Physician Manager
Resume:
Jessica L. Cortez
● **** Curtis Ave, Eugene, OR *7401 ● 919-***-****● *******.*.**********@*****.***
Summary
Administrative management professional with over 20 years of extensive medical office, acute care facility and construction supervision. An organized individual who enjoys working in a fast-paced, high-energy, positive work environment. Desiring a challenging position that will allow me to apply my advanced communication and interpersonal skills to benefit a team of like-minded professionals.
Experience
Quantum Recruiters, Eugene, OR
PacificSource Health Plans
Business Support Analyst
October 2020 – Current
Daily reconciliation of Lockbox and TPC deposits.
Prepare daily spreadsheet to be sent to Finance team.
Process group terminations via Facets and PSE.
Set up new or make changes to Group EFT payments.
Review and set up Group account structures for 834 processing.
Analyze and correct enrollment rows in Facets to match MAT entries.
Process Group refunds as directed by the Membership Representatives.
StorageMax, LLC, Wake Forest, NC
Commercial Property Manager
April 2012 – May 2020
Oversee the day-to-day operations for 75,000 square foot of commercial rental property.
Negotiate lease agreements between our legal team and potential clients to include tenant improvements, lease term, and price per square foot.
Schedule and oversee contractors, maintenance providers, and utility repairs.
Review, correct and submit all AR/AP, payroll, mortgage, and tax invoices for office and contracted tenants
Prepare financial statements to include occupancy levels, property conditions and lease terms
Supervise onsite major repairs, new construction and renovations
Community Health Centers Santa Maria, CA
Health Center Manager Women’s Health Services
January 2010 – December 2011
Transition a private practice to a federally funded healthcare system
Integrated the electronic healthcare record, to include merging patient databases, account ledgers and provider databases.
Standardize flow and communication between staff and providers that were required to rotate between facilities
Responsible for Electronic health record chart audit for accuracy of coding and to ensure documentation meets expected plan of care for all regulatory agencies
Direct patient involvement regarding the state funded programs for indigent populations; Family Pact, Breast and Cervical Cancer Detection Program, Sliding Fee program and low cost laboratory services and special programs for our migrant farm worker population.
Responsible for administrative and clinical staff evaluations, competency, and salary increases.
Responsible for provider and insurance credentialing as well as ensuring providers are current with CME requirements.
Ensure all providers/staff are within Federal/State Guidelines regarding care, reporting, and grant requirements.
Responsible for Budget planning to include salary increases, FTE staffing and supply cost.
Continuous education of JCAHO, OSHA, and administration policies and procedures
Assured organizational conformance with legal accreditation (JACHO, NCQA, Medical Home) and other regulatory requirements related to perinatal care
Responsible for all hospital, surgical, delivery and office charge input into billing system, to include coding, posting, correction and oversight of AR follow up.
Responsible for educating registration staff regarding account accuracy, effective collection procedure, and streamlining registration process.
Worked collaboratively with Chief OB/GYN to achieve utilization and clinical quality and service quality benchmarks
Continuous evaluation of processes/policies/procedures to improve systems, patient/physician satisfaction.
Oversight of busy Surgery Scheduling Department to ensure all pre-certification/authorization, co-insurance/copay/deductible have been verified and collected.
Direct communication with Hospital and numerous other ancillary sources regarding financial, medical and scheduling issues.
Arbor Medical Group, Santa Maria, CA
Practice Manager OB/GYN
August 2004 – December 2009
Direct supervision of 6 provider office and patient support staff for one of largest private practices in Santa Barbara County.
Organized, managed and directed construction of state of the art 7500sq ft medical facility
Conducted employee evaluations, competency, salary increases and disciplinary actions.
Responsible for provider/insurance credentialing and CME requirements.
Negotiate Insurance contracts to include fee schedule and provider services.
Budget planning to include salary increases, FTE staffing and supply cost.
Oversight for all hospital, surgical, delivery and office charge input into billing system, to include coding, posting and correction.
Responsible for education of registration staff regarding account accuracy, effective collection procedure and streamlining registration process.
Maintained open communications with all physician staff regarding billing requirements directly related to Federal/State/Facility guidelines.
Designed and evaluated processes/policies/procedures to improve systems, patient/physician satisfaction, and to streamline registration practice.
Implemented Electronic Health Record and Electronic Practice Management through NextGen Software to include all payer, ICD-9, CPT-4 and transaction posting codes set up and continuous maintenance and update responsibility.
Close working relationships with all IT vendors for software and system maintenance issues.
Oversight of outsourced billing/collection unit to include AR review, monthly reporting oversight, on-sight collector supervision, and all collection decision making.
Oversight of busy Surgery Scheduling Department to ensure all pre-certification/authorization, co-insurance/copay/deductible have been verified and collected.
Direct communication with Hospital and other ancillary sources regarding financial, medical and scheduling issues.
Brandywine Hospital, Coatesville, PA
Assistant Director Patient Financial Services
October 2002 – July 2004
Direct supervision of Admitting, Patient Accounting, Cashier, Central Scheduling, Telecommunications, Insurance Verification Unit, Physical Therapy Secretaries and HIM Liaison Staff.
Responsible for Budget planning to include Capital expenditures, salary increases and supply cost.
Personally responsible for FTE staffing requirements and development of interview, hire and training process.
Conducted employee evaluations, competency and disciplinary actions.
Responsible for education of all Admitting staff regarding account accuracy and effective collection process.
Maintained open communications with all physician staff regarding billing requirements directly related to Federal/State/Facility guidelines.
Designed and evaluated processes/policies/procedures to improve systems, patient/physician satisfaction, and to streamline admitting practice.
Actively manage AR and Patient Account Representatives for reconciliation of open accounts below industry standard.
Review past due self-pay account with patients and completion of charity applications, to include credit reporting and itemization of expenses for possible adjustments.
Continuous education with ancillary departments regarding coding, charge master review, and registration practice.
Developed Insurance Verification Unit to ensure active policies, referral/precert and to inform patients prior to arrival of co-pays, co-insurance, deductible and any outstanding balances.
Manage AR for offsite entities to include Rural Health Clinic, Wound Care Center, Physician Practices, Ambulance Services, Speech Therapy, Nutritional Education and Physical Therapy Department.
Maintain open communications with contracted payors regarding outstanding AR and educated hospital staff regarding updated billing requirements.
Improve relationship between Case Management Department and Patient Accounting Representatives for effective discharge planning and pre-certification process.
Brandywine Hospital, Coatesville, PA
Interim Director Brandywine OB/GYN
12/2002–4/2003
Reviewed Billing and collection procedures to effectively decrease AR and increase cash flow.
Reviewed employee competencies to streamline office policies and procedures.
Reviewed physician files to ensure CCE hours were within compliance, ensure malpractice insurance was active and appropriate for level of care provided, ensure re-credentionaling was completed to avoid lapse in contracts.
Reviewed physician contracts and re-negotiated terms to reflect productivity versus annual salary.
Recruited and hired qualified Practice Director.
Franklin Regional Medical Center, Louisburg NC
Assistant Business Office Director
1/2001–9/2002
Direct supervision of Admitting, Patient Accounting, Cashier, Central Scheduling, Telecommunications, Insurance Verification Unit, Physical Therapy Secretaries and HIM Liaison Staff.
Responsible for Budget planning to include Capital expenditures, salary increases and supply cost.
Directly responsible for FTE staffing requirements and development of interview, hire and training process.
Directly responsible for employee evaluations and competency.
Responsible for education of all Admitting staff regarding account accuracy and effective collection process.
Maintained open communications with all physician staff regarding billing requirements directly related to Federal/State/Facility guidelines.
Designed and evaluated processes/policies/procedures to improve systems, patient/physician satisfaction, and to streamline admitting practice.
Active management of AR and Patient Account Representatives for reconciliation of open accounts below industry standard.
Review past due self-pay account with patients and completion of charity applications, to include credit reporting and itemization of expenses for possible adjustments.
Continuous education with ancillary departments regarding coding, charge master review and registration practice.
Developed new hire orientation for Unit Secretaries regarding correct discharge coding, transferring of patients and appropriate paperwork completion.
Created process for follow-up hospital visits in compliance with Federal/State Billing guidelines.
Increased upfront collection by ensuring all Admitting Staff understood Insurance verification process.
Management of AR for offsite entities to include Physician Practices, Speech Therapy, Nutritional Education and Physical Therapy Department.
Maintained open communications with contracted payors regarding outstanding AR and educated hospital staff regarding updated billing requirements.
Improved relationship between Case Management Department and Patient Accounting Representatives for effective discharge planning and pre-certification process.
Franklin Regional Medical Center, Louisburg NC
Business Office Manager Home Health
6/1999-12/2001
Supervise office staff.
Conducted employee evaluations and competency.
Direct education and resource for two agencies.
Improved communication with Case Management Department for effective discharge planning.
Educated physician staff regarding Medicare/Medicaid policies and procedures.
Developed Billing procedure for compliance with Medicare Perspective Payment System
Reviewed and maintained all billing and employee policies.
Reviewed patient charts to ensure physician orders and care plans were in compliance with State/Federal requirements.
Continuous education of clinician staff regarding Medicare requirements relating to billing and reporting.
ORYX data reporting to State/Federal entities.
Maintained communication with Clinical Director regarding billing practices and the effect of clinical data on reimbursement.
Maintained communication with Hospital Financial Staff regarding AR and cash collections.
Organized and participated in health fairs within the community.
Education
1991-1993
Vance-Granville Community College, Henderson, NC
Completed coursework towards bachelor’s degree in Business
Coursework focused on Healthcare
1986-1990
Wake Forest High School, Wake Forest, NC
Diploma
Studies focused on Business
System Knowledge
Raintree Software
SiteLink
Yardi
Quickbooks
NextGen EHR&EPM
Navicure
State/Local Medi-Cal/Medicare DDE
MS office: Word, Access, Excel, Power Point and Outlook
AS400
Accent
SSI billing software
Medical Manager
Medicare Common Working File
Navinet and other online insurance verification programs
Promed
Monarch
Ten-Key Calculator
Mulit-line phone systems
OnBase
Facets
PSE
MAT
ShareLink
Workday
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