SM

SHARON MOORE

adzfhz@r.postjobfree.com 404-***-**** Clarkston, GA 30021

Talented Administrator highly successful at motivating teams and streamlining operations. Analytical problem solver and persuasive communicator with talent for thinking outside box for creative solutions. Leadership Roles

Accounts Receivables

Microsoft Excel

Medical Office Experience

Hospital Revenue Cycle Management

Practice Management

Medical Terminology

Medical Coding

Managed Care

ICD-9, ICD-10

Medical Collections

Account Reconciliation

Insurance Verification

Bank Reconciliation

HIPAA

Medical Records

Anatomy Knowledge

Management

Documentation review

CPT coding

IVR

Customer service

Typing

EDI

Cash handling, Payment Posting

Front End Administrator

Audits (10+ years)

Basic math

10 key calculator

Phone etiquette

Accounting

Primary care, FQHC, Multi-specialty billing

Patient service

Medical scheduling

Medicare

Healthcare management

Laboratory experience

Supervising experience

Employment & labor law

Epic

Medicaid (10+ years)

Contracts (10+ years)

NATIONAL DEAN'S LIST FRESHMAN YEAR- Baker

College

MANAGEMENT, PROJECT MANAGEMENT,

SUPERVISION, MICROSOFT OFFICE SUITE,

CENTRICITY, IDX, GPMS, Athena Health,

RAINTREE, EMR/EHR, CERNER, nTHRIVE, KAREO,

CENTRIX

CMS 1500, CM-1450/ UB-04,

HIPPA COMPLIANCE

Project Management

Budget Development

Attention to Detail

Oakhurst Pediatrics Decatur, GA

Front Desk Administrator

11/2020 - Current

Patient registration, eligibility, check-in, check-out, follow-up, scheduling, payment posting, faxing, scanning, payment collection, emails, Athena Health system

Maintained transaction security by verifying payment cards against identification

Designed employee work schedules to address complete operational needs Generated reports to suggest corrective actions and process improvements Summary

Skills

Experience

Aided colleagues, managers and customers through regular communication and assistance

Adapted to workflow changes and implemented continuous process improvements to overcome obstacles.

MEDICAL BILLING MANAGEMENT LLC

Atlanta, GA

REMOTE MEDICAL REVENUE CYCLE

MANAGER

02/2012 - 03/2020

Monitored and guided revenue cycle operations over 14 million Supported clinical team members with revenue cycle procedures and addressed issues

Completed financial reporting and analysis for billing revenue cycle for hospitals group practices and SNF

Identified discrepancies between budgetary targets and actual revenue and expenses

Provided guidance and service on various financial problems in order to assist taxpayers' in resolving tax issues

Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities

Performed routine closings, maintained clean, accurate and accessible records and kept close eye on transaction updates throughout each quarter Assessed current revenue cycle procedures and implemented improvements to foster efficiency

Performed banking, business administration and financial tasks to guarantee five-star service for clients.

Managed a staff of 14

Reduce turn around time in collection

Monthly Reporting

Evaluated revenue cycle processes for hospitals established actionable methods to increase productivity and efficiency.

Provided revenue cycle process support to all clinical personnel, including resolving procedure challenges.

Monitored revenue and compared to targets to address variances and resolved actual-to-budget variances.

Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions. Analysis of trends and patterns leading to lower denial rates on UB-04 and CM-1500 for hospitals, Group practices, FQHC and specialty facilities Oversaw complete lifecycle of revenue operations for hospitals, group practices and Professional Billing, hospital billing and denial management Participated in revenue cycle processes, working to maximize profitability and increase revenue.

LifePoint Health Atlanta, GA

Remote Contract Modeler

11/2016 - 01/2017

Mastered professional use of Software modeling programs to input and update contract plus gained working knowledge of various other programs.

Built library of standard models for use and customization on multiple projects, saving costly rework on future jobs.

Approved contract rates and negotiations with insurance for multiple hospitals.

Reviewed patterns for payments over and under

AdvancedMD Springfield, MA Supervised 12 employees, duties included medical billing and collections, SR. REIMBURSEMENT SPECIALIST

12/2011 - 02/2013

denial management in a CBO for Multispecialty providers, groups, and hospitals

Supervision of the junior Denial reimbursement specialist Reporting trends and patterns

Appeals, grievances, write-offs,

Set-up system codes to capture denials, payment posting, and insurance verification

Skip Tracing

Maintained confidentiality and integrity of patient data. Researched rejections, investigating problems to appeal claims. Determined medical necessity, using individual insurance carrier regulations.

Easter Seals Windsor, CT

MEDICAL BILLING FINANCIAL CASE

MANAGER

06/2011 - 10/2012

Resolved billing issues by applying knowledge and completing in-depth research.

Developed improved standard operating procedures to increase billing accuracy and cash flow.

Conducted insurance verification and pre-authorization, coded procedures and managed patient charts.

Set up and maintained electronic billing system.

Built high-performance team by collaborating with new members on procedural, administrative, collections and compliance areas. Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions. Articulated growth objectives and operating plans. Negotiated contract terms and rates with banking institutions to increase profitability.

Community Health Services, Inc

Hartford, CT

MEDICAL CODING

MANAGER/BILLING SUPERVISOR

04/2004 - 07/2009

Supervised and managed 27 employees, responsibilities included: ICD-9 and CPT J-codes, HCPC coding for clinic and hospital coding, including pediatrics, adult medicine, women's health, podiatry, dental, optometry, mental health, and substance abuse

Reviewed medical records for completeness and to abstract and code clinical data, such as diseases, operations, procedures, and therapies using standard classification systems for chart audits

Edited system library for updates, delegated and assisted in workload, payment application, account reconciliation, balancing, charge entry, special billing projects, accounts receivable, monitored account aging, created detailed reports, followed-up on accounts, and collections Created training manuals for coding and protocol for providers and intake staff for customer service, patient registration and authorizations, researched electronic errors and rejections reports Resolved issues and made corrections for all insurance carriers including Medicare and Medicaid

Generated electronic claims submission, claims printing, electronic claims reconcilation

Input of insurances and payer organization ID numbers to create plan code numbers and electronic billing capabilities

Updated diagnoses, procedure codes, pricing and revenue codes in EHS database

Assistant to the director of revenue service and CFO Created system roll-up codes, month-end closing, monitored and completed quarterly forms for credit balance reporting for Medicare, worked with Healthpro and EHS billing system, Applied HIPAA privacy and security regulations while handling patient information Completed and submitted appeals for denied claims, Reviewed claims for coding Effective communications between patients, billing personnel and insurances, providers

Verified insurance information and obtained billing authorization Reviewed account information to confirm patient and insurance information is accurate and complete Oversaw medical coding, charge entry, claims, pharmacy communications and other day-to-day operations of billing department, Maintained high accuracy rate on daily production of completed reviews

Completed and submitted appeals for denied claims. Kept accounts current with facility-approved reporting and analysis strategies.

Advanced Medical Billing Associates

Farmington, CT

MEDICAL BILLING COORDINATOR

06/1999 - 04/2003

Managed 7 specialties in the following areas: surgery, infectious disease, cardiology, Diabetes and endocrinology, geriatrics, pulmonary medicine, department of medicine,

Patient registration, charge entry, payment posting, accounts receivable, SNF billing, DME billing, follow-up, reporting, eligibility and insurance verification, evaluating E/M for compatibility and level, corrections, billed and rebilled, provider services,Implemented training for new recruits, worked with all commercial plans, medicare and Medicaid, hmo's PPO's, indemnity and managed care, idx/gpms billing system Completed and submitted appeals for denied claims. Reviewed claims for coding accuracy.

Applied HIPAA privacy and security regulations while handling patient information.

Oversaw medical coding, charge entry, claims, pharmacy communications and other day-to-day operations of billing department. Collins Medical Associates Hartford, CT

MEDICAL BILLING COORDINATOR

02/1997 - 06/1999

Registration, billing, collections, write-offs, deposits, bank Reconciliation, accounts receivable and reporting for 5 specialty practices: hematology/

Oncology, geriatric, pulmonary, endocrinology, cardiology, follow-up, referrals and

Rebilled all insurance types including medicare and medicaid, utilized the IDX/GPMS billing

Wheeler Clinic Plainville, CT

MEDICAL BILLING REPRESENTATIVE

01/1995 - 02/1997

Medicaid/Medicare and HMO's billing for 15 clinicians and doctors, obtained referrals,

Partial hospital and intensive out-patient treatment authorizations for substance abuse

And mental health, payment posting, follow-up and rebilled accounts receivable, write-

Offs, appeals

Posted charges, payments and adjustments.

Prepared and submitted claims to insurance companies electronically and manually.

Completed appeals and filed and submitted claims.

Verified proper coding, sequencing of diagnoses and procedures. Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.

ORTHOPEDIC ASSOCIATES OF

HARTFORD, BILLED Hartford, CT

BILLING REPRESENTATIVE

03/1993 - 01/1995

Medicare, medicaid, hmo's, liability, and worker's compensation for 16 physicians

Including dme billing, verified eligibility, private collections, accounts receivable,

Payment posting, follow-up and rebilled on idx/gpms billing systems Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.

Worked with outside parties to obtain payments and solve problems. BAKER COLLEGE ONLINE Flint, MI

BACHELOR OF SCIENCE Degree

09/2013

HEALTHCARE ADMINISTRATION 3 Years Completed

Fox Institute of Business, GENERAL West Hartford, CT Certificate in Administrative Medical Assistant

03/1993

CONNECTICUT INSTITUTE oF BUSINESS East Hartford, CT CERTIFICATE in Nurse Assisting in Nurse Assistant

01/1991

State of Connecticut Hartford, CT

DIPLOMA in GED

12/1987

ASSISTANT CONNECTICUT BUSINESS INSTITUTE - East Hartford, CT CERTIFICATIONS BILLING (10+ years) COLLECTIONS (10+ years) Payment Posting (10+ years) IDX (8 years) MEDICAL BILLING (10+ years) QUICKBOOKS (10+ years) DATA ENTRY (10+ years) CPT (10+ years) MANAGEMENT (10+ years) REVENUE CYCLE (10+ years) claims

ADDITIONAL INFORMATION, Authorized to work in the US for any employer EHS BILLING SYSTEM, AVAILITY, CMS INVOICING, QUICKBOOKS, CODING, MEDICAL BILLING AND COLLECTIONS, WRITE-OFFS, APPEALS, REGISTRATION, REVENUE CYCLE MANAGEMENT, DENIALS, FOLLOW-UP, PAYMENT APPLICATION, SYSTEM CONTRACT IMPLEMENTATION, REPORTING, MONTH-END CLOSING, REGISTRATION, ELIGIBILITY AUTHORIZATIONS, VERIFICATION, INPUT OF CHARGES, PAYMENT POSTING, RECONCILLIATION OF EOB'S AND RA'S SHARON D. MOORE EXPERT IN MEDICAL BILLING/REVENUE CYCLE

Education and Training

Accomplishments

Additional Information

Contact this candidate