Manager Front Desk
Resume:
Angela South
Palmetto, FL ***21
********@*******.***
SUMMARY OF EXPERIENCES:
An accomplished and dedicated operation’s professional, with a Masters Degree in Healthcare Management and Business Administration. Develops and implements processes to achieve operating standards and secure significant company savings. Utilize knowledge of healthcare privacy (HIPAA) rules and billing regulations to standardize programs, in order to eliminate inconsistency and inaccurate information. Proves as an instrumental contributor to realizing the direction of an organization. Develops and implements strong marketing plans to facilitate business growth. Knowledgeable about CMS, SNF and Long Term Care Services, requirements, standards and guidelines as determined and governed by CMS. EXPERIENCES:
Palm Garden of Sun City Center, Sun City Center, FL Business Office Manager, November 2020 - Present
Strategically Plan and maintain Aging in the Accounts Receivable department by following the rules, guidelines and process of billing and collecting. Have a current track record of achieving and exceeding collection goals 95 to above 100 percentiles.
• Manage a staff of four (4) employees
• Maintain daily census through collaboration with admissions department to confirm accuracy in numbers being reported
• Meet with residents to discuss insurance plans and collect co-payments and discuss payment options as needed
• Supervises the Concierge, front desk operations to ensure all our internal and external customers receive optimal customer service, as well as maintain CDC guidelines as it relates to COVID-19 and the proper usage of PPE.
• Cover front desk whenever needed
• Work collaboratively with internal Senior Leadership Team, Staff members, Regional Team and AR directors to ensure Business operations are being carried out timely and effectively.
• Coordinate efforts with MDS, DOR, Social Services team for billing accuracy and discharge planning.
• Process and bill claims to Medicare, Medicaid, HMO plans and all Third Party insurance companies in accordance to CMS guidelines
• Bill coinsurances to variety of secondary payers,
• Process ADR’s, Appeal claims denials,
• Process Resident Refunds and Medicare RBD’s
• Follow up on claim status
• Perform collection efforts
• Pull EFT remits and Post cash to accounts, balance cash log
• Process adjustments and make the necessary contractual adjustments as it pertains to 2% sequestration, deductibles, write offs, refunds
• Maintain and report on accounts over 5K reporting
• Coordinate efforts with Elder Law Attorneys offices and Report on Medicaid Pending accounts. Follow through on processes until cases are approved.
Palm Garden of Pinellas, Largo, FL
Business Office Manager, January 2020 – November 2020 Strategically Plan and maintain Aging in the Accounts Receivable department by following the rules, guidelines and process of billing and collecting. Have a current track record of achieving and exceeding collection goals 95 to above 100 percentiles.
• Manage a staff of three (3) employees
• Maintain daily census through collaboration with admissions department to confirm accuracy in numbers being reported
• Meet with residents to discuss insurance plans and collect co-payments and discuss payment options as needed
• Supervises the Concierge, front desk operations to ensure all our internal and external customers receive optimal customer service, as well as maintain CDC guidelines as it relates to COVID-19 and the proper usage of PPE.
• Cover front desk whenever needed
• Work collaboratively with internal Senior Leadership Team, Staff members, Regional Team and AR directors to ensure Business operations are being carried out timely and effectively.
• Coordinate efforts with MDS, DOR, Social Services team for billing accuracy and discharge planning.
• Process and bill claims to Medicare, Medicaid, HMO plans and all Third Party insurance companies in accordance to CMS guidelines
• Bill coinsurances to variety of secondary payers,
• Process ADR’s, Appeal claims denials,
• Process Resident Refunds and Medicare RBD’s
• Follow up on claim status
• Perform collection efforts
• Pull EFT remits and Post cash to accounts, balance cash log
• Process adjustments and make the necessary contractual adjustments as it pertains to 2% sequestration, deductibles, write offs, refunds
• Maintain and report on accounts over 5K reporting
• Report on Medicaid Pending accounts
Greystone Healthcare Management Corporate Office, Tampa, FL Billing Coordinator (CBO), March, 2019 – January, 2020 Instrumental in the Accounts Receivable department as it relates to the billing and collections processes. Have a proven track record of achieving and exceeding collection goals 97 to above 100 percentiles.
• Oversees and manages all billing aspect of three (2) facilities in Florida: 120 beds and 99 beds
• Previously managed billing for two (2) Ohio skilled nursing facilities, 60 beds and 45 beds.
• Work collaboratively with Business Office Manager, Regional Team and AR directors
• Process and bill claims to Medicare, Medicaid and all Third Party insurance companies
• Bill coinsurances to variety of secondary payers,
• Process ADR’s, Appeal claims denials,
• Follow up on claim status
• Perform collection efforts
• Pull EFT remits and Post cash to accounts
• Process adjustments and make the necessary contractual adjustments as it pertains to 2% sequestration, deductibles, write offs, refunds
• Maintain accounts over 10K reporting
Casa Mora Health and Rehabilitation Center Bradenton, FL Business Office Manager, November 2018 – February 2019 Perform efficiently and effectively in current job classification of Overseeing the Payroll Department and Reception area, billing and collections, as a result increased company’s revenue and exceeds company’s collection goals.
• 240 Beds Skilled Nursing Facility Balance facility daily census to ensure that all admission, discharges and payor source are current;
• Meet with residents to discuss insurance plans and collect co-payments; Verify MCD, MCR, HMO Insurances, deductibles, OOPS’s benefits and obtain required authorizations;
• Manage Resident Trust Funds accounts (RTF), functions includes withdrawals, deposits, writing checks, refunds, Care Cost transfers, Petty Cash reimbursement, Prepare deposit slips and make daily bank runs;
• Enroll residents in Medicare Part-D plan; Perform electronic billing to CMS for MCR and MCD;
• Access MAVEN through e-Solutions MCR System, coordinate paperwork for ADR’s and Appeals for claim consideration and payment;
• Process Rugged and Level claims for HMO insurance billing; Work MCR and MCD denials and adjustments;
• Create and Maintain MCR and HMO Cut-Letter spreadsheet; Run Mecca monthly and update Medicare Part- B Eligibility log; Process 1500 form for A/P department; Maintain Cash Reconciliation log; Process and mail monthly statements for Patient Liability, Private (PVT) Co-insurances and Copays;
• Process and mail Commercial Co-A and Co-B claims to insurances; Prepare PVT Co-A and MCR Co-A Write-Offs for corporate monthly write-off processing; Carry out Collection processes such as Calls, Statements, Collection Letters and Demand Bills; Process and file Medicaid applications for ICP/LTC Medicaid; Process Refund requests, Post MCR, MCD and HMO insurances Remits; Process CAVEATS and make request for Guardianship through company’s auxiliary legal group; Run Aging reports and attend A/R Review monthly meetings with Corporate Regional Team; Run MCR Part-A Days report and update insurance information for UR weekly meetings;
• Process Medicaid application and gather the necessary documentations not limited to LOC, 3008, PASRR and collect Patient Liability (whenever applicable).
• Review and Process Funnels (financial packet) daily for MCR, MCD, Commercial Prime and HMO recipients; Audit Mecca for HMO disenrollment, MCR Part-B eligibility and Open MSP’s;
• Review Arbitrations and admission packets for form completion and signatures; Verify insurances; Enter End Of Month (EOM) charges for ancillaries which includes X-rays, Pharmacy and Lab billing; Update daily admissions log and distribute copies to Admissions Director, Executive Director (Administrator); Order office supplies; Cover front desk reception area as needed; Process monthly EOM Cash, Census and Resident Trust Account Reconciliations; Conduct monthly End Of Month activities relating to billing, refunds, adjustments, write-offs, collections, A/P, G/L coding, running reports and closing building; Sarasota Health and Rehabilitation Center Sarasota, FL Business Office Manager, November 2017 – November 2018 Perform efficiently and effectively in current job classification of billing and collections, as a result increased company’s revenue and exceeds company’s collection goals.
• 120 Beds Skilled Nursing Facility
• Balance facility daily census to ensure that all admission, discharges and payor source are current;
• Meet with residents to discuss insurance plans and collect co-payments; Verify MCD, MCR, HMO Insurances, deductibles, OOPS’s benefits and obtain required authorizations;
• Manage Resident Trust Funds accounts (RTF), functions includes withdrawals, deposits, writing checks, refunds, Care Cost transfers, Petty Cash reimbursement, Prepare deposit slips and make daily bank runs;
• Enroll residents in Medicare Part-D plan; Perform electronic billing to CMS for MCR and MCD;
• Access MAVEN through e-Solutions MCR System, coordinate paperwork for ADR’s and Appeals for claim consideration and payment;
• Process Rugged and Level claims for HMO insurance billing; Work MCR and MCD denials and adjustments;
• Create and Maintain MCR and HMO Cut-Letter spreadsheet; Run Mecca monthly and update Medicare Part- B Eligibility log; Process 1500 form for A/P department; Maintain Cash Reconciliation log; Process and mail monthly statements for Patient Liability, Private (PVT) Co-insurances and Copays;
• Process and mail Commercial Co-A and Co-B claims to insurances; Prepare PVT Co-A and MCR Co-A Write-Offs for corporate monthly write-off processing; Carry out Collection processes such as Calls, Statements, Collection Letters and Demand Bills; Process and file Medicaid applications for ICP/LTC Medicaid; Process Refund requests, Post MCR, MCD and HMO insurances Remits; Process CAVEATS and make request for Guardianship through company’s auxiliary legal group; Run Aging reports and attend A/R Review monthly meetings with Corporate Regional Team; Run MCR Part-A Days report and update insurance information for UR weekly meetings;
• Review and Process Funnels (financial packet) daily for MCR, MCD, Commercial Prime and HMO recipients; Audit Mecca for HMO disenrollment, MCR Part-B eligibility and Open MSP’s;
• Review Arbitrations and admission packets for form completion and signatures; Verify insurances; Enter End Of Month (EOM) charges for ancillaries which includes X-rays, Pharmacy and Lab billing; Update daily admissions log and distribute copies to Admissions Director, Executive Director (Administrator); Order office supplies; Cover front desk reception area as needed; Process monthly EOM Cash, Census and Resident Trust Account Reconciliations; Conduct monthly End Of Month activities relating to billing, refunds, adjustments, write-offs, collections, A/P, G/L coding, running reports and closing building;
• Process Medicaid application and gather the necessary documentations not limited to LOC, 3008, PASRR and collect Patient Liability (whenever applicable).
Greystone Healthcare Management Corporate Office, Tampa, FL Billing Coordinator (CBO), October 2016 – November 2017 Fulltime. Continued PRN Instrumental in the Accounts Receivable department as it relates to the billing and collections processes. Have a proven track record of achieving and exceeding collection goals 97 to above 100 percentiles.
• Oversees and manages all billing aspect of three (3) facilities in Florida: 159 beds. Ohio 60 beds and 45 beds.
• Work collaboratively with Business Office Manager, Regional Team and AR directors
• Process and bill claims to Medicare, Medicaid and all Third Party insurance companies
• Process ADR’s, Appeal claims denials,
• Assisted AR Director in processing Medicare Reimbursable Bad Debt
• Follow up on claim status
• Perform collection efforts
• Pull EFT remits and Post cash to accounts
• Process adjustments and make the necessary contractual adjustments as it pertains to 2% sequestration, deductibles, write offs, refunds
• Maintain accounts over 10K reporting
Lexington Health and Rehabilitation Center, Greystone Healthcare Management Co., St. Petersburg, FL Business Office Manager, June 2016 – October 2016
Perform efficiently and effectively in current job classification of billing and collections, as a result increased company’s revenue and exceeds company’s collection goals.
• 159 Beds Skilled Nursing Facility
• Balance facility daily census to ensure that all admission, discharges and payor source are current;
• Meet with residents to discuss insurance plans and collect co-payments; Verify MCD, MCR, HMO Insurances, deductibles, OOPS’s benefits and obtain required authorizations;
• Manage Resident Trust Funds accounts (RTF), functions includes withdrawals, deposits, writing checks, refunds, Care Cost transfers, Petty Cash reimbursement, Prepare deposit slips and make daily bank runs;
• Enroll residents in Medicare Part-D plan; Perform electronic billing to CMS for MCR and MCD;
• Access MAVEN through e-Solutions MCR System, coordinate paperwork for ADR’s and Appeals for claim consideration and payment;
• Process Rugged and Level claims for HMO insurance billing; Work MCR and MCD denials and adjustments;
• Create and Maintain MCR and HMO Cut-Letter spreadsheet; Run Mecca monthly and update Medicare Part- B Eligibility log; Process 1500 form for A/P department; Maintain Cash Reconciliation log; Process and mail monthly statements for Patient Liability, Private (PVT) Co-insurances and Copays;
• Process and mail Commercial Co-A and Co-B claims to insurances; Prepare PVT Co-A and MCR Co-A Write-Offs for corporate monthly write-off processing; Carry out Collection processes such as Calls, Statements, Collection Letters and Demand Bills; Process and file Medicaid applications for ICP/LTC Medicaid; Process Refund requests, Post MCR, MCD and HMO insurances Remits; Process CAVEATS and make request for Guardianship through company’s auxiliary legal group; Run Aging reports and attend A/R Review monthly meetings with Corporate Regional Team; Run MCR Part-A Days report and update insurance information for UR weekly meetings;
• Review and Process Funnels (financial packet) daily for MCR, MCD, Commercial Prime and HMO recipients; Audit Mecca for HMO disenrollment, MCR Part-B eligibility and Open MSP’s;
• Review Arbitrations and admission packets for form completion and signatures; Verify insurances; Enter End Of Month (EOM) charges for ancillaries which includes X-rays, Pharmacy and Lab billing; Update daily admissions log and distribute copies to Admissions Director, Executive Director (Administrator); Order office supplies; Cover front desk reception area as needed; Process monthly EOM Cash, Census and Resident Trust Account Reconciliations; Conduct monthly End Of Month activities relating to billing, refunds, adjustments, write-offs, collections, A/P, G/L coding, running reports and closing building;
• Perform Manager On Duty (MOD) tasks on a monthly basis; Purge inactive files and organize for storage. Process Medicaid application and gather the necessary documentations not limited to LOC, 3008, PASRR and collect Patient Liability (whenever applicable).
Sarasota Point Health and Rehabilitation Center, Southern Healthcare Management Co., Sarasota, FL Business Office Manager, June 2015 – June 2016
Perform efficiently and effectively in current job classification of billing and collections, as a result increased company’s revenue and exceeds company’s collection goals.
• 120 Beds Skilled Nursing Facility
• Balance facility daily census to ensure that all admission, discharges and payor source are current;
• Meet with residents to discuss insurance plans and collect co-payments; Verify MCD, MCR, HMO Insurances, deductibles, OOPS’s benefits and obtain required authorizations;
• Manage Resident Trust Funds accounts (RTF), functions includes withdrawals, deposits, writing checks, refunds, Care Cost transfers, Petty Cash reimbursement, Prepare deposit slips and make daily bank runs;
• Enroll residents in Medicare Part-D plan; Perform electronic billing to CMS for MCR and MCD;
• Access MAVEN through e-Solutions MCR System, coordinate paperwork for ADR’s and Appeals for claim consideration and payment;
• Process Rugged and Level claims for HMO insurance billing; Work MCR and MCD denials and adjustments;
• Create and Maintain MCR and HMO Cut-Letter spreadsheet; Run Mecca monthly and update Medicare Part- B Eligibility log; Process 1500 form for A/P department; Maintain Cash Reconciliation log; Process and mail monthly statements for Patient Liability, Private (PVT) Co-insurances and Copays;
• Process and mail Commercial Co-A and Co-B claims to insurances; Prepare PVT Co-A and MCR Co-A Write-Offs for corporate monthly write-off processing; Carry out Collection processes such as Calls, Statements, Collection Letters and Demand Bills; Process and file Medicaid applications for ICP/LTC Medicaid; Process Refund requests, Post MCR, MCD and HMO insurances Remits; Process CAVEATS and make request for Guardianship through company’s auxiliary legal group; Run Aging reports and attend A/R Review monthly meetings with Corporate Regional Team; Run MCR Part-A Days report and update insurance information for UR weekly meetings;
• Review and Process Funnels (financial packet) daily for MCR, MCD, Commercial Prime and HMO recipients; Audit Mecca for HMO disenrollment, MCR Part-B eligibility and Open MSP’s;
• Review Arbitrations and admission packets for form completion and signatures; Verify insurances; Enter End Of Month (EOM) charges for ancillaries which includes X-rays, Pharmacy and Lab billing; Update daily admissions log and distribute copies to Admissions Director, Executive Director (Administrator); Order office supplies; Cover front desk reception area as needed; Process monthly EOM Cash, Census and Resident Trust Account Reconciliations; Conduct monthly End Of Month activities relating to billing, refunds, adjustments, write-offs, collections, A/P, G/L coding, running reports and closing building;
• Perform Manager On Duty (MOD) tasks on a monthly basis; Purge inactive files and organize for storage. Process Medicaid application and gather the necessary documentations not limited to LOC, 3008, PASRR and collect Patient Liability (whenever applicable).
Greenbriar Nursing and Rehabilitation Center, Greystone Healthcare Management Co., Bradenton, FL Business Office Manager, May 2012 – June 2015 – Fulltime. Continued on PRN Perform efficiently and effectively in current job classification of billing and collections, as a result increased company’s revenue and exceeds company’s collection goals.
• 79 Beds Skilled Nursing Facility
• Balance facility daily census to ensure that all admission, discharges and payor source are current;
• Meet with residents to discuss insurance plans and collect co-payments; Verify MCD, MCR, HMO Insurances, deductibles, OOPS’s benefits and obtain required authorizations;
• Manage Resident Trust Funds accounts (RTF), functions includes withdrawals, deposits, writing checks, refunds, Care Cost transfers, Petty Cash reimbursement, Prepare deposit slips and make daily bank runs and UPS dropoffs;
• Enroll residents in Medicare Part-D plan; Perform electronic billing to CMS for MCR and MCD;
• Access MAVEN through e-Solutions MCR System, coordinate paperwork for ADR’s and Appeals for claim consideration and payment;
• Process Rugged and Level claims for HMO insurance billing; Work MCR and MCD denials and adjustments;
• Create and Maintain MCR and HMO Cut-Letter spreadsheet; Run Mecca monthly and update Medicare Part- B Eligibility log; Process 1500 form for A/P department; Maintain Cash Reconciliation log; Process and mail monthly statements for Patient Liability, Private (PVT) Co-insurances and Copays;
• Process and mail Commercial Co-A and Co-B claims to insurances; Prepare PVT Co-A and MCR Co-A Write-Offs for corporate monthly write-off processing; Carry out Collection processes such as Calls, Statements, Collection Letters and Demand Bills; Process and file Medicaid applications for ICP/LTC Medicaid; Process Refund requests, Post MCR, MCD and HMO insurances Remits; Process CAVEATS and make request for Guardianship through company’s auxiliary legal group; Run Aging reports and attend A/R Review monthly meetings with Corporate Regional Team; Run MCR Part-A Days report and update insurance information for UR weekly meetings;
• Process Medicaid application and gather the necessary documentations not limited to LOC, 3008, PASRR and collect Patient Liability (whenever applicable).
• Review and Process Funnels (financial packet) daily for MCR, MCD, Commercial Prime and HMO recipients; Audit Mecca for HMO disenrollment, MCR Part-B eligibility and Open MSP’s;
• Review Arbitrations and admission packets for form completion and signatures; Verify insurances; Enter End Of Month (EOM) charges for ancillaries which includes X-rays, Pharmacy and Lab billing; Update daily admissions log and distribute copies to Admissions Director, Executive Director (Administrator); Order office supplies; Cover front desk reception area as needed; Process monthly EOM Cash, Census and Resident Trust Account Reconciliations; Conduct monthly End Of Month activities relating to billing, refunds, adjustments, write-offs, collections, A/P, G/L coding, running reports and closing building;
• Perform Manager On Duty (MOD) tasks on a monthly basis; Purge inactive files and organize for storage. Lehigh Acres Health and Rehabilitation Center, Greystone Healthcare Management Co., Lehigh Acres, FL Assistant Business Office Manager, July 2011 – May 2012 Performed efficiently and effectively in job classification of billing and collections, as a result assisted Business Office Manager increase company’s revenue and exceed collection goals.
• Assistant to Business Office Manager in Daily and End of Month tasks;
• Balance facility daily census to ensure that all admission, discharges and payor source are current;
• Meet with residents to discuss insurance plans and collect co-payments; Verify MCD, MCR, HMO Insurances, deductibles, OOPS’s benefits and obtain required authorizations;
• Manage Resident Trust Funds accounts (RTF), functions includes withdrawals, deposits, writing checks, refunds, Care Cost transfers, Petty Cash reimbursement, Prepare deposit slips and make daily bank runs and UPS dropoffs;
• Enroll residents in Medicare Part-D plan; Create and Maintain MCR and HMO Cut-Letter spreadsheet; Run Mecca monthly and update Medicare Part-B Eligibility log; Process 1500 form for A/P department; Maintain Cash Reconciliation log; Process and mail monthly statements for Patient Liability, Private (PVT) Co-insurances and Copays; Process and mail Commercial Co-A and Co-B claims to insurances;
• Prepare PVT Co-A and MCR Co-A Write-Offs for corporate monthly write-off processing; Carry out Collection processes such as Calls, Statements, Collection Letters and Demand Bills; Gather information and prepare Medicaid applications for ICP/LTC Medicaid; Process Refund requests, Post MCR and MCD Remits;
• Run Aging reports and attend A/R Review monthly meetings with Business Office Manager and Corporate Regional Team; Run MCR Part-A Days report and update insurance information for UR weekly meetings;
• Review and Process Funnels (financial packet) daily for MCR, MCD, Commercial Prime and HMO recipients; Audit Mecca for HMO disenrollment, MCR Part-B eligibility and Open MSP’s;
• Review Arbitrations and admission packets for form completion and signatures; Verify insurances; Enter End Of Month (EOM) charges for ancillaries which includes X-rays, Pharmacy and Lab billing; Update daily admissions log and distribute copies to Business Office Manager, Admissions Director, Administrator; Order office supplies; Cover front desk reception area as needed; Purge discharged resident files and organize for storage;
• Maintain Business Office in Business Office Manager’s absence. Baptist Health South Florida, Inc., Coral Springs, FL Patient Financial Representative, March 2009 – July 2011 Performed in the top percentile of performers in job classification
• Meet and greet patients and customers in a cordial and professional manner in a Urgent Care facility;
• Process registration information, while adhering to organization’s standards and regulations;
• Process insurance information efficiently to ensure accurate and timely billing and reduce claim denials;
• Collect payments, offer Baptist Outpatient Services (BSO) financial assistance to patients when necessary;
• Enter daily charges and physician orders; Complete the required documentation scanning processes;
• Assist several BSO facilities in Urgent Care and Radiology departments in meeting the requests of patients and cultivating business demands.
• Process the appropriate checkout processes and schedule follow up appointments (as needed) Absolute Medical Supply, Inc., Oakland Park, FL
Assistant Operations Manager, February 2008 – March 2009 As a result of working closely with managers in developing various marketing strategies to increase business volume and productivity, my contribution increase the company’s revenue by $90,000 in one month.
• Assisted Operations Manager in daily operational procedures such as coordinated, monitored, and supervised delivery schedules and timelines of DME equipment in conjunction with physician’s orders, referrals and marketing development; Served as a liaison between the billing department and upper management to ensure ICD-9 and CPT coding was effectively billed and payments collected. Education:
2006 - 2008 Masters in Healthcare Management and Business Administration, University of Phoenix, Florida 2004 - 2004 Certificate in Supervisory Management Techniques, Florida Atlantic University, Florida 1986 - 1992 Bachelors of Arts in Psychology and Sociology, Hunter College, New York Awards:
June, 2014 Safety Award -Team Player in Facility & Resident Safety, Greystone Healthcare Management Co., Tampa, FL
July, 2013 Bronze Award - Exceptional job Performance in Timely Billing, Achieving Collections Goals & Effective Time Management, Greystone Healthcare Management Co., Tampa FL Computer Skills:
Proficient in Microsoft Word, Excel, PowerPoint, Office, Project and Outlook. Software Billing System knowledge of Omni, Profiler, IDX, Fast-Track, Quick-Care, e-Solutions MCR electronic Billing, DDE Medicare System, MAVEN
(ADR and Appeals monitoring system) and Point Click Care(PCC), Health Med-X (Vision), Zirmed, Availity, References available upon request
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