Michele Gooden
*******.******@*****.***
Directs all activities associated with a full agenda of an operating department's day-to-day production regimen
Manages overall staff administration, including Permanent or Temporary employee staffing models, recruiting, performance management, salary administration, with oversight of exempt and non exempt staff
FUTA, SUTA, FICA, FMLA, Federal and State labor laws and Workers Compensation Credentialing and Contract Negotiations with Medicare, Medicaid, and Third-Party Payor’s Designs, implements, and manages necessary operational workflows Prepares, produces, and delivers management reports on a daily, weekly, or monthly frequency Marketing and business development
EMR Navision, Centricity, Mysis Tiger and Med manager Medicare and Medicaid changes and ICD 10 implementations Focused in AP/AR, payroll, billing, collections, and HR Access, Word, Excel, Works, Power Point, Peachtree and Quickbooks software Financial Analyst
Create and maintain budget
Work History:
02/2015- Present- Aurora Mental Health Credentialing Specialist/Contract Negotiations Interface and collaborate with internal and external professionals, including accreditation and government regulation representatives
Processing Medical Staff applications to verify compliance with regulatory requirements and accreditation standards Primary source verification of information Collection and analysis of information received
Getting providers licensed in multiple states.
Ensures that all documentation is current, accurate and meets all necessary requirements for JCAHO and NCQA. Experience with credentialing in a Medicare Managed Care Plan and large provider group with Medicaid, Third party Payors, practitioner enrollment and provider network management experience Experience with medical and professional credentialing processes, policies and procedures, including delegated credentialing requirements
Experience with contract negotiations in a Medicare Managed Care Plan, large provider group with Medicare and Medicaid, Tricare and Third-Party insurance.
Facility certification
Experience in practitioner enrollment for Kaiser,Optum,CAQH Proview and provider network management 09/2009- 02/2015- AllTech Mechanical- Office Manager Payroll
Human Resources
Accounts Payable/Accounts Receivable
Invoices
Budget
Forecasting
07/2008 -09/2009 -Erickson Retirement -Practice Administrator Payroll Managed all aspects of payroll for 20 employees Managed family practice and 10 physical therapy departments
Recruited and hired 6 specialty physicians to work part time at our site to fulfill the needs of the patients. Business development
Credentialing
Contract Negotiations
Hospital Privileging
A/R Worked the account receivable and posted payments to accounts Workman’s Compensation claims and case management
A/P Performed all accounts payable
Prepared and maintained Yearly budget and financial analyst reports Hired and fired all employees, completed 90 day and annual performance reviews. Drug and alcohol testing
Wellness Classes
CLIA
03/2004- 07/2008- Metropolitan Women’s Healthcare- Office Manager Payroll Managed all aspects of payroll and 401k
Raised patient satisfaction from 36% to 97% in less than a year Marketing and Business development
Grant writing
Credentialing
Hospital Privileging
Contract Negotiations
Month end reconciled all monthly reports: bank records and credit card payments. Human Resources, hired and fired all employees, performed 90 day and annual reviews, administered health plans and 401k.
Wellness and birthing classes
Created and maintained monthly and yearly budget and cost analysis
. Deposits
Financial analyst reports
In-house Billing
AR/AP completed all Accounts Receivable and Accounts Payable utilizing the Quickbooks program. 09/2002- 03/2004 - Liberty Medical Center at Coors - Office Manager Payroll Managed all aspects of payroll for 16 employee Workman’s Compensation claims and case management
Managed family practice, work comp and physical therapy departments Business development
Credentialing
Contract Negotiations
A/R Worked the account receivable and posted payments to accounts. A/P Performed all accounts payable
Reconciled end of the month reports, bank records and credit card payments Yearly budget and Financial analyst reports
Human resources hired and fired all employees, completed 90 day and annual performance reviews. In -House Billing
12/2001- 07/2002 -Dental Health Centers- Office Manager Payroll 8 employees utilizing the Dentrix system Marketing and business development A/R Worked the accounts receivable and posted payments to the appropriate accounts. Billing
Created monthly statements for clients and insurance companies Contracts Wrote and reviewed contracts with patients including down payment and monthly payments. 10/1994- 11/2001- Union First Pediatrics- Office Manager Month end reconciled all monthly reports; bank records and credit card payments Billing created and sent monthly statements to insurance companies and patients Human resources hired and fired all employees, performed 90 day and annual reviews, administered health plans and 401k
Grant writing
Created and maintained yearly budget and cost analysis Credentialing
Contract negotiations
Restructured and controlled medical office supplies and ordering format. Collections Sent out monthly statements and worked closely with a collection agency. AR/AP Completed all Accounts Receivable and Accounts Payable utilizing Peachtree system.
Budget Maintained monthly budget
12/1989- 04/1994 - United States Navy Hospital Corpsman-Honorable Discharge Iraq War -Desert Storm/Defense Service Medal
Sharp Shooter Medal
Manager of the Emergency Room treated 60- 120 patients a day Manager of Surgery Clinic treated 10- 20 patients a day. Manager of Pediatric Clinic treated 30 -50 patients a day. Education:
Almeda University Great Lakes-2009 -MBA- Healthcare Administration Almeda University Great Lakes-2003- Bachelor Business Administration Arapahoe Community College-1994-1996 Prerequisites Hospital Corps School -1990-1991- Nursing
Colorado Medical and Dental Careers-1989-1990 Pharmacy Tech