Medical Billing

*

Sandra Garrido

***** ****** *****, ****** ******, FL 33545

Cell: 813-***-****

adgr1m@r.postjobfree.com

EMPLOYMENT HISTORY

James A. Haley VA Hospital, Tampa, FL

***** ***** *. ***** ****, Tampa, FL 33612

3/2011 – Present

Administrative Officer

40 Hours per week

Grade GS-9

Supervisor: Charles Slonim, M.D. – 813-***-**** ext 5785 (can be contacted)

• Responsible for the overall daily administrative operations of the eye clinic with a total current staff of 55 employees

• Onboarding of Fee Basis physicians

• Preparation of annual budget by analyzing workload and reviewing costs

• Contracting Officer’s Representative for the eye clinic. Coordinate acquisition of supplies, equipment, and service contracts

• Liaison with Human Resources concerning all personnel actions, ePerformance, create/update position descriptions and functional statements, new hires, awards and bonuses

• Coordinator for travel requests through Leaf program

• Maintenance of personnel competency folders

• Timekeeper with comprehensive knowledge of VATAS and Time and Attendance policies

• Maintenance of FPPE and OPPE folders

• Primary ADPAC

• Extensive knowledge of the Non-VA Community Care process

• Completion of White House Hotlines complaints, Congressional inquiries and Patient Advocate complaints

• Primary Point of Contact for Secure Messaging

• Coordinate clinic grid set up and cancellations for over 85 clinics James A. Haley VA Hospital, Tampa, FL

13000 Bruce B. Downs Blvd, Tampa, FL 33612

12/2008 – 3/2011

Auditor

40 Hours per week

Grade GS-9/11

Supervisor: Seth Teague – 727-***-**** (can be contacted)

• Review of outpatient and inpatient encounters, claim rejections and denials for coding and billing discrepancies, medical necessity, service connections, potential revenue opportunities and compliance issues

• Run and analyze various reports to identify coding and billing errors and identify trends

• Prepare and present reports of audit findings and recommendations to management

• Liaison between Business Office and clinical staff for quality improvement

• Review denied claims through the ARRIVE database 2

• Review and billing of fee basis reimbursable claims. Run third party billable reports out of FBCS to identify billable encounters. Identified cost saving measures for the fee program

• Participate in Live Meetings to different stations and VISN’s that are going live with the Fee program to aid and assist in using the FBCS reports to maximize revenue opportunities James A. Haley VA Hospital

13000 Bruce B. Downs Blvd, Tampa, FL 33612

12/2005 – 12/2008

Claims Examiner

40 Hours per week

Grade GS-7

Supervisor: Chuck Perry – Retired

• Billing of inpatient and outpatient claims including specialty billing such as prosthetics, pharmacy, fee basis, radiation therapy, chemotherapy, ambulance, humanitarian and hospice

• Ability to identify potential discrepancies in coding and insurance prior to billing and work in coordination with those sections for resolution of those discrepancies

• Adherence to all compliance regulations, HIPAA regulations, CMS guidelines, local policies and procedures

• Working knowledge of billing related software such as EDI or electronic date interface

• Interpretation and resolution of payer edits

• Graduate of the “Stepping with PRIDE” leadership program which consists of attending and completing 8 modules of face to face training and working with a mentor over a 6 month period

• Served as Acting Billing Supervisor when supervisor absent

• Served as trainer for new billing employees and contractors

• Creation of training material

• Proficiency with CPRS and Vista

Hi-Tech Healthcare

1805 Shackleford Ct, Suite 100, Norcross, GA 30093 6/2007 – 6/2008

Medicare Biller

40 hours per week

$14.50 per hour

Supervisor: Micki Mangan – 770-***-**** Retired

• Medicare and Medicare Secondary Payer billing of durable medical equipment

• Review and confirm transaction tickets to ensure accurate billing

• Interpretation and resolution of payer edits

• Communication with Medicare intermediary and other payers to solve issues regarding payments and systems issues

• Complete adjustments to clear and resolve accounts

• Communication with patients regarding account status, payments or any issues regarding their account

• Communication with referring physician offices to obtain required forms to ensure timely billing

• Work aging reports daily

3

Gentiva Health Services

3903 Northdale Blvd, Suite 200, Tampa, FL 33624

12/2003 – 12/2005

Senior Medicare Collector

40 hours per week

$15.00 per hour

Supervisor: Yvonne Wainwright – 813-***-**** (can be contacted)

• Research, resolve and prepare claims daily which have not passed payer edits

• Communication with Medicare intermediary and other payers to solve issues regarding payments and systems issues

• Participated in peer Quality Assurance projects

• Clear payment variances, resolve differences and initiate corrective action

• Analyze each agency’s outstanding monthly account receivables and process claims to obtain zero balances

• Communication with satellite branches to educate them as to the requirements for clean claims

• As a senior collector, assist co-workers in working through issues and educate them to help them to be more efficient

Gentiva Health Services

7725 Woodland Center, Suite 100, Tampa, FL 33612

6/2001 – 11/2003

Reimbursement Specialist

40 hours per week

$12.50 per hour

Supervisor: Sabrina Bolta – 813-***-**** (can be contacted)

• Contact various insurance companies that included PPO’s, HMO’s, Medicare, Medicaid, Work Comp, Tricare and auto to obtain benefits and authorizations for home health care and durable medical equipment

• Ability to interpret benefits and payer guidelines EDUCATION

Tampa Catholic High School

4630 North Rome Ave, Tampa, FL 33603

Diploma, 1989

ITT Technical Institute

4809 Memorial Highway, Tampa, FL 33634

Certificate of Completion, Automated Office Technology, 1990 Erwin Vocational Institute

2010 East Hillsborough Ave, Tampa, FL 33610

Certificate of Completion, Medical Terminology, 1999 LANGUAGES

• Read, speak and write fluent Spanish

REFERENCES

Nancy Kirk, Ophthalmologist-Retired, James A. Haley VA Hospital 813-***-**** Shelly Ingram, Administrative Officer, Geriatrics, James A. Haley VA Hospital 813-***-**** ext 3647 Sharon Brock, Health Technician, James A. Haley VA Hospital 727-***-****

Contact this candidate