Manager Medical Billing
Resume:
Louisa A. Parker
Desoto, Texas 75115
******.******@*********.***
*****************@*******.***
Objective:
To obtain a secure management level position at a reputable medical institution where my 18 years of experience and education can benefit the employer while allowing me an opportunity to give, learn and grow with a stability company.
Education:
2008 – Current Columbia Southern University, Orange Beach, Alabama
(Healthcare Administration - BS graduate spring 2010)
2007-- 2008 Virginia College Birmingham Alabama
2006—2007 Ashford University Clinton, IA
(Business Administration)
2005-- 2006 Western International University Phoenix, AZ
(Healthcare Administration)
1996—1996 Practice Management Institute Dallas, Texas
(Certificate Program-Advanced Coding/Insurance Processing)
1991--1993 Jarvis Christian College/El Centro Hawkins, TX
(Business Communication)
Experience:
04/2008- 09/2009 GHN Online (Healthcare Clearinghouse) – Dallas, Texas Executive-Corporate Services (Account Manager)
As a previous Surgery Center Administrator I effectively identify choke points and execution risks with prompt mitigation which ensures that lessons learned are incorporated into our future opportunities. My primary focused was software implementation, solidifying client relationships and creating revenue opportunity. I performed as the implementation manager on all new client accounts ensuring a clean claims process. I collaborated with the EDI & IT departments to troucbleshoot issues. I train and develop healthcare providers on their total revenue cycle management processes as well as all industry mandate transitions (i.e. NPI, 5010, ICD-10 etc...). Translation of HCFA CMS/1500 and UB-04/92 forms into ANSI (X-12) electronic billing formats. Implemented 835 for clients. Internally I govern/manage the help desk department in ensuring quality customer services to providers with billing and revenue cycle processes. Coding/billing audits upon the client’s request. Q/A on 172 corporate billing account functions. Identify and analyze issues encountered during service or implementation deployment and provide appropriate solutions. Travel to client/prospect sites when applicable. Participation including travel at client organizational meetings and other meetings as needed.
2006-2007 PFS (Palladium for Surgery) ASC- Dallas, TX Administrator/Business Office Manager Out of Network-Multi-Specialty (pain-management, cardiology, anesthesia, orthopedic, podiatry etc...)
Oversee daily operations of front and back office functions, billing, materials management, purchasing, insurance processing, daily receipt control, scheduling, medical records, precertification and verification process, accounts receivable and payroll; Personally performed coding and bill reviews, claim edits, transmittals, month end closing, budgets, supply purchasing, ran various physician reports to reflect case rate and monthly ratios; contract negotiation, implemented and enforced departmental policy and procedure. Specializing in both Medicare, Medicaid HMO’s and Workman’s Compensation
1999–2003, 2005 US Oncology Dallas, TX Supervisor Financial Counselor /Account Receivable Coordinator
Specializing in Bone Marrow Transplants, I collaborated with the National Marrow Donor Program, Medical City Dallas’ and Baylor Medical Center’s Transplant departments in effort to obtain financial clearance locate donor matches and obtained financial assistance if necessary. I assisted private pay patients with the applications and interview process for S.S.I Disability, Medicaid and indigent programs. Oversaw team ensuring the verification of all insurance benefits, appeals, refunds and adjustments. Producing daily, monthly and quarterly reports were also a responsibility. I managed Stem Cell Transplant contracts and LOA’s. I performed consistent contract review and collaborated with the patient’s case managers to govern the guidelines and treatment plans for pre & post transplant. (maternity complications 2003/career advancement 2005) Supervisor of Account Auditing/Account Receivables Medical billing, insurance verification, refund processing, account follow-up and EOB review. Bad debt and clean up projects. Worked with managed care, workman’s compensation, government programs, commercial and private indemnity programs. (promotion/advancement)
2005 J. Michael Putman M.D. & Anil Pinto M.D. P.A. Reproductive Endocrinology Managing Billing Coordinator/Contractor
Manage all aspects of daily operations including billing, Account Receivable, Charge entry, coding, payment posting and daily transmittal of electronic billing system; Pre-op counseling for IVF patients and potential candidates. I governed the daily balancing and depositing, I ensured all positions had proper coverage; PRN front desk, switchboard, check-in, checkout and scheduling. I maintained accuracy with heavy patient contact with excellent patient relation and problem solving skills. (entrepreneurship/career advance)
2003-2004 Texas Cancer Associates Dallas, TX Supervisor Patient Financial Counseling
Trained and updated new and existing PFC’s on their responsibilities. Implemented new protocols, policies and procedures in the restructure process. Provide support for PFC staff. Counseled patients about their insurance and financial responsibility. Provided patients with a cost estimate analysis for contingent chemotherapy, radiation therapy and BMASP. Assisted private pay patients with applications and interview process for S.S.I Disability, Medicaid and indigent programs. Verified all insurance benefits, perform audits, refunds and adjustments. (career advancement)
6/98–06/1999 Lake Pointe Orthopedic Associates Dallas, TX A/R Coordinator/Business Office Coordinator
Managed the area of medical billing. I performed transcription of dictation, worked billing transmittal report, claims processing, patient account review and audit, account receivable, payment posting, charge entry, preauthorization of surgeries and visits, front desk check in and out, surgery scheduling day end balancing. (opportunity for better benefits)
10/97–06/98 Columbia Healthcare Dallas, TX Medicaid Supervisor
I ushered the Denton and Dallas county facilities into the new Medicaid HMO (Managed Care) products implementation. Facilitated classes for CBO and provider staff. Governed a team of A/R Specialist at the Dallas CBO. Audited accounts and reviewed R&S reports, time and attendance and employee review, ran special reports, attended seminars and performed training classes. (CBO relocated out of state)
06/95—01/98 Baylor University Medical Center Dallas, TX Lead Financial Counselor/Account Receivable Specialist
I prepared physician orders, obtained patient’s signature on consent forms and counseled the patients giving them preoperative instructions. I ordered EKG’s, auto blood, x-rays, reviewed test results for problem and notified the physician accordingly. The daily duties also included; ensuring the patients were aware of all financial responsibilities, preparing the preoperative and postoperative instructions for elective surgery patient and assisting with the application and certification process for charity programs and governmental assistance. Team Lead Account Receivable Specialist I was responsible for the medical billing, insurance verification, refund processing, account follow-up and EOB review. I assisted and trained new and existing employees in the area of account receivable, supervised PRN; work with managed care, government programs and commercial and private indemnity programs. (advancement)
2/91 thru 8/93 & 1/94 thru 05/95 Parkland Memorial Hospital Dallas, TX Team Lead Medicaid Specialist/ Medicaid Specialist I/ Bed Control Clerk
I worked R&S report in the attempt to appeal denied claims, reviewed UB92’s for errors before filing and refilling and certified patients for governmental programs such as CIDC, Medicaid and Victims of Violence. (college advancement)
Computer & Other Skills: Certified Notary Public, Certified Medical Insurance Specialist, Contract Negotiation/Management, Transplant Contracts and LOA’s Supervisory, Managed Care, Commercial and Medicare/Medicaid, CIDC, Victims of Violence, Transplant Assistant Programs, Comparing fee schedules-vs. - RVU, Account Receivable, Insurance verification, surgery scheduling, Day/Month end balancing, Budget management, Payroll, Time and Attendance, Training/Seminars facilitating, Bed Stats, Private Billing Contracting, Software: Advantx/Source Medical Medic, Medic Vision, Medisoft, Medical Manager, THIN, PSIMED, TX Mednet, Millbrook/Centricity, GE/Centricity IDX, A4 , GHN and all Microsoft applications, microfilming & processing, vital signs, ten key by sight & touch,
Minimum Salary $68K - $85K Annually (Negotiable)
Letter of Recommendation and References are available upon request
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