**** ****** ******

Jacksonville, FL. *****

cell904-***-****

E-mail: adichu@r.postjobfree.com

Karen Gorday

Objective: To obtain a responsible career position in a progressive company that provides the opportunity for personal and professional development.

July 4 2012– Present Community Hospice of North Florida Janie Williams 904-***-****) 4266 Sunbeam Road Jacksonville Florida 32256

Hospice AR Supervisor

Ensures receivables are converted to revenue quickly and effectively, increasing cash flow and reducing days in accounts receivable

Oversee Medicaid application process.

Responsible for 7 employees reviewing their AR and managing their work flow payment billing and collections.

educate employees on how to use different billing systems like Availity, FISS, Eservice, Molina Healthcare, NaviNet and DDE

Responsible for hiring, action plans and performance evaluations

Billing on a 1500 and UB04 form,monitor Super bills entry for palliative care program and Hospice program

Research billing requirements thru CMS, Medicare, PI and Medicaid

Troubles shoot all aspect of the AR Finance department and resolve any payment, collection and billing issues with all Insurance companies.

Create Insurance excel spreadsheet for PI, Medicare and Medicaid companies

Submit excel Spreadsheet to Insurance companies and monitor correct payments with provider’s contract and CMS guidelines.

Appeal any incorrect billing issues for the Provider to the Insurance companies before the insurance timely filing guidelines.

Send Education info to Insurance companies on correctly processing claims for provider.

Work with Manage Care complains to get Authorization and participate in the Peer to Peer calls.

July 1 2009– July 4 2012 Heartland Rehab Brett Kendal 407-***-****) and Debbie Booth ( 904-***-**** 3648 University Blvd. S. Jacksonville, FL. 32216

Skilled Nursing AR Manager

Medical Billing of all insurances, Electronic and Paper claims

Systems used: EPremis, Point click care, DDE

Research Billing requirements

Trouble Shooting in every aspect in the business office

Manage all accounts receivable

Participate in facility Medicare Triple Check Meetings and HMO Meetings

Assisted in helping with Medicaid applications.

Ensures receivables are converted to revenue quickly and effectively, increasing cash flow and reducing days in accounts receivable

September 2005 – July 1 2009 Brooks Health System Rita Sturm or Maria Raura 904-***-**** 904-***-**** 3599 University Blvd. S. Jacksonville, FL. 32216

Business Service Representative

Team Lead

Medical Billing of all insurances, Electronic and Paper claims

Primary and Secondary insurances, Electronic and Paper claims

Systems used: EPremis, Meditech, DDE

Research coding

Trouble Shooting in every aspect in the business office

Review A/R

January 2002- August 2005 Dr. Jesus Sahad, Dr. Cesar Arias 806-***-**** 1215 S. Coulter Suite 204 Amarillo, TX. 79106

Office Manager

Confident in all financial aspects of the medical office.

Experienced in HCFA claims billing (electronic billing and paper claims)

Provider credentialing and enrollment

Verifying patient eligibility and benefits

Collecting on accounts receivable/ working accounts payable

Posting EOBs and RAs / Working denials and entering daily procedures.

Answering multi-line phones and scheduling patient appointments.

Ordering all office supplies.

Maintained all of the credentialing and contracts compliance issues with insurances.

Billing Software: Medical Manager

Responsible for hiring, action plans and performance evaluations 4 people

keying in charges off a Super bill /Encounter

oJune 2001-December 2001 Resolutions Consulting Inc, 806-***-**** 301 South Polk street, suite 700 Amarillo, TX. 79101

Billing / Collections

Medicaid, Managed Care Medicaid, Medicare, Blue Cross/ Blue Shield, Workman’s Comp, and commercial insurance.

Billing software, EPremis, Cortex, Thin, HMS, Dairyland, Palmetto, and Compass 21. Familiar with APS, and DDE.

Billing facility ID’s: Home Health Care, Durable Medical Equipment (Hospital and Clinic), Rural Health Clinic, Rural Hospital, Ambulance, Familiar with Family Planning, and Hospice.

Coding

Accounts Receivable/ Payable

Age trial balance

Traveling

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