Office Customer Service

LaToya Crum

**** **** ** ******* ****. #***

Buford, GA 30519

Phone: 678-***-****

Email: ************@*****.***

Professional Summary

Highly motivated Business Administrator with over 20 years of office administrative experience in the healthcare industry. Currently serves as the Business Office Manager in a franchised Nursing Home facility overseeing a business office of ten-member staff. Manage the revenue cycle process by using innovative health insurance verification systems. Process claims and collect funds from governmental (Medicaid and Medicare) and all major commercial insurance companies. Manage expense reports, analyzes financial data, oversees training program, and provide outstanding customer service to client.

Skills:

Expert in Microsoft Office

Excellent communication skills both oral and written

Results Driven / Goal-Oriented

Provide Effective Leadership

Team Player

Work History:

Life Care Center of Lawrenceville – Lawrenceville, GA

Business Office Manager (02/2017 – Present)

Manage a medical office of 10 administrative healthcare employees; Assists the Director with various complex financial reports; Train all new recruits on HIPPA Laws; Provides excellent customer service

Always 100% accurate in Expense Reporting by assessing all organizational expenditures and reimbursement request to prevents non-work-related compensations; Draft proposals for the Director

Utilize income and cash flow statements to balance Account Receivables; Reduce Account Receivable issues by 95% using daily status trackers, performing data analysis, and lead weekly meetings

Saves the organization thousands of dollars by minimizing the amount of write offs each year; Renegotiate payment agreements to recoup delinquent funds for Account Receivables

Emory Johns Creek Hospital- Johns Creek, GA

Supervisor/Payer Authorization Specialist-Case Management/ UR (07/2016 – 02/2017)

Responsible for obtaining clinical authorization by communicating patient and clinical information, medical necessity, and level of care to the payers to secure account for reimbursement

Authorized all in-patient hospital and observation stay accounts; Contacted third party payers for preauthorization for services; Calculated deductibles and collected co-payments due

Processed all out-of-network requests and notified Case Managers in a timely manner; Maintained database integrity by identifying correct account information that secured and completed patient’s information

Implemented Revenue Cycle Processes to fully optimize office operations and minimized financial risk of both patient and hospital; Entered authorization documentation into Midas and IDX

Emory Johns Creek Hospital- Johns Creek, GA

Supervisor -Patient Account Rep/Outpatient Radiology (08/2012 – 07/2016)

Master-trainer for Enterprise Scheduling and provided updates to master schedules;

Trained staff on new workflow processes, metrics, and customer service modules

Maintained annual coding updates and utilized the IDX Billing Accounts Receivable applications using Windows based software packages; Created spreadsheets to organize and categorize information

Analyzed and coded surgical procedures and diagnoses using ICD-9, IDC 10, and CPT-4 codes; Used hospital systems and online tools to access UB's, 1500's, EOB's, remits, and other information as needed

Called various insurance companies for pre-certification & authorizations, posted insurance & self-pay payments, entered charges, processed refunds, write-off/adjustments, appeals, denials & worked EOB's

Emory Saint Joseph Hospital- Atlanta, GA

Supervisor - Call Center - Internal Medicine/Cardiology/GYN (03/2010– 08/2012)

Answered and directed incoming multi-line phone calls for Internal Medicine, GYN, and Cardiology Physician’s Office; Processed all online medical requests from patients including online appointments

Corresponded to inquiries by phone regarding past-due accounts and insurance guidelines; Researched incorrect addresses for past-due accounts

Documented all calls, correspondence, and related activities to each patient's account; Performed timely follow up telephone calls on all assigned accounts to both patients and insurance companies

Demonstrated flexibility in providing coverage and availability for the call center for unexpected absences, events, or call volume variance

Northwood’s Surgery Center- Cumming, GA

Associate Administrator (05/2007-02/2010)

Responsible for providing leadership to six administrative staff members in the surgery center; Created Financial reports for board members and hosted weekly staff meetings; Briefed director on critical issues

Scheduled pre-operations and set up payment arrangements for outpatient surgeries and procedures; Filed copies of invoices and bills for official expenses; Submitted original documents to the accounts department

Liaise between managers and employees; Assisted in recruitment and arranged training for newly hired; Formulated physician marketing strategies and campaigns

Implemented and enforced the use of electronic medical records; Assessed prices on invoices and made medical and office supply purchases; Communicated with various vendors concerning inventory

Chattanooga Pain Surgery Center- Chattanooga, TN

Supervisor Front Office/Admissions (10/2005– 05/2007)

Responsible for the supervision all front office staff, payroll, insurance verification, billing claims, and securing patients’ confidential information; Wrote performance evaluations and recommended awards

Received patient information from the team of Care Managers and Financial Counselors; Secured and identified patient accounts within 24hours of admission adhering to company’s policy

Remained compliant with HIPPA guidelines and maintained the strictest confidential practice when dealing with patients' personal and financial information

Cross-trained in front office coordination duties, front desk, (EMR) billing, payment posting, and insurance verification

Certifications/Training:

HIPPA

Safety/Security

Education:

Currently a Business Management Major at Strayer University Atlanta, Georgia

Concentration and Completed Courses:

Accounting

Healthcare Management

Quantitative Analysis

Organizational Behavior

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