Customer Service Quality Assurance
Resume:
MARGARET ROSKY
Pittsburgh, PA 15241
Home: 724-***-**** Cell: 724-***-****
*******@*****.***
Accomplishments
Nine years of successful staff management in a quality and production driven healthcare environment.
Six years experience in recruiting and training for a national healthcare company.
Extensive experience in employee development.
Extensive experience in the development of standard operating procedures.
Extensive experience in the development and presentation of training for the adult learner.
Expert knowledge of CMS regulations as they apply to healthcare billing operations to include ICD-9, CPT and HCPC codes.
Professional Experience
Apria Healthcare, Canonsburg, PA 15317
2005 to June, 2010 - Corporate Trainer/Recruiter
Managed and supported all training needs for billing operations. Training responsibilities included corporate policy and procedure, regulatory guidelines, standard operating procedures, product /service and computer systems.
Recruited new hires for operations. Successfully recruited 130 employees to support a centralized reorganization.
Developed and implemented standard operating procedures and Policy and Procedure for billing operations.
Developed and implemented new hire training and orientation to extend through the 120 day introductory period.
Developed and implemented leadership training to support employee development. This included identifying development paths and skill assessments.
2004 to 2005 - Billing Compliance Supervisor
Responsible for day to day supervision of the billing team. Responsibilities included recruiting, training and development 15 employees.
Ensured 100% data entry of all government claims.
Managed all government and internal audit requests.
Developed and managed QA process. This included identifying quality standards as well as defining auditing procedure.
Managed all HIPAA disclosures for the billing center.
2002 to 2004 - Revenue Qualification Supervisor
Day to day Supervision of the quality assurance team. Responsibilities included recruiting, training and development 25 employees.
Ensured 100% quality audit of all billing documentation.
Developed and implemented work-flow procedures for reviewing billing documentation. This included identifying quality standards, defining auditing procedure and developing statistical summaries for executive review.
Managed all HIPAA disclosures for the billing center.
UPMC Health Plan, Inc., Pittsburgh, PA 15219
2001 to 2002 - Manager, Statutory Reports & Quality Audit
Managed Statutory Reporting & Quality Audit function for the Health Plan. Responsibilities included recruiting, training and development of 35 employees.
Directed the government reporting team to assure timely filling and accurate financial report for Federal and State regulatory agencies.
Developed and implemented work-flow procedures for reviewing daily production of claims and membership processing. This included identifying quality standards, defining auditing procedure and developing statistical summaries for executive review.
Developed focus audit processes to identify trends and provide root cause analysis for Health Plan operations.
Marsh USA Inc., Pittsburgh, PA 15222
1998 to 2001 - Claims Specialist
Administered workers compensation program for self-insured clients with multi state operations.
Prepared annual and quarterly state filings, meeting requirement deadlines to secure self-insured status for the client.
Acted as a liaison between the state and client in communicating self-insurance requirements.
Part Time Experience
David’s Music House, McMurray, PA 15317
April 2011 to Present - Customer Service/Business Support
Develop and implement business initiatives for a newly created small business.
Support day to day business operations to include: sales, public relations, education and customer service.
Health Club at Southpointe, Canonsburg, PA 15317
August 2009 to April 2011- Front Desk Customer Service/Receptionist
Perform all customer service responsibilities at the front desk.
Process daily sales.
Post account receivables.
Promote and design materials for club events.
Computer Skills
Excel, Word, Access, Power Point
Education
University of Pittsburgh, Pittsburgh, PA
BA Economic, Math
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