Experience

Baptist Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Contract Administrator

  • May 2011 - Present

  • Provides analytical and operational support to the BHSF Supply Chain Function throughout the organization. • Responsible for managing a portfolio of designated BHSF current, new contracts, project and capital purchases. • Makes independent decisions and takes actions involving various degrees of complexity, in the management and analysis of various BHSF contracting areas, which have a direct impact on Baptist Health's financial well being. • Works directly with Accounts Payable on invoice issues between suppliers and departments. • Responsible for pricing discrepancies between suppliers and BHSF. • Works directly with internal depts regarding financial request spend needed for capital purchase or service lines across the board. • Makes sure the proper approvals have been obtained through committees review/ evaluations have been approved or value analysis has been obtained- if needed. • Responsible for research through various internal and external databases in order to , direct/indirect supplier negotiations, benchmarking review of bids with suppliers while, working within deadlines, addressing violations under BHSF guidelines and procedures. • Responsible for review of terms and conditions- redlines, as needed and addressed with internal and external supplier. • Works closely with BHSF legal counsel on contracting and risk/insurance issues. • Regular business management meetings to address effective solutions and set up meetings needed with internal departments and external suppliers. • Supported in the commodities Laboratory, Respiratory, Pharmacy, Dialysis, ALF’s, Professional services, Baptist Outpatient Services, Miami Cancer Institute, Medsurg, and am currently supporting Surgery & Miami Cardiac Vascular Institute. • Works closely with GPO contracting – Premier – products, pricing, benchmarking, contract terms and conditions, etc. • Special projects as assigned. Show less



HealthExcel Medical Group

• Miami, Florida, United States

• Medical Center Supervisor/Manager-Miami office

  • Feb 2010 - Sep 2011

  • Oversee office operations, financial and development • Responsible for training, auditing, payroll, benefits, etc…to insure successful performance of local office. • Regular office management meetings to address effective solutions with staff and doctor • Maintain policy and procedure manuals- HIPPA/OSHA. etc… • Verification of all insurances, collections of copays/deductibles/co-insurance, scheduling and answering phones/complaints, etc… • Request all referrals that are needed for services provided outside of the center. • Handle all payroll issues at the center and supplies that need to be ordered; reviews to that are needed or issues to be addressed with staff. • Assist with set up of transportation for patients at the center. • Weekly conference call Office Manager Meetings given by our direct VP of Operations, regarding employee, patients and/or company issues. • Assist marketing department to provide and grow our local practice • Increased communicational interactions with all areas of business functions resulting in business growth • Responsible for developing business to business alliances for local center • Streamlined daily process and increased operational efficiency levels • Maintain excellent customer service environment to maximize profits • Successfully manage and service staff and patients • Handle petty cash as well as cash at hand in the office. Close the day out for the office daily. • Work closely with physician to assist patient’s healthcare needs, as well as office growth. • Work closely with billing, addressing billing, invoice payments for the office, Medicare, Medicaid, Commercial payments. Billing vendor issues, vendor management, and agency issues. • Supervise 4 staff employee’s- (2) Medical Assistance’s, front desk receptionist, as well as the driver at the center. • Oversee staff management and making sure all protocols are followed under HealthExcel Medical Group policy. Any projects or presentations that are needed. Show less



VITAS Healthcare

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Business Manager/Contract Specialist

  • May 2003 - Aug 2009

  Vitas Innovative Hospice Care Business Manager/ Contract Specialist 2003 – 2009 • Oversaw operations, financial, development, and contract matters • Drafted and negotiated contracts to insure all areas of service were covered legally • Responsible for all HR functions, hiring, training, auditing, payroll, benefits, etc…to insure successful performance of branch office. • Regular business management meetings to address effective solutions • Motivated marketing department to provide and improve services offered • Increased communicational interactions with all areas of business functions resulting in major business growth • Responsible for developing business to business alliances and corporate accounts • Streamlined daily process and increased operational efficiency levels • Maintained excellent customer service environment to maximize profits • Successfully managed and services multiple corporate accounts • Supervised employee’s at branch office • Responsible for all data entry in PeopleSoft HR, PeopleSoft Financials and VX for all employees, physicians, agency’s, Nursing Home and Alf’s. • Maintain and analyze financial and statistical reports regarding our revenue. • Billing vendor issues, vendor management, agency issues, cell phone set ups and physician billing Show less



AvMed

• United States
• Insurance
• 400 - 500 Employee

• Physician Sevice Spec.

  • May 2000 - May 2003

  Physician Service Coordinator- Provider Relations Dept. •Acted as a liaison between provider and member as well as the claims dept., contracting and credentialing, medical dept., network processing and with the outside provider representatives in the field. •Received calls from providers concerning claims, check problems, correction to addresses or new providers being added to there office, authorization problems as well as contract issues. •Received calls concerning reimbursement rates for all products- HMO, EPN, PPO, St. Augustine Medicaid and Medicare. •Answered at least 20 calls per day. •Researched/resolved grievances received from customer service filed by members. This involves investigation concerning provider and facilities billing a member for claim issues or member’s being put in collections, authorization’s issues, and complaints concerning provider’s availability standards. •Provided education on standard and guidelines required under the health insurance company. Show less



Avmed Health Plan

• Customer Service Representative

  • Jan 1996 - May 2000

  Received calls from provider and members. Answered at least 80 calls per day. Gave member eligibility and benefits. Resolved/Researched claims and authorization problems. Filed grievances and appeals on behalf of member. Received calls from provider and members. Answered at least 80 calls per day. Gave member eligibility and benefits. Resolved/Researched claims and authorization problems. Filed grievances and appeals on behalf of member.