Follow Up Customer Service

PRISMA HEALTH DATE OF HIRE **/**/****-THROUGH PRESENT

OBJECTIVE:

SEEKING A RESPONSIBLE, CHALLENGING JOB IN HEALTHCARE AND/OR ORGANIZATION. MY TRAITS ARE THOSE THAT EXEMPLIFY INTEGRITY, DEPENDABILITY, DECISIVENESS AND DEDICATION, THESE ARE SOME OF MY STRONG POINTS. PRISMA EMPLOYS > 33K EMPLOYEES. I AM A COMMUNICATOR; MOTIVATOR AND I AM A HARD WORKER.

PRISMA HEALTH DATE OF HIRE 07/13/1998-THROUGH PRESENT

PFS FOLLOW UP SUPERVISOR OCTOBER 15, 2015, THROUGH PRESENT-

I HAVE A TEAM OF 15 STAFF THAT I LEAD DAILY FOR MEDICARE AND THE MILITARY PAYOR(S). OUR EMPLOYEE SURVEY FOR THE LAST TWO YEARS HAVE BEEN 96% AND ABOVE. I CHOOSE ENCOURAGEMENT, LEADERSHIP AND SELF CONFIDENCE BY WAY OF TRAINING AND MOTIVATING FOR SELF CONFIDENCE. I AM A COMMUNICATOR; MOTIVATOR, LOYAL, AND I AM A HARD WORKER.

I AM AN ENCOURAGER, TRAINER, MOTIVATOR, MENTOR, LEADER, AND I AM ALWAYS IN CUSTOMER SERVICE MODE. THIS IS A DAILY PART OF MY JOB WITH ALL TEAMS, DEPARTMENTS AND/OR STAFF. I AM RESPONSIBLE FOR STAFF YEARLY EVALUATIONS, STAFF PRODUCTIVITY WEEKLY REPORTING, MONTHLY STAFF ROUNDING AND/OR MONTHLY QUALITY AUDITING OF THE STAFF. I HAVE TWO ANALYSTS ON MY TEAM AND FOURTEEN FOLLOW UP REPRESENTATIVES. I TRAIN VIA TEAMS FOR THE TEAM AND/OR INDIVIDUAL AS WE HAVE BEEN WORKING REMOTELY SINCE MARCH 2020. THERE ARE NO MISTAKES, ONLY TRAINING OPPORTUNITES WHICH MEANS Q&A WITH THE TEAM AND/OR THE INDIVIDUAL(S) THAT HAVE QUESTIONS. I LEAD TEAM MEETINGS WITH MY STAFF AND FELLOW CO WORKERS. I TRAIN THE NEW SUPERVISOR(S) THAT JOIN OUR PATIENT FINANCIAL SERVICES TEAM. I AM RESPONSIBLE FOR THE MEDICARE AND MILITARY A/R AND I REVIEW TRENDS AND/OR ISSUES THAT ARISE WITH THE PAYOR(S). I COMPILE PROJECTS FOR THE ANALYST(S) AND TEAM EACH WEEK WITH AN EMPHASIS ON AREAS NEEDING REVIEW AND/OR REDUCTION. OUR FOCUS IS ON ALL A/R REDUCTION > 60 DAYS TO DECREASE AND ACHIEVE < 20% AGING. CURRENTLY WITH MEDICARE OUR TEAM IS AT 13%. I AM RESPONSIBLE FOR SCREENING CANDIDATES, INTERVIEWING CANDIDATES AND WORKING WITH PRISMA HEALTH RECRUITERS TO ASSURE THAT OUR CANDIDATES FIT OUR ORGANIZATIONAL GOALS. I DO THE WORKFLOW(S), PROCESSES AND TIP SHEETS TO KEEP STAFF UP TO DATE.

MY BIGGEST ACHIEVEMENT IS COMMUNICATION. KEEPING MY MANAGER, ANALYST(S) AND STAFF IN THE KNOW IS HALF OF THE BATTLE OF KEEPING THEM INVOLVED. I DO TOUCH BASE CALLS BIWEEKLY WITH MY ANALYSTS TO DISCUSS HELP REQUESTS, ISSUES, ESCALATIONS AND/OR REPORTING. I REACH OUT TO OUR MEDICARE CONTACT(S) IN COLUMBIA SC FOR TRAINING AND OUR PGBA CONCIERGE CALLS FOR MONTHLY CALLS TO REVIEW AND DISCUSS OUR MEDICARE ISSUES FOR RESOLUTION. I WORK WITH THE RAC TEAM-RECOVERY AUDITING TEAM FOR MEDICARE’S ADDITIONAL DOCUMENTATION REQUESTS.

PFS ANALYST 2007-2015 FOR BILLING AND FOLLOW UP-I WAS PROMOTED TO SUPERVISOR-

BEING THE RIGHT ARM OF THE SUPERVISOR. BEING ACCESSIBLE FOR THE TEAM. REVIEWING CLAIMS > 50K, APPROACHING TIMELY FILING DEADLINES, FRONT DOOR PAYOR REJECTIONS FOR MEDICARE. TRAINING MEDICARE’S ONLINE DDE SYSTEM FOR THE STAFF. REVIEWING AGING A/R FOR ACCOUNTS > 50K. MONITORING DAILY WQ(S) FOR TEAM RESPONSIBILITY. MONTHLY REPRTING TO MANAGER FOR THE HIGH DOLLAR REPORT > 250K. HELP REQUESTS FROM THE STAFF AND/OR LEADERSHIP.

PFS INPATIENT BILLER 2002-2007 PROMOTED TO ANALYST-

BEING THE ONE AND ONLY INPATIENT BILLER OF THE PATIENT ACCOUNTS DEPARTMENT FOR ALL PAYORS. TO KEEP ALL CLAIMS ACCURATE WITH MINIMAL DELAYS. ESCALATING BILLING ISSUES TO THE DEPARTMENT(S) FOR RESOLUTIONS. KEEPING DEADLINES AND REPORTING BACKLOGS TO UPPER MANAGEMENT.

PFS COMPLIANCE 2000-2002 PROMOTED TO INPATIENT BILLER-

ASSISTING THE CORPORATE COMPLIANCE OFFICER WITH GUIDELINES, TRAINING, BILLING, FOLLOW UP, RESEARCH, ACCURACY AND/OR PROCESSES. WORKING WITH BILLING AND FOLLOW UP CORRECTIONS AND/OR ERRORS TO ENSURE THAT THE PAYORS RECEIVE A CLEAN CLAIM FOR PROCESSING TO EXPEDITE PAYMENT IN A TIMELY MANNER.

PFS CLAIMS INVESTIGATION TEAM AND MEDICARE FOLLOW UP AND BILLING 1998-2000-

PROMOTED TO COMPLIANCE. BILLING AND/OR FOLLOW UP ISSUES WERE RECEIVED FOR RESOLUTION. WHETHER CONTACTING THE PAYOR AND/OR THE DEPARTMENT(S). RISK MANAGEMENT, UTILIZATION REVIEW AND/OR REACHING OUT TO THE PAYOR(S) FOR ADDITIONAL PROCESSING AND/ERROR INFORMATION. EXPEDITING THESE REQUESTS MEANT QUICKER TURNAROUND TIME AND QUICKER PAYMENTS FROM THE PAYOR(S).

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