Business Office Manager

Sally J. Martinez, CPC

***** ********* *****, ******, ** 37167/615-***-****/*****************@*****.*** PROFESSIONAL SUMMARY

Healthcare professional with more than 30 years of experience in Practice Management, Software Implementations, Billing, Coding, Denials, Audit, Regulatory Compliance SKILLS

• Government and Commercial Auditing

• HIPAA Regulatory Compliance

• Denials Management

• Project Management

• Customer Success

• Medical Coding

• Microsoft Office • Customer Service

WORK HISTORY

Business Office Manager, 08/2020 to Present

Franklin Wellness and Rehabilitation – Franklin, TN

• Manage day to day office activities

• Plan, develop, design, implement and evaluate the Business Office policies and procedures

• Supervise front office staff

• Recruit and train employees, complete employee evaluations and handle disciplinary issues

• Develop and maintain a good working rapport between the Business Office and all other departments to ensure a positive working environment

• Billing for Medicare, Medicaid, Commercial Insurance and Private Pay Accounts, collections

• Accounting duties including posting Cash Journals, Cash Receipts, Bank Deposits, Monthly Statements, Petty Cash, Resident Cash, Resident Fund Management Accounts, Accounts Payable, Balance and Close the Month

• Daily and Monthly Census

• Coordinate Daily Morning Meeting

• Review, Approve and Manage Admission and Discharge requirements

• Financial counseling

• Liaison with residents, families and outside agencies

• Review complaints and grievances and handle accordingly

• Ensure the facility policies and procedures for personnel, residents, visitors and vendors are maintained

• Provide statistical data as needed

Implementation Manager, 03/2009 to 4/2020

Craneware – Atlanta, GA

• Manages the implementation of Audit SaaS software to hospitals across the nation

• Successfully implemented 98% of projects on time and within budget

• Provides conflict resolution and ensures successful outcomes of project deliverables

• Creates training material and provides training services to hospital staff and internal departments

• Provides remote support

• Prepares monthly financial reports that demonstrates customer benchmark performance

• Design custom audit workflow

• Manages the resolution of product bugs and enhancements Coding Consultant, 04/2008 to 02/2009

Horne LLP – Nashville, TN

• Perform Coding audits on medical records for all specialties

• Perform office procedure audits for all areas of the clinic

• Prepare detailed reports and present audit findings to management

• Research Chargemaster coding questions and perform Chargemaster maintenance and updates

• Conduct seminars on various billing and coding topics HCC Coding Specialist, 08/2007 to 02/2008

The Coding Source – Los Angeles, CA

• Perform HCC Coding audits on medical records at various client locations utilizing the MCR HCC guidelines

• Enter all HCC coding information into the HCC software. This position was 100% travel. Business Manager, 04/2005 to 08/2007

NeoGenomics, Inc – Fort Myers, FL

• Manage all aspects of the business department

• Supervise all coding, charge entry, payment and adjustment posting, and accounts receivable follow-up for both insurance companies and patients

• Review accounts for collections. Conduct appeals and reviews.

• Perform all month end reporting. This position also included performing all accounts payable functions utilizing QuickBooks and reported directly to the CFO. Office Manager, 07/2004 to 04/2005

Family Physicians of BVL – Kissimmee, FL

• Manage all aspects of the physician office including payroll, accounting, physician credentialing, billing, CPT and ICD-9 coding as well as collections.

• Hire, supervise and schedule all employees. Assisted the physician in patient care as necessary; taking vital signs, administering injections and assisting with in-office surgery.

• This position involved heavy Customer Service.

Billing Manager, 04/1998 to 07/2004

Associates In Nephrology – Fort Myers, FL

• Manage the billing department for an eight provider specialist office; responsible for hiring, training, scheduling, yearly evaluations and disciplinary actions for all department employees

• Oversee all billing related tasks to ensure the timeliness and accuracy of CPT and ICD-9 coding, charge and payment posting

• Conduct Medicare appeals, reviews and ALJ Hearings

• Review accounts for collections and write-offs

• Perform end of month close and review month end reports with physicians

• Develop and execute a plan of action for decreasing the outstanding accounts receivables

• Conduct department meetings and perform monthly in-service training for billing staff and physicians

• Conduct monthly chart audits to ensure correct coding practices

• Served on both the Compliance and HIPAA committees

• Prepared credentialing applications for all government and private insurance companies for both current and incoming providers

• Negotiated managed care contracts and resolved contracting issues Assistant Office Manager, 02/1988 to 01/1998

Kidney and Hypertension Specialists – Miami, FL

• Train and supervise front office staff and billing personnel

• Billing, CPT and ICD coding, denials and collections

• Manage physician schedules, charges, payments and write-offs for office, hospital and dialysis units

• Patient care, schedule testing and hospital admissions

• Assist in payroll, accounts payable, physician credentialing EDUCATION

Health Service Administration

Florida Gulf Coast University – Fort Myers, FL

Associate in Arts Degree Health Services

Edison College – Fort Myers, FL

Certified Professional Coder August 2003 – Current Professional Affiliations – American Academy of Professional Coders July 2003 - Current APPRAISALS

• Sally is a talented Healthcare professional who is constantly praised by her peers and her customers. A self- guided employee that needs virtually no direction. Her knowledge and work ethic make her the model employee. Wayne Landry – Director of Customer Engagement - Craneware

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