Office Manager Business

**** ***** ***** **, **** ***, NAPERVILLE, ***** • **********@*****.*** • 630-***-****

RAMONA SCALES

PROFESSIONAL SUMMARY

Results-oriented Business Office Manager with over 3 years of experience in streamlining operations and enhancing productivity in fast-paced environments. Proven track record in managing administrative functions, overseeing office budgets, and leading cross-functional teams to achieve organizational goals. Seeking to leverage strong leadership skills and expertise in process improvement.

EMPLOYMENT HISTORY

ADVOCACY COORDINATION TEAM SPECIALIST Nov 2023 - Present

Sedgwick

Authorize claims, ensuring accurate benefit determinations and efficient resolutions.

Communicate with claimants and clients to resolve issues effectively.

Assess complex medical data to determine disability status under guidelines.

Adjust payments, manage claims processes, ensuring compliance and efficiency.

Mentor new employees, enhancing team skills and knowledge.

Evaluated complex medical data to determine disability status, ensuring compliance with plan guidelines and reducing processing time.

BUSINESS OFFICE MANAGER Jan 2022 – Current

Aliya of Evanston formerly Aperion of Evanston

Assists with Medicaid Pending applications, and works with residents, family and applicable outside agencies to finalize facility coverage through Medicaid.

Establishes and maintains a system of financial record keeping, to include issuing receipts, preparing and making bank deposits, and recording payments using proper segregation of duties.

Interacts with corporate office billing team and payers to define billing requirements and ensures prompt payment of claims.

Manages census activities including daily, weekly, and monthly balancing with the nursing and admissions departments.

HR Responsibilities including payroll and benefits.

Responsible for Resident Trust Account for in-house residents, to include weekly and monthly reconciliations.

Responsible for petty cash and collections.

Interacts with residents, family members, staff, visitors, government

Correspond with residents and families regarding NOMNOCs and Private Pay collections.

WORKFORCE ACCOMMODATIONS SPECIALIST Oct 2022 - Oct 2023

Reliance Matrix

Assess ADA requests, ensuring compliance and confidentiality.

Manage diverse cases, collaborating for tailored solutions.

Educate on ADA, enhancing workplace inclusivity.

Partner with JAN for effective strategies, boosting satisfaction.

Protect health information, adhering to HIPAA regulations.

Engaged with employees, supervisors, and medical professionals to identify effective accommodation solutions, fostering a collaborative environment.

Conducted thorough evaluations of accommodation requests, applying best practices and legal guidelines to uphold compliance and protect employee rights.

ADA COORDINATOR/STD EXAMINER

Feb 2021 - Oct 2022

Sedgwick

Schaumburg, IL

Inform claimants of claim requirements via phone and correspondence.

Review medical info for ADA compliance and make claim decisions.

Process ADA claims ensuring regulatory and client compliance.

Determine accommodations and refer claims for further eligibility review.

Conduct initial employee interviews and maintain client relationships.

Reviewed complex medical documentation to determine ADA eligibility, ensuring compliance with regulations and improving claim processing accuracy.

EDUCATION

BACHELOR OF SCIENCE IN APPLIED MANAGEMENT Jun 14 - Present

Grand Canyon University

PATIENT CARE TECHNICIAN/EKG

Aug 09 - May 10

HIGH SCHOOL DIPLOMA

Aug 99 - Jun 03

Proviso West High School

COURSES

CERTIFIED EKG/PHLEBOTOMY TECHNICIAN

National Health Association

CERTIFIED PATIENT CARE TECHNICIAN

National Health Association

CERTIFIED NURSING ASSISTANT

National Health Association

HRCI Human Resource Associate Professional Certificate

PROJECT MANAGEMENT

SKILLS

Training, Mentorship, Analytics, Negotiation, Customer Service, Problem Solving, ICD Coding, Workday, Kronos, Epic, Microsoft Office, Project Management, Risk Management, Process Improvement, Medical Terminology, HIPAA Compliance, ADA Regulations, Claims Processing, Behavior Health, Case Management

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