P.O. Box ****

Crosby, Texas*****

Phone: 281-***-****

E-mail: ade24s@r.postjobfree.com

TaWanda K. White

Objective Seeking a position that not only allows but encourages the ability to continue to learn and grow professionally. My proven ability to demonstrate my work ethic, drive, dedication, and loyalty to a company, compliments my overall attitude and strive to be successful personally and professionally. I have over 15 years of experience from the front to back of the Revenue Cycle flow and 10 years with coding. I am an active member of the AAPC and continue to stay abrupt with the federal laws and regulations. Employment

September 2017-Current-KRW Medical Admin & Consulting-Crosby, TX Owner, Director, A/R Manager, Records Manager

Direct all business operations for facility & staff

Promote and lead a shared mission, vision, identity, and culture.

Maintain an environment committed to understanding the expectations and requirements of facility’s customers and clients.

Develop and sustain communication and relationship will all clients.

Manage all activities and personnel in the information systems department

Direct all training and performance management.

Manage work processes, develop realistic plans and timetables, and implement performance measures to track progress, outcomes, and accomplishments.

Establish measurable goals and best practices that focus on client expectations and financial success.

Act as a liaison and working with physicians, carrier and facilities.

Ensure the physician/carrier’s credentialing is maintained and current.

Maintains minimum disruption to business by assuring all supported applications are performing within expected service levels.

Ensures the facility’s systems disaster recovery plan is documented, complete, and current, and educated to all appropriate personnel.

Payroll functions or each employee; Time, PTO, sick leave or FMLA.

Revamping the entire office to run according to a Revenue Cycle Management workflow.

Provides historical reference by defining procedures for retention, protection, retrieval, transfer, and disposal of records.

Maintains office efficiency by planning and implementing office systems, layouts, and equipment procurement.

Created and implemented office policies and procedures by measuring the production of each employee.

Reviewing and analyzing special reports, summarizing information, identifying trends and communicating the information back to the Physician in a timely manner, in order to decrease deficiencies or trends.

Oversee hiring, firing or counseling of new and current employees.

Achieves financial objectives by preparing an annual budget, scheduling expenditures, analyzing variances, initiating corrective actions.

Contributes to team effort by accomplishing related results as needed.

Ensure guidelines and procedures are documented and current for all systems and support operations. Also ensures all staff members are versed in accordance to facility and State guidelines.

Participate in the planning and implementation of strategic and business plans.

Provide annual budget for areas of responsibility.

Maintains system efficiencies and appropriate system utilization levels of all applications.

Ensures all system data is stored and “backed up” appropriately and timely according to established criteria.

Ensure timely response and follow through on all internal help desk inquiries maintained and managed by.

Keep abreast of current trends and developments in the industry and provide recommendations on opportunities to improve or expand services.

Identify, develop, and implement systems needed to support the business objectives.

Provide effective and routine communication and reporting to customers that identify opportunities for improvement, problem resolution and enhancement for services.

Maintain professional growth, skills, and competencies to continuously improve the quality of services provided.

Ensure JACOH protocols and standards are met

Code and Bill all claims for procedures done at the hospital March 2014- Dec. 2018 – Red Oak Hospital/New Life Houston, TX Director, Revenue Cycle Management Services/Credentialing (Shutdown)

Promote and lead a shared mission, vision, identity, and culture.

Maintain an environment committed to understanding the expectations and requirements of facility’s customers and clients.

Develop and sustain communication and relationship will all clients.

Manage all activities and personnel in the information systems department

Direct all training and performance management.

Manage work processes, develop realistic plans and timetables, and implement performance measures to track progress, outcomes, and accomplishments.

Establish measurable goals and best practices that focus on client expectations and financial success.

Act as a liaison and working with physicians, carrier and facilities.

Ensure the physician/carrier’s credentialing is maintained and current.

Maintains minimum disruption to business by assuring all supported applications are performing within expected service levels.

Ensures the facility’s systems disaster recovery plan is documented, complete, and current, and educated to all appropriate personnel.

Ensure guidelines and procedures are documented and current for all systems and support operations. Also ensures all staff members are versed in accordance to facility and State guidelines.

Participate in the planning and implementation of strategic and business plans.

Provide annual budget for areas of responsibility.

Maintains system efficiencies and appropriate system utilization levels of all applications.

Ensures all system data is stored and “backed up” appropriately and timely according to established criteria.

Ensure timely response and follow through on all internal help desk inquiries maintained and managed by.

Keep abreast of current trends and developments in the industry and provide recommendations on opportunities to improve or expand services.

Identify, develop, and implement systems needed to support the business objectives.

Provide effective and routine communication and reporting to customers that identify opportunities for improvement, problem resolution and enhancement for services.

Maintain professional growth, skills, and competencies to continuously improve the quality of services provided.

Ensure JACOH protocols and standards are met

Code and Bill all claims for procedures done at the hospital

Communicate all financials to the Chief Executive Office and Board of Directors. May 2013- March 2014 Doctor’s Diagnostic Hospital Cleveland, TX Revenue Cycle Manager; Coder

Monitor and analyze assigned unresolved self-pay accounts. Contacting patients and assisting them with payment plans or payouts.

Maintain departmental workflow i.e. request for medical records, E.O.B., filing of claims, failed claims and ERAs.

Analyze and request refunds for insurance companies, focusing on correct COB for each account to determine correct party for valid refund.

Posting of Patient Accounts Receivables including Railroad Medicare, Medicare, Medicaid, and Commercial accounts.

Counsel patients at time of service on their deductibles, copays or out of pocket. I have a proven record that I increased up front collections by 87%, which the Hospital has never collected in the past.

Perform new hire training& performance expectations on the Practice Managements Systems.

Perform Revenue Cycle reporting & presentations for upper management and physicians.

Perform Medicare RAC reviews and audits according to demand letters.

Audited and coded charts for compliance according to the documentation provided.

Communicated with the clinical staff regarding the process of compliance involved in their overall documentation.

Worked one on one with Physicians to increase their proficiency of coding; LCDs and NCDs due to medical necessity.

Renegotiated insurance contracts, which provided the hospital with higher reimbursements; Fee for service, case rates & DRGs.

Created & maintained the charge master, as well as kept the diagnoses up to date according to Federal Regulations.

Worked closely with the Director of Revenue Cycle and CFO, on reporting of finances; Month End, Cost Reporting, etc. March 2013-May 2013 Edward W. Leahey- Baytown, TX

Office Manager

Payroll functions or each employee; Time, PTO, sick leave or FMLA.

Revamping the entire office to run according to a Revenue Cycle Management workflow.

Provides historical reference by defining procedures for retention, protection, retrieval, transfer, and disposal of records.

Maintains office efficiency by planning and implementing office systems, layouts, and equipment procurement.

Created and implemented office policies and procedures by measuring the production of each employee.

Reviewing and analyzing special reports, summarizing information, identifying trends and communicating the information back to the Physician in a timely manner, in order to decrease deficiencies or trends.

Oversee hiring, firing or counseling of new and current employees.

Achieves financial objectives by preparing an annual budget, scheduling expenditures, analyzing variances, initiating corrective actions.

Contributes to team effort by accomplishing related results as needed. June 2006-March 2013 Kelsey-Seybold Clinic Houston, Texas Collector, Insurance Follow-up Rep. II, Refund Analyst, Biller, Team Lead and Collections Coordinator

Monitor and analyze assigned unresolved self-pay accounts. Increasing collections by communicating with the patients on payment plans or resolving their account completely.

Assist Collection Supervisor in assuring policy and procedures are followed while accounts are being processed through P.C.S.

Maintain departmental workflow; i.e. request for medical records, E.O.B., copies of payments, correspondence with internal customers and clients.

Facilitate the flow of accounts through P.C.S. cycle by analyzing accounts to ensure appropriate resolution action has occurred and take action as necessary. Emphasis on self-pay and insurance collections.

Assist and train staff when necessary.

Analyze and request refunds for insurance companies; focusing on correct COB for each account to determine correct party for valid refund.

Balance check run and mail out request refund checks along with completing refund request from various carriers.

Performing various A/R special projects; RAC, MAC or MIP January 2002-June 2006 Geriatric Associates of America, PA (GAA) Webster, Texas Accounts Receivable Specialist, Certified Insurance Specialist

Responsible for Posting of Patient Accounts Receivables including Railroad Medicare, Medicare, Medicaid, and Commercial accounts.

Responsible for all aspects of a heavy Medical Director Billing and collections process which included detailed tracking and follow-though and excellent communication skills with both internal and external customers from all levels. Insurance Verification Team Lead

Responsible for insurance verification/follow-up /obtaining managed care authorization/referrals.

Collections on each insurance carrier using various tracking methodologies including aging lists, alpha splits, etc.

Success achieved due to personal philosophy that working solely from an EOB and on only one date of service is not enough. The account is to be worked from beginning date of service to the end date of service.

Success with various collection methodologies resulting in significant reductions in outstanding accounts receivables providing a more accurate picture of what is realistically collectable.

Proficient with all aspects of insurance and eligibility verification with numerous insurance carriers including Medicare, Medicaid, AARP, Aetna, etc.

Up to date with Federal and local rules and regulations and proficient in knowing where to go to find the answers.

Quickly promoted throughout the department, which allowed for more responsibility and increased exposure to all aspects of the billing and collections continuum, as well as interdepartmental promotions utilizing my strong leadership skills. Included but not limited to Front End Team Lead, Insurance verification Team Lead, as well as continuing to be a strong support for the Accounts Receivable Team.

Proficient with all aspects of Charge Posting and Coding to help ensure clean claims are submitted the first time, thereby speeding up the turnaround process of collections.

Skills/Qualifications: supply management, tracking budget expenses, delegation, staffing, managing processes, supervision, developing standards to improve billing process, promoting process improvement, inventory control, reporting skills, supervising and assisting in billing, coding and patient's insurance verification processes and tracking reimbursements and denials Education

and

Certifications

2001-2007 - San Jacinto College North Houston, Texas

Associate of Applied Science/Health Information Management

Actively completed coding courses. Pending CPC

2019-Current – Houston Lone Star College Houston, Texas

Associate of Applied Science. Nursing

Software Millbrook, Microsoft Word, Excel, PowerPoint, Centricity, Access, EPIC, IDX, Prognosis, E-clinicals, Citrix, Advantix, Advanced MD, M-systems,

References

Available upon request

Contact this candidate