Administrative Medical Billing

Teresa Shane

**** ***** **. ****, ** *****

**********@*****.*** * 928-***-****

Administrative Leadership

Operational Management, Research Operations, Preparing Reports, Scheduling Events

Broadly accomplished professional with knowledge and experience in Administrative Operations and Customer Services Programs, leading to progressive achievements, innovations, and improvements in data collections, office management functions, and administrative leadership objectives. Identified problems in former administrative programs and implemented effective contingency plans to better manage and control budgets, guidelines, and managerial programs. Reputation as a "quiet achiever" reflects capacity to pursue business objectives, maintain focus, and partner with others to meet a common goal. Subject matter expert in administrative functions and responsibilities. Proven ability to develop, meet and exceed program and company goals while enhancing administrative services. Consistently maintaining a high quality of work in every area of responsibility. Areas of expertise and competency:

Strategic Leadership & Management Responsibilities

Overseeing & Managing Day-to-Day Operations

Office Leadership & Program Management

Managing Calendars & Event Planning Procedures

Workforce Management & Managerial Operations

Administrative Leadership Responsibilities

Customer Service and Administrative Duties

Utilizing MS Outlook, Excel, PowerPoint & Word

Coordinating Projects & Productivity Improvement

Problem Resolution, Decision Making/Negotiations

Liaising Between Customers & Upper Management

Researching Procedures & Data Collections

Professional Experience & Notable Accomplishments

Billing & Accounts Receivable 2013

Desert Dermatology, Yuma, AZ

Successfully performed assignments using office procedures of considerable complexity. Created spreadsheets including the use of functions and formulas, also compiled reports. Maintained administrative staff by recruiting, selecting, orienting, and training employees; maintained a safe and secure work environment; developing personal growth opportunities. Exercised independent judgment in controlling office routines and setting up protocol and guidelines for practice. Processed Company documentation with accuracy and prepare routine accounting journal entries according to supervisor’s directions. Streamlined program usage and client demographic reporting procedures through the revision of source documents and instituting real time data collection.

Served as the lead point of contact for the Administrator while implementing effective office management procedures in order to improve administrative functions and prevent potential problems from escalating.

Received and processed transactions with the patients, Handle vendors, suppliers or contractors by telephone or in person.

Balanced accounts payable, with invoices, also prepare monthly reports along with completing payment authorizations, material requisitions and work orders; and pay invoices.

Directed staff as needed threw out the day also handle any complaints from patients and scheduling issues.

Handled any minor fixes and updates on computers and printers.

Maintained professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

Completed administrative operational requirements by managing calendars and ensuring that all documents were routed through the proper channels.

Conducted data entry, process all medical claims, post payments and balance on a daily accounts as well as handled and negotiated contracts.

Medical Biller/Accounts Receivable 2005 - 2016

Highland Park Medical, East Brunswick, NJ

Successfully oversaw billing and administrative staff in completion of daily procedures, ensuring strict adherence to regulations. Processed medical claims electronically, verifying accuracy of data prior to submission. Distributed additional claims via postal mail as necessary. Contacted insurance representatives and other professionals to discuss claim specifications, appeal denials, and negotiate insurance contracts for five doctors. Responded to patient account inquiries; receive payments, and record daily deposits. Generated monthly financial reporting forms for use by physicians. Trained office staff in use of computer applications/system and provide instruction regarding organizational policies.

Established strategic goals by gathering pertinent business, financial, service, and operations information; identifying and evaluating trends and options; choosing a course of action; defining objectives; evaluating outcomes.

Maximized total reimbursements by streamlining billing system for greater efficiency and ease in claims processing.

Maintained office services by organizing office operations and procedures; controlled correspondence; designed filing systems; reviewed and approved supply requisitions; assigned and monitored clerical functions.

Business Office Manager 2003 - 2004

Victoria Healthcare Center, Matawan, NJ

Executed accounts receivable processes for 200-bed assisted living and nursing facility. Administered billing to Medicare, Medicaid, HMOs, hospices, and private individuals, preparing required documents and submitting according to indicated guidelines. Reconciled explanation of benefit forms, prepared monthly revenue reports, and analyzed bank statements. Reviewed vendor invoices for errors and returned as needed for modification. Communicated with patient families regarding financial issues and assisted with application for various assistance programs. Contacted admissions staff to confirm census counts and accuracy of facility usage data. Adeptly liaised in order to resolve billing disputes and negotiate appropriate settlements.

Responded to and effectively resolved problems within administrative programs, staff management, quality assurance standards, while implementing improvements in case management services.

Supported administrative teams during staff onboarding process by providing useful documentation and office orientation for new hires.

Developed organization strategies by improving administrative functions; contributing information, analysis, and recommendations to organization strategic thinking and direction; establishing human resources objectives in line with organizational objectives.

Billing & Surgical Coordinator 2002 - 2003

Marshall P. Allegra, MD-Hazlet, NJ

Verified insurance coverage and appointment schedules for all surgery patients. Submitted claims for payment to Medicare, HMOs, Workers’ Compensation, New Jersey No-Fault Insurance, and private organizations/individuals. Followed up with insurance specialists regarding claim progress and to request review of denied claims. Ensured precision of billing codes and rigorously observed billing policies. Entered payment information into computer system and reconciled explanations of benefits.

Skillfully renegotiated physician insurance contracts and increased compensation rates for services provided.

Managed Accounts Receivable and Billing staff, providing training to ensure consistent quality, addressing employee concerns, and implementing small excelling functions.

Accomplished financial objectives by forecasting requirements; preparing an annual budget; scheduling expenditures; analyzing variances; initiating corrective actions.

Additional Experience

Medical Billing Specialist 1999 - 2002

Mid Jersey Pediatric Group, East Brunswick, NJ

Account Representative/Collector 1997 - 1999

Radiology Group of New Brunswick, East Brunswick, NJ

Medical Billing Receptionist 1994 - 1996

Dr. Anthony J. Micale, MD, Holmdel, NJ

Assistant Supervisor 1993 - 1994

Eyes First Vision Center, Iselin, NJ

Education/Training

Medical Billing/Coding Certification

Coding and Documentation, Medicare Compliance, Medicare Update (yearly courses)

Undergraduate Studies, Brookdale Community College, Lincroft, NJ

Additional Knowledge, Skills & Abilities

Networking effectively with insurance representatives to ensure timely and accurate completion of claims procedures and to negotiate physician contracts.

Training and mentoring medical billing employees and train staff on computers and insurance carriers to facilitate highest level of performance.

Achieving quality assurance operational objectives by contributing information and analysis to strategic plans and reviews; preparing and completing action plans; implementing production, productivity, quality, and customer-service standards.

Developing administrative staff by providing information, educational opportunities, and experiential growth opportunities; resolving administrative problems by coordinating preparation of reports, analyzing data, and identifying solutions.

Managing administrative and clerical duties that require discretion and independent judgment to ensure efficient operations of the office.

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