Account Manager

LAUREN HARLEY

**** ****** *** **********, ** ****8 · 513-***-****

*********@*****.***

Introduction

Business entrepreneur & Team leader. Seasoned Accountant & Payroll &Manager with AR and A/P expertise, seeking a Management career in Accounting & payroll.

20 +years of Finance exposure affords me the ability to train and teach in this area of expertise. Strong accounting skills focused on balancing deposits to receivables. Post transactions for auditing and reporting purposes. Knowledgeable in budgets, forecasting, Grant tracking detailing chart of accounts which focused on assignment of restricted and non restricted funds using Quick books. Reconciled bank deposits to withdrawals. Set up and managed all corporate credit cards and limits. Reconciled credit cards charges to receipts from management in Quick books. Payroll, benefits, taxes, HRA FSA, 401k 403b

Past Employers

04/18 – 01/2023

4c For Children-Non Profit

Finance Department

04/18 – 01/2020

BILLING & PAYROLL A.P SPECIALIST - HYDE PARK HEALTH CENTER

Duties include; Billing Medicare, Workers Comp and insurance claims. Claim Charge data entry, reconciling the A/R, in addition to month end close procedures, adjustments, appeals on all levels, insurance credentialing and verification. Processing private pay monthly statements. Addressing customer complaints leading to customer satisfaction resolution. Obtain insurance verification for inpatient facility stays and therapy in which include direct contact with major insurance companies such as United healthcare, Cigna, Anthem, Caresource, Humana, Aetna, Molina and Medical Mutual. Current duties include: Process payroll and accounts payables. Transferred to payroll role in

2019: Ref Experience letter attached .

08/16 - 04/18

BILLING SPECIALIST - COMMUNICARE HEALTH

Served as a billing liaison for seven skilled nursing facilities at the corporate level. Trained and assisted business office personnel in the fundamentals of corporate policies and billing procedures. Co-captain of month end close for accountant. Generate charges, adjustments, writes offs, refunds, balance cash receipts. Track MDS/Case Mix Scores changes to Medicare, Medicaid, and Managed Care.

01/2016 - 08/2016

ACCRUALS SPECIALIST - MERCY HEALTH

Worked on past accruals in the department. Troubleshot missing items on orders if invoiced and not received. Communicated with vendors and sales contacts to resolve discrepancies. Worked closely with sales department to confirm purchase orders.

04/2010 - 01/2016

REVENUE CYCLE ANALYST - MAPLE KNOLL VILLAGE RETIREMENT COMMUNITY Coordinate billing information with MDS and Therapy to ensure correct coding of claims to Medicare and Managed care policies to ensure proper Medicare reimbursements.

Managed all authorizations and obtained pre certifications on managed care plans for inpatient billing for all insurance plans except Medicare.

File claims with Palmetto GBA. Set up new billing procedures and processes based on federal standards. Set up EFT’s for more efficient revenue flow. Process billing for Long Term Care & manage physician credentialing.

03/2008 - 04/2010

ACCOUNTING MANAGER - SL SEASON RETIREMENT COMMUNITY

Actively maintain and manage all aspects of the business office in its entirety. Responsible for all daily and monthly billing activities. Set up patient information for billing in AHT. (American Health Tech). Use Cost Analysis Tools to obtain higher reimbursements on certain levels of care. Focus on all managed care products and contracts to comply with billing & reimbursement rules which include: verification of benefits, obtaining authorizations and advising members of patient responsibility prior to receiving services. Process Part A and Part B Medicare. Track case mix scores to reimbursements. Reduce and monitor aging of receivables to ensure prompt payment from insurance. Post cash, issue credits and assist with tax preparations.

Monitor fiscal changes and present standings. Input charges and assisting residents with billing questions. Report financials directly to the corporate controller. Input GL entries and chart of accounts. Process deposits and reconcile cash to A/R to days to Rugs Score.

Complete financials for corporate reporting for our investors and auditors. Reconcile month end close.

06/2005 - 03/2008

COLLECTION SPECIALIST/ACCOUNTS RECEIVABLE TRAINER - HCR-MANOR CARE, TOLEDO, OH

Major job duties consisted of 100% travel to and from multiple skilled nursing facilities to assist & train business office managers in billing & collections of medical claims. Minor duties constituted manual adjustments, write offs reconciliations and appeals with additional follow-up with Insurance Companies.

09/2003 - 06/2005

MEDICAL ACCOUNTS RECEIVABLES - MILLENNIUM RECEIVABLES, TAMPA, FL. A/R medical billing and collections for hospitals including University Community Hospital, Helen Ellis Memorial Hospital and Sarasota Memorial Hospital. Responsibilities include reducing A/R for hospitals & skilled nursing facilities in all facets of billing including radiology and mammography. Follow up on claims billed, pending and appealed with additional follow up on aging accounts involving all payers, Medicare Part A & B, Medicaid, Insurance and private pay.4

NOTABLE EXPERIENCE

MEDICAL COLLECTIONS AND APPEALS AT ALL LEVELS INCLUDING: ● Redetermination

● Reconsideration

● Administrative Law Judge (ALJ)

● Departmental Appeals Board (DAB) Review

● Federal Court (Judicial) Review

MEDICAL RECORD AND BILLING SYSTEMS:

● Point Click Care

● E-Solutions

● DDE

● American Health Tech

● Epic Billing Software

SKILLS

Ability to work well on all accounting programs Result driven

Great attention to detail

● Customer service oriented

● Ability to multitask and prioritize workflow

EDUCATION

06/1978- 05/1982

SOUTHERN OHIO BUSINESS COLLEGE

BA Business Administration

06/1978

WITHROW H.S

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