Department Secretary Admitting Clerk
Resume:
Laura J. Ferreira
**** *** ****** *** **** *** Work & Cell s 904-***-****
Jacksonville Beach, Florida 32250 **************@******.***
SOFTWARE/COMPUTER EXPERIENCE
Microsoft Office (Word, Excel, Power Point & Outlook)
Mosiaq
Cerner Powerchart
Testrat
Avaya
Wilma / SMS System
Relay Health
Emdeon
Change Healthcare Assurance & Clearance
Craneware
Kronos Timekeeping System
SPECIALIZED EXPERIENCE
Customer Service Management and Leadership
Healthcare Revenue Cycle Leadership / Financial Clearance
Medicare, Medicaid, Worker’s Compensation and Commercial Payors including Blue Cross Blue Shield, Aetna, CIGNA, and United Health
Human Resources / Personnel Administration
Retail, Infusion Pharmacy and Limited Durable Medical Equipment (DME) Billing, Collections and Business Practices.
CERTIFICATES
HFMA Certified Specialist Managed Care (07/15 – Present)
PROFESSIONAL ORGANIZATIONS
HFMA - Healthcare Financial Management Association – Member
NAHAM – National Association of Healthcare Access Management
Duval County PTSA Health and Safety
CORPORATE ACTIVITIES
Baptist Health United Way Committee (current)
Baptist Health Peer Review Grievance Resolution Committee (current)
Baptist Home Health and Infusion Pharmacy Operational Improvement Project (past) Joint Commission Survey
Baptist Medical Center Credit Union Loan Review Committee (past)
Consolidated/Pavilion Home Health Advisory Board (past)
NOTARY PUBLIC – STATE OF FLORIDA
State of Florida Notary Public (1996-Present)
Commission # FF930129 – Expires 2023
EDUCATION
Florida State College of Jacksonville (2018-2019) will return 2022
Florida State College of Jacksonville (1984-1996)
SUMMARY OF EXPERIENCE
34 years Billing/Collections Management experience in all facets of pharmacy and medical insurance billing and collections, including commercial/government insurance and patient billing (837, 1500, Universal, UB 04), ICD 10, HCPC, CPT4 coding, charge entry, payment posting (manual and electronic 837). Skilled and dedicated professional offering a solid background in administration, operations, and leadership within the Healthcare Revenue Cycle Industry.
Customer Service Management and Leadership
Demonstrated Leadership Ability, Initiative, Teamwork and Assertiveness.
Complete Understanding of Third Party Payor and Managed Care Requirements, Procedures and Regulations.
Complete Understanding of Primary, Secondary, and Tertiary Insurance Requirements, Procedures and Regulations.
Face-to-Face and Telephone Customer Service Skills and Experience.
Effectively Communicates with a Variety of Internal and External Customers.
Receives and Expresses Detailed Information Through Oral and Written Communications.
Works in High Volume and Team-Oriented Environment.
Takes Directions and Works Independently.
Uses Specialized Applications Software and Computer Systems for Patient Registration and Scheduling.
Healthcare Revenue Cycle Leadership / Financial Clearance
Insurance Verification and Authorization.
Denial Management and Contract Management.
Implementation of Process Improvement and Operational Efficiency to Meet Regulatory Compliance Guidelines.
Orientation and Training.
Mentors Employees through Staff Engagement and Commitment to Strategy, Mission and Goals.
Enforces Departmental Policies, Practices Procedures and Work Rules in Accordance with Approval Hospital Policies.
Assists in the Development of New Policies and Provides Feedback to Director.
Human Resources / Personnel Administration
Employment Recruiting and Employee Relations.
Compensation and Benefits.
Developed and Design Job Descriptions.
Performance Evaluation Preparation.
Maintained Merit Increase Percentages.
Developed and Maintained Policy and Procedure Manuals.
New Employee Orientation and Training.
Corporate Compliance and Risk Management.
Pharmacy Licensure Form Preparation Experience
State of Florida – Agency for Health Care Administration (ACHA).
State of Florida – Health and Rehabilitative Services (HRS).
Department of Business and Professional Regulation.
Florida Board of Pharmacy.
Drug Enforcement Administration (DEA).
Medicare and Medicaid.
Unisys.
Joint Commission on Accreditation of Health Care Organizations (maintain correspondence required to maintain compliance with Federal and State Laws and Regulations).
Laura J. Ferreira
Page Two
EXPERIENCE
1986 - Present Baptist Health System, Inc., Jacksonville, Florida
Revenue Cycle PFS Education & QA Manager
2019 – 2022
Baptist Heath System – Patient Financial Services
Oversee the PFS Educators whom are responsible for providing education for the PFS new hires, process training and team members who need remediation training.
Oversee the PFS Quality Assurance team members who are responsible for reviewing PFS Billing and Follow Up team member’s accounts. The QA Specialist evaluate the work of their peers to continuously improve the organizations processes in being effective and congruent with the company’s mission, values, and goals. The QA team provides feedback, training, and may even implement new processes in order to ensure patient assurance and satisfaction
Responsible for identifying and implementing strategies to improve processes, promote operational efficiency.
Active engagement and collaboration with operational leadership and staff.
Promotes the standardization and alignment with the overall vision of the organization.
Collaborates with the Baptist Health leadership and the revenue cycle leadership to set initiative goals, pinpoint opportunities to fortify the patient experience, and develop effective patient access operations.
Organizes functions through establishing clear accountabilities, delegation of duties and appropriate departmentalization without creating silos.
Develops and maintains an effective, visible and well-respected team by selecting, evaluating, coaching and managing the performance of qualified processionals.
Coordinates and serves as primary liaison for communication with PFS Teams, PFS Leaders and PFS QA Specialist to ensure designated QA criteria is met and maintains Quality and Quality Improvement.
Prepares performance appraisals, provided feedback, and coaches PFS employees to enhance productivity, staff cohesion and teamwork.
Revenue Cycle Financial Clearance Manager (Total Access Program)
2017 – 2019
Baptist MD Anderson
Managed the MD Anderson Authorization Team consisting of 22 team members and responsible for daily operations of all functions of the Authorization Teams for over 50 Physicians, including referrals for office visits, authorization for hospital/facility services including diagnostic testing, chemotherapy, and surgeries for oncology patients.
Responsible for identifying and implementing strategies to improve processes, promote operational efficiency, enhance the patient experience and meet regulatory compliance guidelines.
Actively engaged and collaborated with operational leadership and staff.
Achievement of annual and periodic goals for significant statistical indicators of patient access performance and support the organizations’ overall financial performance.
Promoted the standardization and alignment with the overall vision of the organization.
Collaborated with the executive-level and revenue cycle leadership to set initiative goals, pinpoint opportunities to fortify the patient experience, and develop effective patient access operations.
Organized functions through establishing clear accountabilities, delegation of duties and appropriate departmentalization without creating silos.
Developed and maintained an effective, visible and well-respected team by selecting, evaluating, coaching and managing the performance of qualified processionals.
Negotiated and recruited with other department managers the need for cross training and support in areas as necessary.
Coordinated and served as primary liaison for communication with physicians, nurses, and pharmacists to ensure medical necessity/medical coverage for appointments and procedures.
Implemented and maintained Quality Improvement Program, proactively implements approved action plans to resolve problem areas, actively participates in goal setting for the practice, and coordinates the efforts to meet the goals.
Implemented denial tracking and education to staff to reduce systems overall denial rate.
Prepared performance appraisals, provided feedback, and coached employees to enhance productivity, staff cohesion and teamwork.
Revenue Cycle Billing Manager
2016 - 2017
Baptist MD Anderson
Managed the MD Anderson Billing Team and managed Physician (1500 Claim Form) and Hospital Billing (UB04 Claim Form) to ensure accurate revenue was captured and billed in a timely manner.
Served as a resource to research and communicate to providers, physicians, clinical staff and other medical professional regarding billing documentation policies, procedures, and regulations.
Actively maintained knowledge of CPT and ICD10 coding guidelines, government regulations, protocols, and third party requirements regarding billing and ensured Billing Teams were updated on any billing changes.
Hired and trained new employees to use billing software and understanding of revenue cycle management.
Billing and Collections Manager
1990 – 2015
Pavilion Plaza Pharmacy, Inc., and Pavilion Infusion Therapy, Inc., a division of Pavilion Health Services (for-profit corporation of Baptist Health System generating more than $60 million annual gross revenue in health care related businesses).
Managed intake, billing, collection staff and operations related to Retail Pharmacy, Infusion Pharmacy and Home Medical Equipment.
Managed intake functions, claims submissions, accounts receivable, insurance appeals, third-party audits and customer service.
Administered various department resources, plans and procedures for all company personnel; assisted in development and implementation of personnel policies and procedures; prepared and maintained employee handbook and policies and procedures manual. Managed performance standards and evaluations. Maintained company organizational charts and employee directory.
Administered compensation program; monitored performance evaluation program and reviewed as necessary.
Participated in developing department goals, objectives, and systems.
Project Management – developed and implemented collection projects to reduce AR collection day from an average of 55 days to a low 26-36.
Managed evaluations of patient’s financial status and established budget payment plans for self-pay/private-pay patients.
Participated in monthly operations meetings and provided feedback to pharmacy leadership on business-related functions and overall AR management.
Evaluated reports, decisions and results of the Billing and Collection Department in relation to established goals. Recommended new approaches, policies and procedures to effect continual improvements in efficiency of department and services performed.
Maintained compliance with Federal and State Regulations concerning billing and collection processes. Responsible for pharmacy’s re-Certification and license renewal process for all locations. Including governmental and licensure form preparation.
Prepared correspondence, contracts, and proposals. Analyzed, compiled and audited Data. Developed spreadsheets, statistical information, and customized special Reports. Contract management.
Performance Improvement / Patient Satisfaction Trending. Quality Improvement Reports. Public Relations and Conflict Resolution. Sales and Marketing Materials. Negotiation of Purchase Agreements.
Department Secretary / Admitting Clerk
1988 – 1990
1986 - 1988
Assisted the Director of Social Services and Director of Admitting and Director of Social Services and Director of Admitting for Baptist Health System
Prepared business correspondence for the Director of Admitting.
Reviewed and maintained Charity Fund for the Baptist Health Social Services Department.
Prepared weekly staff meeting minutes and maintained departmental budget and expense accounting systems.
Registered patients for outpatient services – obtained, verified, and entered all patient demographic, insurance information into software.
Collected copays and evaluate patient’s financial status to determine if patient needed to be referred to the Baptist Health Financial Counseling Department to enrollment in a payment plan.
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