Experience

Capital City Surgery Center, LLC

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Business Office Manager

  • Jun 2015 - Present

  Manage and supervise daily activities of the business office including account receivable, account payable, patient registration, medical records, payroll, scheduling, personal administration, cash management, material management, and financing reporting. •Maintains and promotes professional competence through continuing education. •Organize business office activities to support Facility operations and keeps appropriate records for financial status monitoring. •Evaluates account receivable procedures to maintain correct and lawful practices for billing third party payers and patients for services at the Facility. •Evaluates account payable and purchasing procedures to maintain correct and lawful practices. •Organizes and maintain payroll and employee benefit records to maintain compliance with correct and legal practices. •Manage activities of medical records department policies and procedures are followed. •Manage actives of material management department and ensure policies and procedures are followed. •Manage and motivates staff to include: hiring, firing, and performance management. •Maintain daily schedules for proper manpower utilization. Show less



WALGREENS INFUSION SERVICES

• Intake Manager

  • Oct 2008 - Jun 2015

  • Serves as a resource for the billing center to include collections, authorization, HCPC coding, and contract clarifications. • Serve as a Board member on the reimbursement monthly calls to discuss bad debt, overpayment, refunds, and high dollar accounts. • Oversee referral source pertaining to Home Health services. Collaborated with departmental managers to streamline the organization of incoming referrals. Managed insurance coverage verification, prior authorization, and patient benefits and assessments. • Ensure patients were notified, as appropriate, of their financial responsibility, benefit coverage and payor authorization for services to be rendered. Identified, resolved, and escalated issues pertaining to insurance, billing, and customer satisfaction. • Direct negotiations for pricing of non-contracted services. Conducted continuous research on the most current trends in how insurance companies pay for various services and investigated overpayments and short pays. • Monitor adherence to Policies and Procedures. Ensure operational compliance with local and federal regulations, standards, and company-wide Standard Operating Procedures. Performed audits as necessary. • Successfully foster a customer-centric workplace ethos through strategic recruitment and retention efforts and knowledge-sharing initiatives. Developed, monitored, coached, and managed personnel through orientation, the training of company-established objectives, communication of rules and constructive discipline. Trained new intake employees and conducted ongoing skills assessment as necessary. Monitored and evaluated Intake Employee productivity and performance goals. Built employee morale, motivation and loyalty in a team atmosphere. • Collaborate closely with the Department Managers and acted as Liaison among branch managers, regional reimbursement managers, and corporate accountants to drive the growth of the Infusion site. Completed all required projects and reports in a timely Show less



CONCIERGE INFUSION, HOME INFUSION COMPANY

• Regional Reimbursement Manager

  • Nov 2007 - Oct 2008

  Mobilized the operational development of the reimbursement process and patient account management procedures from verification of insurance to obtaining necessary documentation and collection on aged receivables. •Performed financial review activities on assigned accounts. •Developed, analyzed and deployed instructional materials to cultivate a staff of reimbursement specialists. •Oversaw the verification of insurance and submission of claims in a timely manner. •Managed KPI reports, insurance trends, collection activities, and documentation statuses. •Supervised the calculation and application of payments received, credit/debit adjustments, and contractual requirements, and determined a satisfactory settlement of each account. •Refined and adapted the functional knowledge of reimbursement guidelines for DME and Respiratory equipment. •Executed human resources related functions of agency in accordance with state and company policies, including screening applicants, checking references, and properly conducting exit interviews according to protocol. Show less



Intrepid USA Healthcare Services

• United States
• Hospitals and Health Care
• 500 - 600 Employee

• Business Office Manager

  • Jul 2006 - Nov 2007

  Mobilized Managed billing and payroll processes through direct involvement, direction of delegated office personnel, and close coordination with key office administrators. •Gathered and organized insurance information in compliance with HIPPA rules and operating standards. •Monitored the agency data processing functions to streamline data integrity verification related to billing, payroll, corporate, and state/federal reporting requirements. •Directed the orientation and training regimens of selected staff to increase awareness of agency business operations, billing and payroll software procedures. Educated and trained staff on company resource materials. •Ensured accuracy of ICD-9 coding through training and feedback to clinical staff. •Monitored Medicare/Medicaid programs to ensure the lawful inclusion of agency applicants/contractors in these programs, as well as company awareness of program applicability. •Monitored, audited, and corrected payroll and billing errors. •Oversaw agency compliance with applicable employment and hourly wage earner laws. •Executed cross-functional HR functions to include staffing, performance management and assessments, recruitment and retention. Acted as a liaison between the agency and Corporate Human Resources department. Consulted with them on issues, projects, and benefits. Previous positions include Reimbursement Manager of Critical Care Systems for National Home Infusion Company Show less