions, transfers, corrective actions, performance reviews and terminations.
Manage payroll data input to the external payroll vendor, and in coordination with the Finance Department, manage payroll and payroll vendor relationships overall.
Manage all benefit programs such as life, health, vision and dental insurance, Flexible Spending Account, and 401k plans with hosting benefits administrator.
Recordkeeping of vacation, sick leave, and leave of absence.
Act as key support to CEO; which may include meeting organization and travel for CEO and other key managers.
Perform other special projects assigned by the CEO.
Business Management
Senior Management Team Member
Work directly as a senior management team member that included the Chief Executive Officer (CEO), Chief Medical Officer, Chief Operations Officer (COO), and Laboratory Director.
Strategic planning for business operations growth
Budget construction, review, analytics and data to accountants
Contract coordination
Business staffing oversight
Business Operations
Direct and coordinate all business operations with senior staff and coordinate business staff with laboratory staff operations
Provide analytics for business decision making
Financial reporting
Responsible for all banking transactions including financial coordination for company accounts
Contract review and negotiation, providing advice directly to CEO and COO
Compliance with state and federal guidelines (e.g. HIPAA)
Employee training and assessment
Revenue Management
Manage all accounts receivable activities
Assess and resolve collection issues
Implementation of successful billing and collection program (Accounts Receivable)
Healthcare contract negotiation and contract implementation
Detailed knowledge of coding rules and regulations
Responsible for hiring and training new personnel within the scheduling and billing department.
Address billing and scheduling staff issues and conduct regular performance reviews.
Accounts Payable Management and Supplies Management
Manage all accounts payable activities including
oInvoice review and approval
oPurchase order reconciliation
oCoordinate payment with business financials
oVender contracting and accounts review
Human Resource Management
Manage Human Resource activities including
oHiring and termination
oAddress and resolve employee grievances
oState and federal compliance
oReview and maintain Employee Handbook working with attorneys as well as senior staff
oGuidance to employees for Human Resource policies
oRecruiting for all exempt and nonexempt personnel
oNew employee orientation and training
oAdministering payroll biweekly through Paychex and maintaining employee records
oAdvising on pay and other remuneration issues, including promotion and benefits;
oUndertaking regular salary review
oEmployee review coordination
oAssure Human Resource compliance in company
oReport, discuss and advise other senior management on Human Resources issues
oCompany Benefits assessment and compliance
Medical Biller/ Account Specialist
Medical Neurogenetics, LLC
Responsible for keying charges for facility/lab and all physicians’ charge
Process Aging reports from Centricity software system
Transmit and correct medical claims electronically via Centricity/McKesson to be forwarded to the appropriate insurance company for processing and payment.
Prepare report documents and work assignments accurately to meet deadlines.
Place calls to various health plans to obtain appropriate precertification prior to the patient's appointment and estimating the patient's financial responsibility. Answer calls from hospitals, and patients using exemplary customer service skills.
Accurately enter required information into computer database.
Established and maintain effective rapport with the hospital support service staff and providers.
Actively support departmental and corporate strategic plans and ensure successful implementation.
Review structured clinical data matching against specified diagnoses or procedure codes and follow established procedures for authorizing request for further review.
Post all electronic checks from insurance carriers.
Balance payments accurately to ensure appropriate daily balances.
Verify checks against totals on summary transmittals.
Post insurance payments from EOB’s against appropriate line-item services.
Accurately process all contractual adjustments as necessary.
Effective follow-up and collection on outstanding insurance and patient payments of $100,000 weekly.
Handle A/R activities for aged receivables, Initiate collection calls to patients with invoices past 60 days
Medical Biller/Collections October 2007 – November 2011
Child Neurology Associates Atlanta. Georgia
Designated primary internal and external liaison for multi-office billing department.
Responsible for billing of medical and all commercial carriers, following up on unpaid accounts or denied claims for their status, heavy data entry tasking, answering phones, filing, faxing and copying documents.
Look up ICD-9 codes to verify if a code has been changed and enter deposited and updated patients' demographics using the Medic Costar Software system
Complying and preparing reports documents and work assignments accurately to meet deadlines
Effective follow-up and collection on outstanding insurance and patient payments in amount of $50,000 weekly.
Transmit and correct medical claims electronically via Mysis to be forwarded to the appropriate insurance company.
Organized and requested referrals from insurance companies to receive correct payment for billed charges.
Assisted in coaching and developing new hire personnel on policies and procedures.
Selected to handle A/R activities for aged receivables.
Initiate collection calls to patients with invoices past 60 days, establish mutually agreeable payment solutions, and track account activity to ensure follow through.
Field patient and customer service inquiries.
Medical Biller/Medicaid Collector August 2005 - March 2007
Cardiology of Georgia, LLC Atlanta, Georgia
Highly experienced in posting deposits / payments and reconciling accounts with a high degree of accuracy
Reviewed account activity, and calculated and processed overpayment reimbursements.
Refiled Medicare, Medicaid, and private insurance claims to ensure correct payouts. Posted cash payments to the Nextgen software system.
Organized and processed medical record requests to hospitals pertaining to additional information on certain procedures resulting in correct payments from Medicaid of GA.
Processed A/R reports from Nextgen software system for status check of Medicaid GA claims on outstanding balances.
Assisted Medicare representative with claim status.
Checked Navicure for incorrect claims not submitted to Medicaid. Corrected and resubmitted.
Processed and submitted EOB’s to Medicare/Medicaid for receipt of secondary claim payments.
Reduce claims on hold by sourcing missing information such as physicians’ NPI, Medicare, and Medicaid provider numbers
Contacted hospitals and physician offices concerning prior authorization and referrals.
Medical Biller/Collections April 2003 - March 2005
Gwinnett Pediatrics and Adolescent Medicine Lawrenceville, Georgia
Designated Team Leader for billing department consisting of five employees.
Transmitted and corrected medical claims to Navicure to be forwarded to the appropriate insurance company.
Collected updated insurance information from patients to bill claims correctly.
Organized and requested referrals from insurance companies to receive correct payment for billed charges.
Processed billing involving reviewing eligibility, initiating claims, and working with patients and carriers to guarantee payment.
Handled A/R activities for aged receivables. Initiate collection calls to patients with invoices past 60 days.
Coached and developed new employees.
Completed front office duties including check-in, check-out, scheduling, collecting co-payments, and entering new
patient demographics.
Front Office Assistant August 2001 – July 2002
Carroll County Neurology Carrollton, Georgia
Entered patient's lab work into computer system.
Requested medical records from other doctors and insurance companies.
Scanned radiology reports.
Pulled EOB's for patients and insurance companies to be mailed out.
Completed general clerical and receptionist duties including copying, filing, and making/answering phone calls.
Phoenecia Houston
6980 Foxmoor Way
Douglasville, Georgia 30134
acwhl2@r.postjobfree.com
EDUCATION
Bachelor of Science in Business Administration – Healthcare Management
Graduated Class of 2015
School of Business, Liberty University, Lynchburg, Virginia
GPA 33
Central High School - Academic Diploma with Distinction
Graduated Class of 2002
Carrollton, Georgia
GPA 3.4
SKILLS
Office Productivity Applications: Microsoft Office Suite of Products
Knowledge in Medical Programming (Medical Manager, GE Centricity, Encounter Pro, Nextgen, Lotus EMR, Medicare EOB, Medic Co Star, SRS, Docstar, LIMS)
QuickBooks
Paychex Flex Online
Contact this candidate