Business Office Manager/Medical Billing in Skilled Nursing Facility se

Remedios (Remy) Reyes

*** **** **.,*** *****, CA 92114

aczxgb@r.postjobfree.com - 323-***-****

WORK EXPERIENCE:

Business Office Manager

Amaya Springs Health Care Center –April 1, 2016-September 16, 2016

Manage Accounts Receivables. Medical, Medicare, HMO insurance, Hospice and private pay billing.

Manage A/P for Vendors related to A/R Resident Invoices prior to monthly book closing

Prepare/Pre-run billing to make sure all resident invoices are inputted to the system prior to submission of claims

Prepare/re-submit back billing for any denied claims as identified in the explanation of benefit.

Prepare/re-submit appeals for any denied claim as indicated in the R.A/E.O.B.

Prepare monthly projected revenue based on census and insurance rug reimbursements.

Prepare collection report for end of the month.

Prepare comparative report against revenue versus actual collection.

Prepare financial aging reports every end of month.

Attend scheduled meetings:

Stand-up meeting

Medicare/Mgd. Medicare weekly meeting

Triple Check meeting-1st week of the month

Aging review meeting 3rd week of the month

Manage patient trust account. Prepare Monthly and Quarterly Statement. Bank Reconciliation.

Added task assigned from time to time

Billing Specialist

Premier B.H. LLC-October 2015 to February 26, 2016

Review aging- Identify financial class and Health Plan Provider-search verify reasons of denial, with reference to Contract of Agreement’s billing schedule and time frame limitation; Level of care and rates and other related aspect in relation to the aging.

Recommend: methods and procedures what to do and to attach/include documents to make sure that corrected or re-submitted claims will get paid.

Prepare communication (letter of appeal) as needed.

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Billing and Collection Specialist

SulmeyerKupetz (A Professional Corporation) –June 2015 to October 2015

Review SNF Aging, Research and analyze reasons of aging. Recommends necessary procedures to collect and submit/re-submit claims as required in the EOB. Submit appeal for any denied claims. Follow-up/calls for Insurance Providers as to track down status of claims until finally get paid..

Prepare/submit Cash Receipt report end of month.

Prepare/Financial Aging Report end of month.

Business Office Manager/Regional Billing Specialist

Eva Care Group - Los Angeles, CA - July 2014 to May 2015

Provide fiscal oversight and educational support to Business Office Managers in eleven skilled nursing facilities throughout Northern and Southern California. Responsibilities include the following functions:

A.Pre-Admission & Admission

1. Admission/Insurance verification

2. Census correctness and completeness

3. TAR/HMO authorization requests and follow-up (review contract prior to

sending request)

4. Train/in-service newly hired employees to this position.

5. Monitor- Patient Trust Account deposit & withdrawal through bank

reconciliation.

B. Supervised end report submission for Census to all providers, and the

AR/AP department for the integration in the month -end billing for all types of insurance (Medicare, Medical,HMO-skilled and custodial, hospice, private and Share of Cost) and payables to providers.

C. Billing Cycle (DSO) 30-45 days window

1. Medicare and HMO-skilled (managed care) claims –Submit claims on 9th of each month but not later than 10th.

2. Medical and HMO medical claims- transmitted on weekly basis (every Wednesday or Thursday) as scheduled.

3. Hospice claims -1st week of the month ancillaries included if not provided by Hospice.

4. Private including SOC, Co-Insurance (pre-billing) 25th day of the month but not later than the 1st day of the following month.

D. Prepare appeals for any denied claims from Medicare, Medical,HMO-health plans.

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E. Other On –Going Goals/Tasks

1. End- goal: increase revenue collections, maintain low DSO (ensure BOM’s understand how

to attain and maintain DSO).

2. Avoid claims denial

3. Educate/Train people (BOM) for the assigned task at hand.

4. Provide Excellent Customer Service

Business Office Manager

Westside Health Care - Los Angeles, CA - July 2005 to 2014

Manage Accounts Receivables. Medical, Medicare, HMO insurance, private pay billing.

Manage patient trust account. Prepare monthly projected revenue based on census and insurance rug reimbursements.

Prepare collection report for end of the month.

Prepare comparative report against revenue versus actual collection.

Prepare financial aging reports for end of month.

Business Office Manager -

Royal Garden - Alhambra, CA - January 2005 to July 2005

Same as job description at Westside Health Care

Manager of the Day

Royal Palms Convalescent - Glendale, CA - October 2003 to February 2004

Week end manager. Monitor the overall operations during week end with the

supervision of the Administrator. Prepare report at the of the day for follow up by the administrator the following Monday.

Education

Master of Business Administration in Financial Management

Wesleyan University Philippines – Cabanatuan City

Bachelor of Science in Commerce in Economics

Wesleyan University-Philippines – Cabanatuan City

Reference is available as per request.

Contact this candidate