SUMMARY OF QUALIFICATIONS

A business office professional with more than 12 years’ experience in the business and healthcare field. An effective team player with a consistent record of reliability, organization, and problem solving skills with a keen attention to details. Demonstrated proven problem solving skills in billing and coding, operational processes and business practices. Adept at communicating and working effectively across all organizational levels. Highly proficient in the development of strategic financial and operational models to meet with the organizations mission statement. An innovator with creative skills and experiences to improve overall business processes.

SKILLS

*Medicaid Management Information Systems *Small group instruction

*Knowledge of Medicaid statutes and regulations *Promotes positive behavior

*Planning and development *Academic advising

*Disease prevention and intervention specialist *Palliative care awareness *Spirometer reading accuracy *Venipuncture/Blood draw

*Problem resolution capability *Professional bedside manner

*Qualified in healthcare billing *Learning management systems *MEDISOFT and other PMP systems proficient *Analytical thinker

*Computer competency includes Microsoft Word, Excel and PowerPoint.

*Diagnostic and clinical skills, detail oriented, Multitasking and Typing 45 wpm.

PROFESSIONAL EXPERIENCE

HIGHLAND SPRINGS HOSPITAL, Cleveland, Ohio

August 2019-Present

Business Office Manager

Support the delivery of quality services and financial goals and objectives of the organization through effective day to day management of patient demographic and financial data. Work in conjunction with the Central Billing Office to ensure accuracy of data necessary in the billing and collections process.

Upfront collections, financial counseling and data processing

Follow policies and procedures to ensure accurate capturing and posting of financial activity to assist in maintaining accounts receivable at amounts appropriate for payer and acuity mix

Verify insurance benefits and eligibility

Conduct meet the leadership meetings to improve patient satisfaction

Prepare monthly quality reports

Completed Leadership Academy

XCEL HEALTHCARE PROVIDERS INC., Cleveland, Ohio

August 2017-August 2019

Billing Specialist

Familiar with various insurance companies including, Medicare and Medicaid. File insurance claims on behalf of patients and work with the patients and families on payment plans and other arrangements to ease the financial burden of skilled nursing care. Experienced with health insurance medical policies as well as insurance carrier benefit structures and the processes to obtain authorizations.

Submit reimbursement requests to Medicare and Medicaid

Process insurance claims for private and employer insurance reimbursement

Enter charges accurately and expeditiously to ensure proper records handling and fast payment responses

Process and follow up on payer denials, consulting with the patient and/or his or her family as needed

Post payments in a timely manner

Initiate private pay collections after insurance cancellation, denial or other issue

Research and resolve client billing problems or issues

Document payment records and issues as they occur

Responsible for obtaining authorization from insurance carriers

Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations

Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs

Established and oversaw implementation of an effective budgeting and accounting system that improved efficiency and reduced costs

Educated staff on state and federal statutes, rules and regulations governing home care services

Coordinated with other internal departments and customers to keep operations running smoothly and solve both routine and complex problems

Ensured HIPAA compliance

BRYANT & STRATTON COLLEGE, Cleveland, Ohio

May 2011- September 2017

Instructor

Facilitate medical assisting and medical administrative assisting curriculum in the Associate’s Degree program. Facilitate healthcare and business curriculum in the HSA Bachelor’s Degree program. Facilitate active learning through alternative delivery methodologies. Support the college mission. Maintain contemporary knowledge and skills in discipline to support expected classroom responsibilities. Advised and counsel at risk students with various issues pertaining to everyday life situations including chronic and mental illness, substance abuse and homelessness. Participate in departmental and campus-wide activities to support the needs of the student population.

Consistently maintain above 70% student retention. A leader in student success records. Consistently meeting departmental and campus goals, including above 70% student pass rates

Ability to establish rapport and build trust amongst the student population

Participate in developmental trainings including ICD-10-CM coding

Assist new hires with the on boarding process, and experienced in EHR, EMR and PHI

Provided clear, informative lectures in Allied Health and Business courses which consisted of 10-30 students

Created guides and course materials that would reiterate lecture information and help students in their study

Tested students on the materials that were presented in workshops and classes

Successfully improved student participation in the classroom through integration of creative role-playing exercises

Created new lesson plans based on course objectives

Documented student attendance and progress against goals

UNIVERSITY OF PHOENIX- Online

April 2014- October 2014

Facilitator

Facilitate curriculum in the Healthcare Administration Associates degree program. Facilitate active learning through alternative delivery methodologies and adaptive learning. Support the college mission. Maintain contemporary knowledge and skills in discipline to support expected classroom responsibilities.

KAPLAN CAREER INSTITUTE, Brooklyn, Ohio

July 2010-August 2011

Instructor

Facilitate medical office specialist and medical assisting curriculum in the diploma program. Facilitate medical practice management curriculum in the Associate’s Degree program. Instruct and monitor laboratory procedures, ensuring safety and accuracy. Advised and counseled at risk students with various issues pertaining to everyday life situations including chronic and mental illness, substance abuse and homelessness. Review academic progress with students and provide timely academic feedback. Maintain overall student retention rate.

Consistently maintain above 70% student retention

A leader in student success records. Consistently meeting departmental and campus goals

Observed other instructors and lecturers, gathering valuable techniques to be implemented into future lectures and courses

Created guides and course materials that would reiterate lecture information and help students in their study

Documented student attendance and progress against goals

Consistently received positive teacher evaluations from students

Facilitated group sessions and provided one-on-one support

Successfully improved student participation in the classroom through integration of creative role-playing exercises

Developed activities and integrated technology to diversify instruction

Created new lesson plans based on course objectives

CLEVELAND CLINIC, Cleveland, Ohio

October 2009- January 2010

Medical Assistant

Escorted patients to exam rooms; scheduled appointments and surgeries. Maintained office equipment and proper disposal of hazardous chemicals. Ordered office supplies

Assisted the physician with minor office procedures. Refilled Prescriptions and answered patient questions using Epic software

Worked directly with the physician, and other clinics within the building to achieve effective and efficient patient care

Verified data integrity and accuracy

Copied, logged and scanned supporting documentation

Entered details such as payments, account information and call logs into the computer system

Responded to customer requests via telephone and email

Performed initial client assessment and analysis to begin research process

UNIVERSITY HOSPITALS MEDICAL PRACTICES, Euclid, Ohio

July 2005- June 2009

Office Supervisor/ Medical Assistant

Triaged patients, obtained vital signs, escorted patients to exam rooms, administered immunizations, Phlebotomy and patient care.

Medical coding and billing, performed collections process, filing, answered phones, dictations and utilized IDX software to abstract patient data

Accurately collected personal, billing and medical details for 15-20 patients per day

Entered procedure codes and diagnosis codes into medical billing software

Adhered to strict HIPAA guidelines at all times according to company policy

Scheduled, rescheduled and handled cancelled appointments for patients

Ensured each medical room was properly stocked with an adequate supply of medications and supplies

Scheduled appointments for doctor visits and procedures using desktop calendar software

Interacted with all necessary partners throughout the establishment including physicians, nursing staff, technicians, and medical assistants

Aided with prescription refill requests

Received, recorded and filed medical payments by check, cash and credit card

Ordered all office supplies including ink cartridges, toner, and paper

Reviewed and sent medical records to other physicians upon request

Maintained privacy of patients’ information

Greeted each patient pleasantly and provided the desk sheet for sign-in

Created and maintained computerized record management systems to record and process data and generate reports

Helped residents with bathing, dressing, feeding, lifting and transferring

Measured urine and delivered specimens to lab

Achieved high staff morale and retention through effective communication, prompt problem resolution, proactive supervisory practices and facilitating a proactive work environment

Monitored fluid intake and output levels

Assisted doctors with surgeries and non-invasive procedures

Oversaw private and MCR billing, payroll, AP, and AR and verified that proper procedures were followed

Assisted patients with daily functions

Oversaw financial operations, producing invoices, processing payments and preparing deposits.

Performed monthly inventory and maintained office and medical supply counts

Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs

Provided patient education

Created children's area in waiting room to make practice more family-friendly

Assessed patients and documented their medical histories

PROFESSIONAL CREDENTIALS

Certified Medical Assistant, Certified Medical Billing Specialist, Certified Professional Résumé Writer, Evaluator for the Accrediting Counsel for Independent Colleges and Schools

EDUCATION

Indiana Wesleyan University, Mayfield, Ohio

Masters of Business Administration in Healthcare Management

Bryant & Stratton College, Eastlake, Ohio

Bachelors of Business Administration in General Management

Remington College, Cleveland, Ohio

Nationally Registered & Certified Medical Assistant

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