LESIA G. SEDORIS

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

Springfield Ohio 45502

CP: 937-***-****

adz3ys@r.postjobfree.com

QUALIFICATION SUMMARY: Experienced medical office manager with varied skills including human relations, medical billing and coding, insurance verification, expense tracking, payroll, physician scheduling, reception, patient screening/care, manual and automated record utilization/maintenance/filing, coordination with external medical offices/specialty clinics for referral treatment via phone/email/fax.

AREAS OF EXPERTISE: Medical Office Management, Medical Office Billing, Medical Office Administration, Office Automation

EXPERIENCE:

Feb 2020 to present, Practice Manager, AccessMD Urgent Care, 1010 Woodman Drive, Dayton OH 45342

Oversees the day-to-day execution of three urgent care clinic activities through effective management to team of 32.

HR responsibilities to include: recruiting, hiring, training, developing, employee relations, evaluating, and termination.

Ensures business functions and clinical activities follow all company policies and procedures.

Interprets and communicates policy and/or program changes with clinic staff to improve client services.

Investigates provider insurance, payment, and billing issues ensuring accurate outcomes.

Scrutinizes OSHA and CLIA standards ensuring compliance adherence.

Supply Management tasks to include inventory, ordering, and maintaining required supplies for all clinics.

Coordinates/facilitates vendor activities and services facilitating appropriate supplies/equipment for clinic procedures.

Inputs ICD-10 and CPT codes for submittal to EMR allowing expedient processing.

Discusses/recommends procedural changes to the Practice Administrator to increase efficiency in the work flow.

Oversees and approves monthly staff schedules ensuring coverage of providers, MAs, and receptionists for all clinics.

Reviews and approves employee payroll timecards ensuring accurate processing.

Nov 2019 to Feb 2020, Business Office Manager, Northwood Skilled Nursing and Rehabilitation Home, 2000 Villa Rd. Springfield, OH 45503

Coordinated/managed office functions to include: employee safety, accounts receivable/payable, and customer service.

Set-up/maintained financial files for residents to include: billing, state and Medicare reimbursement documents.

Discussed/recommended procedural changes to the Practice Administrator to increase efficiency in the work flow.

Managed billing and collection processes ensuring overall long-term care insurance billing accuracy.

Sep 2016 to Sep 2019, Regional Manager, Family Urgent Care, 879 North Bridge St, Chillicothe, OH 45601

Oversaw the day-to-day execution of six urgent care clinic activities through effective management to team of 52.

Spearheaded a company-wide scheduling and payroll system to decrease use of overtime, decrease payroll, and improve personnel utilization while not compromising customer service.

HR-related responsibilities included recruiting, hiring, training, developing, employee relations, evaluating, and terminations.

Ensured that business functions and clinical activities followed all company policies and procedures.

Communicated policy and/or program changes with staff to improve client services.

Over sight of provider files ensuring all met credential requirements and specifications.

Investigated provider insurance, payment, and billing issues.

Ensured compliance with OSHA and CLIA standards.

Supply Management tasks included inventory, ordering, and maintaining required supplies for all clinics.

Coordinated and facilitated vendor activities and services

Created and maintained statistics via spreadsheets and databases.

Maintained Patient Medical Record Confidentiality (HIPAA).

Nov 2013 to Sep 2016, Medical Billing Coordinator, Family Urgent Care, 879 North Bridge St, Chillicothe, OH 45601

Solely responsible for managing billing and claims department for six urgent care clinics.

Input ICD-9/10 and CPT codes for submittal to Supreme Open EMR.

Confirmed insurance coverage prior to billing submittal to clearing house.

Researched and resolved denials and EOB rejections within standard billing cycle timeframe.

Resolved billing issues identified by insurance carriers and patients.

Reviewed claim denials and payer requirements for corrective action and prevention in the future.

Researched and replied in a timely manner to insurance, patient, and internal customer inquiries.

Quickly identified and resolved medical billing, coding and insurance discrepancies.

Responsible for all follow up on insurance claims to Medicare, Medicaid and commercial insurance.

Maintained Patient Medical Record Confidentiality (HIPAA)

May 2012 to June 2013, Administrative Assistant/Medical Billing Coordinator, ECI/Symmetric Revenue Solutions, Inc. 1 South Limestone St, Springfield OH 45502

Compiled and reconciled daily charts to log and transmit to the billing company within 7 days of DOS

Assisted hospital’s HIM Department in the completion of Emergency Department (ED) Physician’s incomplete patient charts

Worked from the Exception Report (Web site) daily and provides information to Symmetric to minimize the percentage of monthly ED volume to align with partnership goals

Provided support to the ED physicians to include preparation of correspondence, opening and sorting of mail, and answering phones

Created and maintains statistics via spreadsheets and databases

Coordinated/collaborated with all levels of hospital and staff personnel

Identified problem areas and communicates those to the Symmetric Supervisor for resolution

Notified Symmetric of any unusual circumstances that may affect patient volume, billing and/or collections.

Completed assigned tasks and applies innovative problem solving

Maintained Patient Medical Record Confidentiality (HIPAA)

Jan 2012 to May 2012, Medical Billing Associate, Cardiologists of Clark and Champaign Counties, Inc., 1911 E. High St, Springfield OH 45505

Input ICD-9 and CPT codes for submittal to NextGen

Collected co-pay prior to client visit

Confirmed insurance coverage prior to billing submittal to clearing house

Input ICD-9 and CPT codes for submittal to NextGen

Proficient in MS Office programs

Nov 2009 to Feb 2011, Medical CoManager, Gastroenterology, Dr. K. L Reed, 2330 East High St, Springfield OH 45505

Responsible for the scheduling of patient appointments

Input ICD-9 and CPT codes for submittal to Medisoft

Confirmed insurance coverage prior to client visit

Collected co-pay prior to client visit

Performed office administrative functions to include filing, faxing, email and standard mail correspondence

Proficient in MS Office programs

Positioned clients in treatment rooms

Obtained vital signs and history and physical

Gathered pre-certification for patient procedures

Verified and deposits daily insurance payments

Followed up with patients in regards to test results

Received/verified patient referrals

Coordinated special procedures at surgical centers

Sep 2007 to Nov 2009, Medical Office Manager, Springfield Gastroenterology, 2355 Derr Rd, Springfield OH 45503

Responsible for all daily operations of gastroenterology center treating over 125 patients weekly

Troubleshot and resolved operational problems requiring management intervention

Input ICD-9 and CPT codes for submittal to Quadax Corporation

Built, maintained, and monitored patient records within the NextGen EMR software program

Received and posted EOBs electronically via NextGen

Evaluated candidates and hired personnel

Trained, educated, and evaluated seven staff members on all aspects of facility functions

Ensured timely and accurate payroll submission for all clinic personnel

Coordinated Medical Representative meetings and training sessions

Instituted training in OSHA, customer service, infection control, and all software technologies

Mar 2005 to Sep 2007, Medical Secretary, Advanced Neurosurgery, Inc. 3533 Southern Blvd. Suite 3000, Kettering OH 45429

Coordinated patient’s schedules for up to 50 patients per day for two neurosurgeons

Utilized and input medical diagnosis codes into medical database ensuring accurate insurance billing

Collected and input insurance information into database

Utilized Appointment Pro and Medi-Soft software programs

Received patients to include check-in procedures, insurance verification, service fee collection (co-pay), and patient positioning in exam room

Provided and instructs patients on use of numerous medical forms

Prepared and files patient records to include billing data

Followed up with patients to ensure appointment availability and ensures all required items, i.e., lab results and X-rays accompany the patient

Coordinated with other medical facilities in regards to patient referrals

Responsible for overall office administrative functions to include faxing and automated faxing, answering phone inquiries, obtaining pertinent patient reports, and office mail screening and distribution

Feb 2004 to Jun 2004, Office Automation Clerk, Evaluations Section, USAF, 426 5th Ave STE 5, Sheppard AFB TX 76311

Accurately reviewed Evaluation Performance Reports (EPR) and Officer Performance Reports (OPR)

Tracked and filed all EPR/OPRs in local automated system

Ensured EPR/OPRs are received by the customer service function and placed into individual Unit Personnel Record Group (UPRG). Updated all new data in the Military Personnel Data Base (MILPDS)

Coordinated referral reports with Air Force Personnel Center (AFPC) and individual units

Communicated/tracked overdue and late reports with AFPC and individual units

Coordinated EPR/OPRS with gaining/losing bases ensuring timely inclusion in UPRG

Mar 2002 to Feb 2004, Office Automation Clerk, Student Assignments, USAF, 426 5th Ave STE 5, Sheppard AFB TX 76311

Maintained vast knowledge/use of office programs such as electronic mail and Microsoft office automation programs: Word/Excel/Access/Outlook.

Maintained 300 student records annually

Briefed students on relocation processes

Assisted students in administrative requirements

Controlled assignment notification process/out-processing actions for technical training squadron

Created/edited a variety of standardized documents necessary in performance of assigned duties

Prepared/maintained office records of various types

Directed telephone calls/visitors to appropriate staff/office

Mar 2001 to Mar 2002, Mail Clerk, USAF, BITC, 527 I Ave, Sheppard AFB TX 76311

Processed in/outgoing mail. Delivered/picked-up all base mail

Operated paragon machine to affix accurate postage

Utilized pertinent AF Forms to accomplish postal actions

Analyzed all transactions with automated information systems

Sorted all mail by base organization

Drove/delivered base mail to more than 20 squadrons daily

Designated as sole trainer for new staff

EDUCATION:

Fairdale High School, Fairdale KY, 1982

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