Joann E. Fisher

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

Miami, FL ****9

Cellular: 786-***-****

Email: adocwv@r.postjobfree.com

Professional Profile

Healthcare Managed Care professional with over 14 plus years of experience in the Healthcare Administration field. Extensive knowledge of Medicare, Medicaid, HMO contracts, credentialing, HIPAA regulations in patient confidentiality policies and procedures, healthcare management, and oncology infusion. Seeking an opportunity within healthcare with increasing responsibilities where I can contribute my knowledge, experience, and expertise to the success of healthcare. Work well under pressure in multi- task management and healthcare professional environments. Able to work well in a self-managed and/or team-based environment.

Additional strengths and skills:

*CPR & First-Aid Certified *American Heart Association *American Red Cross Association

*OSHA Policies & Regulations *HIPAA Policies & Regulations *Microsoft Office Professional Suite

*Promise-Sage System *Cerner-mail & internet *Allscripts system

*Typing-50wpm *Medisoft and Meditech *CAQH Forms

*Pecos software *MS Word Processing *MS Excel Spreadsheets

*Excel Workbook Spreadsheet *Microsoft Outlook *PowerPoint

*Healthcare Information Management *Electronic Medical Records System

*Micro-management training *Outstanding communication and presentation skills Professional Experience:

Miami Cancer Institute 12/2019 to Present

Senior Intake Associate Miami, Florida

In charge of contacting patients and scheduling return follow-up appointments and ensuring medical records are available and uploaded in the electronic medical record system (EMR) prior to the patients visit. Collaboration with the record collection personnel, insurance verification and scheduler in order to facilitate a smooth patient follow-up visit. Exhibit critical thinking and ability to understand patients needs, find solutions and make referrals as needed. Work closely with the intake team and leadership staff to ensure the department achieves outstanding outcomes in all areas related to the department. Meet and triage patients interested in seeing if the institute’s care is appropriate for them. Departments. Reviews all of the assessment information and assigns the patient care to the appropriate clinical staff member for in-depth review and services. Conduct and facilitate crisis counseling to patients on an as needed basis. Enter admissions information into the digital system and completes all admissions paperwork. Answers all incoming calls, responds to questions and explains the admission process to patients, schedule evaluations, meetings and consultation visits for patients. Prepare and maintain patients’ charts.

• Managing and performing timely intake processes on referrals including completion of the referral page and family details page if applicable.

• Providing assistance in tracking enrollment and supervising timelines by considering federal guidelines, completing various reports and forms, drafting emails and letters as well as resource materials to the families of patients.

• Creating and maintaining organizational system and filing for supervisors.

• Participating in team meetings, handling correspondence, sharing meeting responsibilities, responding to routine requests, and assisting with the collaboration of professional learning and professional development.

• Request details from outside agencies for assisting the patients’ families.

• Ordering assessment and instructional equipment supplies and materials for the staff in case of the absence of primary concerned person.

University of Miami Hospital 01/2016 to 12/2019

Senior Discharge Planner Miami, Florida

Coordinated and developed continuing care plans for patients leaving treatment. Assess patient’s individual needs and work with them to develop a plan that promotes long-term health and relapse prevention. Worked with patients, professional staff, the patient’s family members, friends and community support. Coordinated and maintained patient discharge evaluations. Coordinated of post discharge services including home health care, durable medical equipment, nursing homes, oncology infusion. Contacted insurance companies and managed care providers for approvals and assignments of HHC Agencies as well as other providers. Obtained self-pay pricing for uninsured patients. Reviewed the patient’s case and determined the best choice in services and facility to meet the medical and social needs of the patient.

• Meetings with the Case Managers and / or Social Workers to discuss priority cases.

• Review medical records for any pertinent information related to the patient’s discharge needs.

• Participated in daily huddles with Case Managers and / or Social Workers to develop and implement a safe discharge plan for patients.

• Communicated and collaborated with hospital staff and physician for discharge planning.

• Maintained current information on insurance requirements and community resources.

• Developed and maintained a working knowledge of local and statewide rehabilitation facilities, infusion companies and hospice agencies.

• Working knowledge of level of care requirements for Medicare, Medicaid, managed care and private insurance carriers. Interfacing with insurance companies for patient discharge planning needs including authorization of outpatient or next level of care services.

• Performed administrative requirements such as completing forms including but not limited to IMM, MOON, and patient choice forms by getting patients’ signature and follow CMS regulations per policy.

• Participated in departmental and Association wide international meetings and in services, including staff meetings, Association wide forums, and seminars.

• Filled in for UM Coordinators when needed.

Baptist Hospital 09/2013 to 11/2015

Discharge Planner Miami, Florida

Coordinated post discharge services including home health care, durable medical equipment, nursing homes, oncology infusion, hospital transfers, transportation and service for the indigent population. Conducted post discharge follow-up calls and appointments to ensure that post discharge services were being rendered. Problem solving accordingly by contacting service providers to effect patient safety. Negotiated and coordinated donations from community service providers for unfunded and undocumented patients.

• Coordinated patients discharge evaluations.

• Facilitated patients’ discharge summary to their insurance provider to ensure coverage for patients’ care.

• Crafted a comprehensive discharge planning summary on the patients’ continued care of service and treatments.

• Well organized and experienced at managing facts with insurance policy coverage for patients.

• Excellent time-management skills in discharge planning involving coordinating meetings among doctors, outpatient care providers, and other services that are need and / or required for the patient. CHI – Community Health of South Florida 04/2008 to 04/2013 Managed Care Supervisor Miami, Florida

Supervised and coordinated activities of personnel in the managed care operations department of the health care facility. Oversaw staff that processed referrals, authorizations, billing, utilization reviews, and capitation for hospital services. Wealth of knowledge and experienced in utilization review techniques and protocols. Made decisive day-to-day decisions within the division to ensure a consistently smooth workflow with staff. Maintained thorough knowledge of functional area and department processes.

• Initiated preventative and health risk assessments.

• Completed incident reports in their entirety.

• Adhered to confidentiality policies and procedures and HIPSS regulations.

• Conducted and attended monthly meetings on managing critical cases with providers, writing clinical reports and managing HMO contracts, maintained all credentialing processes with CAQH forms.

• Pecos Software system experience.

• Attended in-service educational trainings and provided in-service presentations bi-weekly to new employees and providers.

• Maintained appropriate interdepartmental communications with staff.

• Audited employee referrals and prepared weekly and monthly productivity reports.

• Conducted annual employee performance reviews.

• Prepared and approved e-time payroll for staff.

Jackson Memorial South Hospital 07/2007 to 03/2008 Patient Financial Associate Miami, Florida

Conducted medical billing, collections, Medicaid adjustments, and resolutions of unpaid accounts. Reviewed Medicaid eligibility reports, and edited corrections on UB92 claims. Reviewed Medicaid payments from RA to determine contractual amounts. Requested medical records, MLA-alien, and BBA exhausted benefit accounts. Independently determined initial or ongoing patient insurance eligibility verification, investigated, and corrected accounts within Epic; including updates to patient demographics, financial information, and guarantor information. Researched missing or erroneous information on accounts using various portals and other resources; including outreach and identification of unknown payors.

• Reviewed and / or edited claims and appeals prior to submitting to clearinghouse.

• Followed up with payors via phone on unpaid aging claims.

• Reviewed denials and determined appropriate next actions; such as sending appeals or patient statements.

• Investigated payor underpayments.

• Completed position responsibilities within the department.

• Stayed current with relevant medical billing regulations, rules and guidelines.

• Maintained the strictest confidentiality; adhered to all HIPAA guidelines and regulations.

• Excellent problem-solving abilities and organizational skills.

• Ability to communicate effectively with all levels of staff through both verbal and written communications.

• Ability to work in a team environment.

• Ability to stay focused on task and work independently; motivated to perform quality work.

• Work well with others in a spirit of teamwork and cooperation. Educational Background:

• 04/2015 – 10/2016 Keiser University: BA Health Services Administration; GPA: 3.55

• 01/2010 – 10/2012 Associate of Arts: Health Services Administration; GPA: 3.42 Honor Roll 2012

• 05/1997 – 11/1997 Certificate, Sales-Health Variable Annuities

• 01/1994 – 02/1995 Certificate, Medical Assistant Awards:

• 1999 Outstanding Achievement Award – by Florida City, Chief of Police

• 2004 Ethics, Time Management Certificate

• 2006 Meritorious Award for Distinguished Service

• 2011 Certificates of BLS Healthcare Provider and CPR / First-Aid / The American Heart Association / Red Cross / OSHA and HIPAA

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