Resume

Medical Billing Patient Services

Location:

Hughson, CA

Salary:

85,000

Posted:

December 16, 2022

Contact this candidate

Resume:

Melissa Foreman

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

Hughson, CA

209-***-****

adt3ii@r.postjobfree.com

#Readytowork

Hello Recruitment Department / People Operations/ HR Department, In today’s healthcare workforce climate it requires an alignment with the organizational strategy, understanding the project selection and knowing who the key stakeholders are. Working in collaboration to facilitate organization-wide initiatives with other key departments is critical. In an innovations team it is comprised of a network of resources which identifies risks, initiates assessment, response development, contingency planning and response control. To accomplish this requires a leader with the ability to inspire others by working cohesively to create synergy and to apply situational decision making toward achieving extraordinary positive results. Most importantly you are much more likely to lead high performance teams when you are part of the organizational culture that fosters cooperation and trust. Core competencies:

• Provider payer enrollment and hospital credentialing

• Qgenda provider scheduling

• Proficient in complex monthly invoices

• Proficient in using Docusign

• Entrusted with provider 401K/Retirement plan data, bank statements and practice invoices

• ADP/Lawson payroll programs

• Taleo recruitment software application

• Oracle HCM software application

• QView workforce scheduler to reduce overtime and identify peak performance hours

• Utilization of work order ticket systems

• Data mining and used report algorithms to identify positive and trends

• Proficient in TEAM to collaborate and meet deadlines

• Facilitate strategic planning meetings with executives, key stakeholders and pertinent internal and external departments

• Proficient in video conference meetings using Ring Central, Zoom and GoToMyPC

• Project manager for new policies, vendor selections and change management teams

• Developed productivity enhancement incentive programs

• Developed training modules for compliance, new hire orientation and manuals

• Facilitated RCM Vituity, PM Finance, Moss Adams and Citi National bank audits

• Proficient in CPT, ICD-10, HIPAA, EMR Healthcare Consulting, IT/IS Technology, E-learning, management of remote workforce and regulatory compliance

Kind regards,

Melissa Foreman

Experience

Zotec Partners, LLC: Client Modesto Radiological Medical Group Total Duration: 7 months (Oct.2020-present)

As an Associate Practice Manager I was delegated the task to modernize the clients medical billing and practice management services which is primarily for the hospital based specialty market. At the clients request Zotec provided onsite personalized service this role required an onsite office support person. I was challenged with the opportunity to provide exceptional client collaboration and to build rapport with the client, hospitals, clinics, coding and revenue cycle departments. Within the first 60 days I had transformed all paper processes into electronic formats. As a client liaison I and attended the strategic meetings tasked to communicate challenges and changes to Zotec. Tom Organ, CEO MRI comprised an email to my medical directors, “It was a pleasure working with me! I was always professional and positive when I was attending the executive meetings.”

The essential operations for this practice is the management of 24 practitioners and 52 locums from various staffing agencies. I was trusted to recruit talented providers to our area, interact with the medical office staff, hospital directors, CEO’s, CFO’s and executive board members. Modesto Radiology Medical Group provides Interventional Radiology, Mammography, Diagnostic Radiology, Teleradiology and Neuroradiology at five separate locations. It required the meticulous and timely completion of the providers credentialing documents. This included renewal applications for the DEA, CA Medical Boards, Xray Supervisor and Operator certifications, current CVs, Norcal certificate of insurance, hospital reappointments, industry membership renewals, OIG clearances and CME tracking. Vituity Revenue Cycle Management DBA: MedAmerica Billing Services, Inc. Total Duration: 28 years 9 months

Vituity Patient Services Senior Manager DBA: MedAmerica Billing Services, Inc. June 2014 – May 2020

Managed day to day operations of Patient Services with approximately 50 staff members; supporting 1800 contacts per day, with aggressive SLA and less than 3% abandonment rate, 80% first call resolution, and 96% customer satisfaction. Core strategic driver is a commitment to provide the best possible patient experience and to make an impact in a fast growing organization.

The essential management functions is sensitivity to cultural diversity, ensures existing processes support high levels of performance while continuously reviewing and refining those processes to make additional improvements. Implements quality control measures to ensure compliance with department, hospital and policies, government codes and regulations. Determines and assesses need for staffing levels and to make the appropriate recruitments if necessary. Payroll approval using ADP and Lawson Time Star.

MedAmerica Billing Services, Inc. Associate Director June 2014 to May 2020

• Patient Services, Specialty Clients, Emergency for Los Angeles and San Diego Regions Emergency, Urgent Care, Hospitalists, Skilled Nursing Facility, HBOT, Critical Care, Trauma

• Monitored and directed managers in the management of accounts receivable.

• Compiled reports and analyzes data and site performance by major payer category. Analyzes Performance Management report by site and provides an executive summary of action items needed to be proactive in addressing client concerns.

• Identified financial performance, team structure, and other areas needing improvement and assists division managers in developing corrective action plans. Responsible for the implementation of action plans.

• Interfaced with regional and medical directors to answer questions or resolve issues. Attended site visits and participates in conference calls.

• Conducted staff meetings with billing operations personnel, and conferred with subordinate personnel to discuss operational problems or explain procedural changes or practices.

• Developed procedures and controls to promote communication and adequate information flow within the organization.

• Assisted Director of Operation in facilitating the implementation of site specific and organization-wide programs and initiatives.

• Worked with Director of Operations and division managers in the preparation of short-term-plans and budges based on company goals and growth objectives, including productivity and audit standards. MedAmerica Billing Services, Inc. Client Service Manager (CSM) Specialty Clients, Emergency for Los Angeles and San Diego Regions August 2002- June 2014

• Management of (6) subordinate supervisors and 48 employees.

• Directs all operations of the multi-million dollar emergency business for the San Diego and Los Angeles areas. (12 Hospitals, 14 Hospitalists, 2 Wound Care & HBOT Centers).

• Challenged to turnaround a declining collection loss and improve financial performance.

• Developed and implemented performance and quality improvement programs.

• Established strategies to improve workflow processes from the hospital to billing service.

• Managed overall site performance in accordance with company policies.

• Implementation of new product lines of business.

• Participated on the project planning team to identify and select a coding software vendor. Transitioned, Sovera, Cerner, IBEX, Quadramed, Siemens, and EPIC electronic applications of registration, hospital data capture patient record, dictation, progress notes and discharge information.

• Payroll approval using Lawson Time Star.

Big Valley Commercial / Medtech Billing Services

Operations Manager December 1999 – August 2002

Consultation services and managed new client transitions to the billing company. Straub Hospital, Hawaii, HBOT Services John Muir, Radiation Oncology groups, Radiology groups, Brachiotherapy groups, Orthopedic practices, Bunche Medical Clinic, Trauma, Dr. Lowenberg’s Ilizaroff procedures at UCSF.

• Managed (6) subordinate managers and 60+ employees.

• Extensive knowledge in billing, coding, provider payer contract adherence, negotiations and denial management.

• Credentialing of all new client providers with all payer types (Medicare, Medicaid, Commercial, Workers Compensation and location specific payers).

• Directly responsible for clients’ accounts receivable and to improve outstanding collections for all payer types which includes Medicare, Medicaid, Medicaid Managed Care, Medicare HMO, Workers Compensation, Commercial and Contracted payer types.

• Collaborated with payers to submit clean claims and to reduce rejections and underpayment of services.

• Obtained all billing components to submit a clean claim which included demographics, patient encounter Notes, dictation, prior eligibility, surgery pre authorizations, ABN notifications, updated charge masters, applied appropriate CPT/diagnosis codes/modifiers. Education

Southern New Hampshire University

Bachelors of Science Degree

Health Care Management /Administration and Business Dates attended and graduation completed 2013 – 2017 National Society of Leadership and Success

Chapter Sigma Alpha Pi

Health/Health Care Administration/Management

Dates attended and graduation completed 2013 – 2017 Certified Professional Coder (AAPC) – 15 years

Volunteer Experience / Teen Challenge

Charity Program Chairman – Since 2005

Organizations

References:

Member of AHIMA

The National Society of Leadership and Success