Data Entry Call Center
Resume:
OBJECTIVE
Seeking a challenging and responsible position which will utilize my extensive business experience, as well as the following proficiencies:
•Sstrong organizationak and time management skills
•Sstrong problem solving skills
•Ssuccessful troubleshooting skills
•Ttotal understanding of order intake to cash receipts
•Sstrong computer skills (Word, Excel, Power
Point, Microsoft office, etc.)
•Eeffective communication skills
•Sstrong ability to manage and motivate team
EXPERIENCE
American Treatment Network
3/2022-11/2022
Director of Reimbursement
●Responsible for overall functions of the Reimbursement Services Department
●Responsible for insurance eligibility, collections, cash application and billing
●Work closely with CEO/COO to ensure aligned with company goals
●Responsible for creating policies and procedures
●Responsible for clean-up of outstanding AR and billing issues
●Manage team of five external billing company while transitioning to in-house team
●Enhance Phone tree
MedZed Physician Services
11/2020-3/2022
Director of Reimbursement
●Responsible for overall functions of the Reimbursement Services Department
●Managed team of five Reimbursement Team members
●Responsible for insurance eligibility, collections, cash application and billing
●Work closely with CFO to ensure aligned with company goals
●Decreased time to billing from 2 weeks to 1 day
●Responsible for creating policies and procedures
●Responsible for clean-up of outstanding AR and billing issues
Project Home – Stephen Klein Wellness Center
8/1/2016-11/2020
Practice Manager
●Manager of an FQHC Practice – Medical, Dental and Behavioral Health front office functions
●Responsible for overall operational functions of all front desk processes
●Created policies and procedures to ensure company goals are met
●On the Leadership Team of the practice
●Managed 12 team members in the practice dental, medical, behavioral health and MAT areas for patient intake, authorizations, insurance verification, benefits counseling, billing and collections.
●Work closely with the Director of Operations to ensure front end processes are allowing for clean billing and cash collections
●Manage hospitality process
●Responsible for ensuring all medical documents are scanned into the EMR timely
●Responsible for maintaining a calm and welcoming Practice environment
●Responsible for de-escalation of patients and clients
Healthcare Consultant
7/2015-3/2016
●Assisted Pennsylvania, Delaware and New York Health Departments in obtaining contracts with Medicare/Medicaid and commercial payors
●Created intake, billing and collection processes
●Trained Health Departments on intake, billing and collections for Medicare/Medicaid/Commercial Payors
●Developed HIPAA Training and trained Health Department Team Members
●Developed Basic Insurance Training and trained Health Department Team Members
NovaSom, Inc.
12/2010-3/2015
Sr. Director of Operations 5/2013-3/2015
Director of Reimbursement 5/2011-5/2013
Reimbursement Consultant 12/2010-5/2011
●Responsible for the overall operational functions of data entry, insurance verification, scheduling, clinical, device retrieval and reimbursement
●Prepare and implemented policies and procedures to ensure timely order processing, reimbursement and increase sales
●Worked closely with Financial team on forecasting
●Decreased time to service by 3 days, decreased cancellations by 5%, increased completions by 10%, increased patient satisfaction to 95%
●Developed automated processes, productivity and quality controls to grow sales but not grow staffing as sales increased
●Increased cash collections and recorded record months, developed goals and incentives, decreased time to billing by working with IT team to create interface from clinical system
●Decreased bad debt by 26%
●Increased first pass pay rate by 20%, decreased scrub denials by 70%, decreased front end denials by 59%, increased collector productivity by 50%
●Led team on implementing Salesforce.com and NextGen
●Decreased time to billing by 60%
●Prepared call center metrics to ensure all company goals met
●Implemented bonus plan for all departments based on orders received that resulted into positive cash flow
●Managed team of 25
●Created and managed staffing model
●Prepare and manage department budgets
CardioNet, Inc., Conshohocken PA
2/2003-8/2010
Vice President, Customer Care and Reimbursement Services 11/2009-8/2010
Sr. Director of Customer Care 11/2008-11/2009
Director of Reimbursement Services 5/2004-11/2008
Manager of Reimbursement Services 6/2003-5/2004
Manager of Insurance Verification and Authorization 2/2002-6/2003
●Responsible for the overall operational functions of data entry, insurance verification, scheduling, clinical, device retrieval and reimbursement
●Implemented Regional Pods to work with Sales Team on increasing sales
●Decreased DSO by 40 days within 3 months
●Decreased time to billing by 86% (from 19 days to 2.67), decreased unbilled by 87% (from 3,898 to 500) implemented Emdeon automated processes for benefit verification, billing and ERA processes
●Increased cash collections and met all company goals
●Managed team of 5 Managers and 2 Supervisor
●Created staff models to minimize cost
●Led team on implementation of NextGen billing system
●Prepare and manage department budgets
●Interictal part of team who worked on Sox Compliance and Public offering
LEGEND HEALTHCARE (formerly EquipNet, Inc.), Sharon Hill, PA
5/1995-5/2002
Director of Coordinated Care 1/2001-5/2002
Director of Customer Service 8/1999-1/2001
Director of Provider Placement 11/1998-8/1999
●Responsible for the overall operational functions of data entry, insurance verification, authorizations, reimbursement
●Implement Customer Service goals/metrics
●Led team on implementation of new phone system
●Managed team of 15
●Developed staffing model
●Increased call answer rate to 98% and reduced call abandon rate to 2% by implementing real time call monitoring and reporting system
●Implemented Quality Management Department to investigate customer complaints, seek resolution, and change or implement policies and procedures if necessary. Member of the CQI (Continuous Quality Improvement) Committee
●Prepared departmental budgets
●Decreased pending billing by 60%
●Responsible for client meetings and implementations
REFERENCES
Ron Mikolajczak
Vice President of Managed Markets
adv7jq@r.postjobfree.com
Philip Leone
Executive Vice President Reimbursement and Compliance
adv7jq@r.postjobfree.com
James Richter
adv7jq@r.postjobfree.com
Principle at Jericho Equity Partners
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