Arthur Spriggs

Accounts Receivable Manager

District Heights, MD

adwz5g@r.postjobfree.com

+1-202-***-****

Seeking and managerial position utilizing my extensive knowledge and expert experience as a leading and directing multifaceted medical team and a position which is offering opportunities for both personal contributions and professional growth,

Authorized to work in the US for any employer

Work Experience

Financial Advisor

The George Washington University Hospital - Washington, DC August 2017 to Present

• Responsibility and accountability to admission/registration process; patient flow from pre-registration through dismissal, and initial financial arrangements for accounts.

• Supports an organizational culture for Service Excellence and practice of Service Excellence standards to all customer groups.

• Utilizes the appropriate skills in accepting responsibilities of assignments while exhibiting teamwork, techniques and effective communications which contributes to the overall operation of the department.

• Manage and participate in, and contributes to quality improvement process for the Department and Institution. Applies appropriate policies and procedures, as set forth by the Department of Business System for the purpose of assessing and communicating patient’s needs, from pre-admissions through dismissal, by obtaining demographic and financial information, with explanation and collection of payments.

Accounts Receivable Manager

Walgreens Infusion/Option Care Inc - Catonsville, MD May 2014 to July 2017

• Implement policies and procedures to maintain workflow standards.

• Supervise aging report to assure compliance with company DSO standards.

• Responsible for end of month and financial reporting.

• Schedule and organize work assignments. Prioritize and delegate job task to ensure timely completion.

• Conduct performance evaluations and employee discipline.

• Supervise, train and motivate employees.

• Oversee collection activities per policy and procedure within the company.

• Audit collection activity regularly for compliance to policies and procedures and government regulations.

• Assist the daily functions of the billing center day-to-day operations. Process Lead A/R Representative

Sheridan Healthcare Services - City of Sunrise, FL August 2011 to October 2013

• Research all assigned contracted and or non-contracted carriers & self-pay accounts to ensure proper payment through reports, spreadsheets also special projects deemed necessary.

• processing of correspondence related to assigned contracted and non-contracted carriers to include self-pay accounts.

• Maintain the denial reports both electronically & manually to ensure that account is properly documented.

• Respond to CSR calls/requests forwarded that need to be resolved with collection tools available to strive to completed within a one-time resolutions actions required.

• Research denied & improper claims both electronically & manually processed by carriers under the assigned contracted & non-contracted rates that apply to ensure expected payment is received within the timely contracted agreements.

• Resubmitting improperly processed claims back to carrier either by phone calls or reconsideration forms both electronically & manually within timely filing of contracted carrier for proper payment.

• Identifying & correcting all processed errors to be refilled back to carrier to ensure the contracted payment is sent for services rendered to include (error electronically, data entry mistakes, correcting verification from any online services) & properly documenting the accounts of the actions taken to get resolved.

• Follow-up on status of claims both electronically & manually using all collections tools available (A/ R reports monthly, spreadsheets, incoming mail denials manually) or electronically appealing if need to submit with records that support services rendered to assist with ensuring the processing is being completed fully & payment is forwarded to the payer.

• Identifying the any unprocessed claims that were submitted incorrectly that need further reviewed either by Coding issues or NPI issues that require updating along with credentialing verification.

• Facility based responsibilities include creating claims& posting payments missing

• assist other departments with any back-up that is needed to contain the work flow not to allow a back- up to occur.

• following the rules abides by the Sheridan Healthcare company policy and procedures on collections efforts per company and/or state laws maintaining always good organizational and communicational skills.

• Being able to maximize your time by prioritizing daily work flow to ensure most effective time studies are met.

• Meeting the company daily and weekly productivities assigned by tracking hourly the work flow schedule daily.

• Working with both a specialized system created for collections in the Radiology department called

"Smart time worked in system is 1.5 years. Also, know the working functions of MS office suite, Word Perfect, E-mailing, E-faxing, Multi copier suite.

• Clearinghouse is Emdeon Claims Masters.

Collections Specialist - Temporary Assignment

Ultimate Staffing Services /Sheridan Healthcare Services - City of Sunrise, FL March 2011 to July 2011

• Data entry work into a newly developed Radiology System called (SMART)

• Front end verification for multiple insurance carriers in Emdeon CM & verification system and multiple other online verification system available on line.

• Scanning medical document both face sheets & medical records i.e. Radiology reports

• Creating the encounters (billing charges).

• Pulling remittance advises form various websites to batch for posting in the A/R area

• Creating the batches for scanning prior to posting.

• Maintain the spread sheet created from the bank that shows the electronic payments needed to be pulled for processing if not electronically crossed over.

• Responsible for keeping all line of communications open with other department for any requested information regarding missing remits.

• Responsible for meeting with the Manager to discuss any issue related to missing remits unable to provide form the banking grid.

• Multi-tasking at any given time to assist with any area in back log situations. Billing/Collections A/R - Temporary Assignment

Creative Financial Services/ Catholic Health Service - Lauderdale Lakes, FL October 2010 to January 2011

• Responsible for all aspects of the patient accounting process and A/B.

• Maximizing time between front-end and back end accuracy of data entered information for billing.

• Following up on claims processed thru Electronic billing software (SSI) with correcting of all edits that reject claims form crossing over. The Collections systems name is ANS (Kean Networks, Solutions).

* Primary responsibilities were the Managed Care accounts for the six facilities that the centralized billing department performed AIR activities.

• Ensures that the facilities assigned to them are performing at optimal level.

• Being responsible for conducting research contacting insurance carriers and filing claim appeals.

• Ensuring that all managed care contracts are being upheld and paid in accordance to the contracts per diem rates that are set both within the CEO master files and at the insurance carrier level to allow processing of corrected claims levels.

• Working various special projects on other carriers requested by the CBO Director to help resolve AJR clean-up that was not achievable by their F/T employees.

• Verification of billing address corrections within the system to ensure mailing not to be returned. Layoff from Caledonia 2-2010 to 10-2010

Team Lead A/R Representative

Caledonia Financial Services - Plantation, FL

October 2006 to February 2010

• The Accounts Receivable Analyst is responsible for reviewing and processing non-adjudicated claims older than 6o days

• Ensures that the facilities assigned to them are performing at optimal level.

• Analyzing the A/R monthly reports, identified issues preventing adjudication of claims, planning a solution and resolving A/R problems.

• My goals were to maximize revenues and minimize the time necessary for claims adjudication.

• Being responsible for conducting research contacting insurance carriers and filing claim appeals.

• Being responsible for making recommendations to Production Operations on how to improve front end processing to alleviate issues identified.

• Closely working well with other departments within such as: Payment Posting and Patient Services to problem solve and improve collections.

• Reviews Age Trials Balance's and CPU reports every other week, establishing goals and prioritizing workload.

• Recognizes potential problems including Provider Enrollment issues, HIC format problems, claims transmission problems, internal processing problems, erroneous demographic and insurance information etc. Problems identified shall be brought to the attention of the Director.

• Implements knowledge of practice procedures and policies while requesting the processes claims per the directives. The goal is to ensure that the claims are paid correctly in a timely manner.

• Handles Medicare invoices either via phone calls or tracer claims submissions. This includes calling for status, appealing claims, requesting medical records, researching payments, adjusting claims for non- payable procedures and time limits, updating insurance and financial classes in the system.

• Medicaid invoices, either via phone calls or Internet. Processing includes making phone calls for claim status, or Internet claim verification status, preparing extension forms or crossover forms, filing appeals.

• Processes non-Medicare and Medicaid carrier claims per policies and procedures.

• Processes Medicaid payment denials, including posting rejections, conducting appeals, and requesting medical records as needed. The payment denials are worked within seven working days after receipt.

• Reviews non-payment vouchers from insurance companies to determine steps necessary to resolve the claim.

• Being cross-trained in payment posting and patient services and serves to provide adequate back-up for vacations, sick days, and personnel shortages, also analyzes month end financial reports to identify potential problem carriers for each assigned facility. Reviews "not final" ATB every Monday for scheduled facilities to be reviewed in the upcoming week based on Accounts Receivable schedule.

• Preparing weekly report identifying invoices completed and issues identified during the week.

• Reads and updates provider manuals for Medicare, Medicaid, Tenn-Care, Blue Cross Blue Shield, etc. conveys relevant information to Data Entry staff.

• Communicates all client relation problems and managed care issues to Director. Advises and consults with other supervisors regarding similar departmental Accounts Receivable Issues Participates in weekly Accounts Receivables meeting and Accounts Receivable/Operational meeting. Education

MBA in General Studies

George Washington University - Washington, DC

High school diploma or GED

Additional Information

SKILLS:

• Experience of more than 10 years in the field of medical management.

• Exceptionally good in practices and principle of administration and development.

• In-depth knowledge of federal, state and local laws, principles of budget preparation and control.

• Profound ability to coordinate, manage and direct the technical and professional personnel,

• Strong ability to deal with the problems, identify the problems and implementation of the resolution.

• Good knowledge and ability of performance, supervision and training.

Contact this candidate