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Manager Medical

Location:
Columbia, SC
Salary:
35000.00
Posted:
March 21, 2011

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Resume:

Danielle M Poston

**** *** ***** **

Pamplico, SC 29583

843-***-****

Professional Profile

B.S. Degree in Business Administration and Management, Magna Cum Laude graduate with a record of success in Human Resources, Office Management, Accounting, Collections and Billing for the Health Care industry. Creative problem solver with the ability to resolve conflict, improve morale, motivate employees and direct staff. Hands-on manager with personnel skills and experience in cultivating strategic business partnerships. Experience in employee recruiting, hiring and creating effective training programs. Persuasive communication skills and able to develop productive relationships with colleagues, customers and staff at all levels. Knowledge of marketing disciplines, including research, telemarketing, and advertising.

Computer Experience

Florida Shared System of Medicare, PCPL for Medicaid Eligibility, Microsoft Word, Lotus Notes, Word Perfect, Meditech, Medic Systems (Misys/Allsricpts) FACS, Equifax for Windows, Excel, Internet, CSI for Medicare, HOST data base for payroll and HR, SMART database for Accounting, Print Shop for company newsletter, NAVISON database for payroll, AP and HR, Compusystems (Misys/Allscripts), Practice Partners billing/Insurance and EMR, Microsoft Outlook

Experience

Live Oak Medical Center, Feb 2010- current

Promoted to Office Manager of Kingstree Live Oak Medical Center

Supervise and direct nine employees. Resolve employee conflict. Handle patient complaints and explain patient bills. Refile claims as needed on accounts. Daily deposit and reconcile cash drawer.

Billing Liaison

Billing liaison between outsourced billing company and Live Oak Medical Center. Live Oak is a primary care physician office with five physicians on staff. Follow up on all denials including; transmission reports, Medicaid ECFs, Medicare remits and private payer denials. Take all billing calls from patients explaining account balances and insurance company calls for billing questions. Updated fees for Live Oak based on Medicare fees. Post all money collected from patients and payers. Close of day and close of month. CPT, ICD9 and HCPCS medical coding.

Florence Rehabilitation Medicine, April 2007- Feb. 2010

Billing Manager

ICD-9, CPT and HCPCS PM&R medical coding daily of outpatient physician and inpatient hospital physician charges as well as specialty procedures including ESI, NCS/EMG studies, Spinal Stimulator trials, Botox therapeutic injections, Wound Center and Baclofen pump refills and maintenance. Responsible for sending all 1500/HCFA forms electronic and hardcopy. End of day, end of month and end of year processing. Patient collections on past due balances. Contact person for Allscripts for system updates. Keep current on all payer changes that effect PM&R medical coding. Handle system updates and problems as they occur. Send all patient account statements and make account adjustments as needed. Insurance tracking on claims for all payers. Post all money from all payers including personal payments. Responsible for total AR. Credentialing and the renewal of physician contracts with carriers. Purchase office supplies and medications. Authorizations for procedures. Appeals on denied claims for payment. Resolve patient complaints or questions. Responsible for all other misc reports. Help front desk with check in/out patients, make patient appointments and answer phones as needed.

Florence Nursing Services, July 2006 to April 2007

Office Manager and Marketing Specialist

Advertise for, interview and hire office employees. Supervise, train, reprimand, evaluate and terminate office employees as needed. Pay nurses from facility time slips three times a week. Reconcile paid hours and invoiced hours. Send invoices to facilities and follow up on payment. Maintain and revise newspaper ads for the recruitment of nurses. Interview and take applications for nursing staff. Weekly office reports, and stay abreast of what other nursing agencies and healthcare facilities are doing. Adjust billing and pay rates as the market warrants. Resolve problems as they arise with clients and with nurses. Visit facilities for public relations and contracts needed for clinical staffing.

Carolinas Medical Alliance, September 2000 to May 2006

1/2005 to 5/2006 West Florence Family Practice, Office Manager

Provides management of the physician practice office. Works with physicians to provide information relative to the physician practice‘s financial and operational performance. Transition policies and procedures to meet the Central Billing Office defined standards and determine a plan for items, which require improvement. Manage employees and maintains records of employee time for Payroll. Insure that supplies are ordered in an effective manner. Handle patient complaints and billing questions. Ensure payment of invoices and arrange meeting with other medical representatives. CPT, ICD9 and HCPCS coding for Family Practice.

3/2004 to 1/2005 Administrations, Staff Accountant

Pay all monthly bills, invoices for suppliers and all special check requests for payment for all of Carolinas Medical Alliance to include thirteen separate physician offices. Enforced the Purchase Order Policy and ensured the policy was followed correctly. Create and enter data from Microsoft spreadsheets for accruals on the general ledger at month end for reporting. Journal preparation and entry into database. Maintain lease and service agreements. Create and maintain spreadsheets for physician CME money. Worked closely with company CFO, and CEO.8/2002 to 3/2004

Administration, HR Coordinator

Ensured enforcement of the Human Resources policies and procedures. FMLA paperwork and employee assignment of other leaves of absentness. New hire paperwork for staffing 13 physician offices and a Central Business Office. Enrolled employees into company Stock, 401k, Medical and Dental Insurance, Long and Short Term Disability, Flexible spending accounts. Maintained all employee evaluations and all other employee information in HOST data base. Recruit, hire, and direct clerical and clinical staff for the PRN pool. Workers compensation claims reporting. Created and maintained the CMA newsletter. Conducted company‘s yearly OSHA, Compliance, HIPAA, and other educational training for all employees.

9/2000 to 8/2002 Central Billing Office, Coordinator of Patient Accounts

Quality control management of the medical billing and insurance department. Audited insurance tracker‘s work. Refunded patients and third party payers for over-payments on accounts. Responsible for end of month credit card and refund reconcile reports for staff accountant. AR reversals and write offs as need for patient account corrections. CPT, ICD9 and HCPCS Medical Coding.

Education

1999 to 2002 Limestone College, Gaffney SC

Bachelor of Science in Business Administration and Management, Magna Cum Laude Graduate

1991 to 1995 Hannah Pamplico High School, Pamplico SC

Graduated College Prep

References upon request



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