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Clinic/ Billing Manager

Location:
Friendswood, TX
Posted:
November 02, 2019

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Resume:

AdrianaNeyra

917-***-****-*****

adaqk0@r.postjobfree.com

no address available

Adriana Neyra

Practice/Billing Manager

Friendswood, TX 77546

I come with over 20 years as Practice Manager, Billing Manager, Clinic Advisor, Claims Auditor. I am able to thrive in a fast pace environment, increase claim accuracy by finding proper coding, lead by example and empower my team with the knowledge I bring. Authorized to work in the US for any employer

Work Experience

Billing Manager

Dr Richard W Yee MD PLLC - Houston, TX

August 2018 to Present

Clinic and Billing manager over 6 employees. Created all medical forms for practice. Created and applied OSHA guidelines and office compliance resulting in being approved 100% by Memorial Herman doctor group. Credentialed Doctor with all major insurance groups and negotiated fee schedules resulting in a higher allowable for practice. Created employee handbook and job application for new hires. Created indeed post and interviewed, hired and trained staff, implemented CollaborateMD billing software and mastered in 3 days to bill claims correctly with 100% clean scrub the first time. Registered, maintained and updated PECOS, CAQH, Availity, optum and RR Medicare and Medicaid resulting in re-instating provider with Medicare and Medicaid in network benefits. Networked and obtained privileges for surgeon at Gramercy, UOfH, Memorial Herman, River Oaks Lasik Center resulting in the addition of 6 approved OR time. Creating monthly DPR report to monitor monthly patients, billed claims, expenses, and total profit showing that in 1 year the profit for the practice increased by 66%. Responsible for ordering and sending all cultures to Methodist hospital for testing. Handling all pre auths for prescriptions sent. Keeping all of the Doctors credentials up to date before expiration. First point of contact for all drug reps and ensuring samples were ordered. Ordering and maintaining Botox, Juviderm available for procedures. First point of contact on the upkeep of surgical equipment, Scheduling all surgeries and reviewing with patient pre op, post op and medicine schedule with patients and filling out all documentation and uploading to corresponding surgery center. Billing all daily superbills including coding and diagnosis for practice staying within medicare guidelines. Ordering all sclera lenses and contact lens trials, Collecting monies due from patients. Sending statements, daily payment log, posting all insurance payments and patients, responsible for any refunds. Handled all patient concerns and request. Scheduling and obtaining referrals and pre auth before patient visit. Direct contact between MD Anderson and Doctor on any non compliance issues resulting in a letter from Hospital director stating amazement for quick results. Insurance training on new employees. Handled all employee scheduling, evaluations, discipline and concerns, paying all office invoices, daily check and distribution of daily mail. Assisting in all in office procedures. Ordering donor tissue from Eye Bank for surgeon review, ensuring patient compliance with surgical clearance, checking and distributing daily faxes, ordering compound medications, creating materials and invitations for any presentations to OD's as well as scheduling venue. Marketing through different websites to bring in new patients. Direct contact with Embassy patients including creating charge proposals and check issuance before surgery. In a little over a year the practice patient total went from 85 patients a month to 235 and profit from $325,000 to over $600,000 so far this year. Received letters of recommendation for practice excellence and compliance from Methodist, XIIDRA, Memorial Herman, and Gramercy Surgery Center. Including but not limited to payroll calculation and pay check issuance.

Billing Manager

Clear Lake Dermatology - Webster, TX

March 2018 to November 2018

Promoted to Billing Manager in a month due to collecting over $50,000 in denied claims by correcting mistakes. Trained the whole insurance verification team on how to verify insurance resulting in of modifiers. Credentialed all 4 physicians with all major insurances. Negotiated Fee Schedules resulting in 40% increase for practice. Submitted over 300 charges daily obtaining 100% clean claim submission. Responsible for implementing billing and collections processes by creating policies and procedures.Special program/billing planning and implementation, Assist in balancing accounts receivable reconciling statements as needed,Conduct routine staff meetings regarding billing. Prepared and created a monthly financial reports to document financial revenue. Senior Claim Analyst

COMPLETE WOMEN'S CARE CENTER - Webster, TX

March 2016 to March 2018

I was promoted to being solely responsible for working all denied claims from CBO for all 3 locations bringing monthly total from 2,000 claims to 0. Received recognition from CEO since it was the first time the company had ever achieved this goal also received recognition from HCA for lowest denied claims out of 280 physicians in the PSG group. Kept 0 claims at the end of the month until I left the company. Served as help in entering daily charges. Responsible for billing delivery and antepartum claims for all 3 locations. Established a culture of accountability to achieve operational excellence.Ensured compliance with all federal, state, and local regulations and guidelines. Obtained and negotiated yearly fee schedules to get the highest allowable per CPT codes. Met all billing operational standards by contributing billing information to strategic plans and reviews; implementing production, productivity, quality, and customer-service standards; resolving problems; identifying billing system improvements. Accomplished billing departmental objectives by measuring billing results against plans; evaluating and improving methods; making required changes. Practice Manager

River Oaks Chiropractic - Houston, TX

March 2016 to August 2016

handled all billing functions, including the initiation of goals and procedures, overseeing daily operations, and coordinating office efforts to expedite payment of accounts. Supervised hourly employees in performance of tasks associated with billing and collection from third party payers.

Monitored the billing processes of billing staff to assure that billing is correct and and properly coded. Reviewed and resolved issues related to claim rejections, denied claims and improperly paid claims. Determined the accuracy of charge capture, missing charges, late charges, covered and non-covered charges.

Ensured that all required information is attached to every billing form Ensured appropriate and professional communication with payers and patients and doctors. Elevated issues with payers and reports improvement as appropriate as well as negotiated fee schedules.

Served as a resource to staff by answering questions, assisting with problems, and providing training as necessary.

Assisted the PFS Director and Recovery Supervisor. Implemented quality and performance improvement measures for the business office. Participated in the development of unit policies and procedures. Ensured timely submission and acceptance of claims to all payers. Used a wide variety of communication formats to keep staff regularly informed and trained with one to one and team meetings.

Identified accounts not selected for billing (ANSB). Reviewed system generated billing,collections and medical records abstracting reports to monitor weekly collections, billed and paid accounts. Billing Manager

Madison Physical Therapy Inc - Madison, AL

January 2014 to March 2016

Created website for practice resulting in 25% increase of new patients. Day-to-Day Practice Operations - Staff schedules, conduct team huddles, address patient concerns, meet with providers and external vendors

Strategic Planning - Prepared and created monthly revenue analysis. Ordered supplies and paid invoices.

Remain Current in Healthcare Trends - Obtain insurance, billing, collections, OSHA through Availity, maintained AACP memberships, attend continuing education courses/webinars. Human Resources and Personnel - Resolve conflicts, maintain personnel records, hire/orientate/ evaluate/ discipline/discharge staff, developed job descriptions and office policies. Billing and Accounting: - Negotiated and was direct contact for all insurance companies, negotiated fee schedules, created superbill for practice, billed all claims, handled all denials, posting, patient statements.

Legal Compliance - Ensured all federal and state laws and guidelines were followed (eg OSHA, CLIA, HIPAA, FMLA), by creating an OSHA protocol log and serving as officer. Ensured all providers license stayed current, renewed all business license's stayed in compliance. Maintained and created HIPPA form for protection of medical information.

Manage Expenses - Explore competitive pricing for supplies, bio-hazard waste removal, consultant fees, answering service, etc.

Billing Manager

VisionAmerica - Huntsville, AL

January 2011 to March 2014

Full time office billing specialist responsible for billing, collections and A, /R accounts for 5 Ophthalmic surgeons. Scheduling, check in and check out, translating for patients when needed, writing reconsiderations tbr unpaid EOB's, and but not limited to handling any task that arose with patients. General Manager

America's Best Contacts & Eyeglasses - Huntsville, AL November 2008 to January 2011

Recognized by regional and company CEO for turning an under $200,000 a year store to achieving a million dollars in a years time. Recognized in weekly meeting for highest district sales. Responsible for directing patient flow, payroll, profit and loss report, scheduling, billing, marketing, and monitoring complaints. Closing and opening of store. Meeting all sales quotas set by corporate on a daily, weekly and monthly basis. Assisting the Optometrist with exam flow resulting in seeing over 455 patients a month. Hiring, scheduling, training, marketing, billing, posting, daily bank deposits, payroll. Billing and Collections Manager

Dr. Rios Medical Clinic - Houston, TX

April 2005 to November 2008

Full time Manager in charge of overseeing 6 Employees. Responsible for entering charges for 3 Internal Medicine doctors ensuring correct coding and billing of all primary, secondary and tertiary insurances as well as verifying benefits for all patients. Sending Reconsideration letters on all denials resulting in the

company collecting over 60% increase in revenue. Sending patients statements and collecting pending accounts from A/R reports by reducing outstanding debt from unpaid invoices by 50%. Credentialing, pre authorizations, referrals.

ER Registration Specialist

Bayshore Hospital - Pasadena, TX

March 2000 to April 2005

screening all hospital self-pay palient accounts to see if patients qualify for any government programs such as Medicaid, Medicare and or Social Security Disability. Completing all proper forms for case workers as well as interpreting for all Spanish speaking patients. Meeting with claims examiners to assist undocumented aliens with A&D programs. EDUCATION

Certificate in Billing Procedures

AACP - Houston, TX

January 2018 to Present

SKILLS

Accounting

Accounts payable

Billing

Accounts receivable

Collections

Human resources

Payroll

Quickbooks

Office management

Medical billing

Cpt

Medical records

Customer service

Icd

Multi-line

Multi-line phone

Phone system

Multi-line phone system

Data entry

Filing

Certifications and Licenses

Driver's license

Additional Information

SKILLS

Accounts payable, Billing, Accounts receivable, Collections, Human resources, Payroll, Quickbooks,

Office management, Medical billing, Customer service, Icd, Multi-line, Multi-line phone, Phone system,

Multi-line phone system, Cpt, Medical records, Data entry, Filing, Administrative assistant, claims,

Medical Terminology, Microsoft Excel, accounting, training, coding, Microsoft Office, Receptionist



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