Ana Mary Jimenez
Miami,Fl
Summary
A rewarding and challenging position which will allow me to utilize my extensive experience in customer service and billing/collections.
Overview
18
18
years of professional experience
Work History
Supervisor, Contact Center
University Of Miami
01.2022 - Current
- Supervise daily work flows of staff to ensure performance goals for customer satisfaction, quality, productivity, and key performance metrics are consistently met.
- Monthly monitoring and analyzing productivity metrics
- Work with Quality Assurance team to monitor and analyze team’s quality and patients satisfaction
- Assist WFM in planning, organizing and scheduling for the daily expected calls, service level, volumes of calls
- Responsible for hiring, firing, time approval, supervisor calls from patients.
- Monitor all occurrences per employee and corrective action meetings
- Administer training programs for all new hires
- Conduct formal performance reviews, including annual goal-setting/performance development plan, mid-year performance review, and final year- end performance review.
- Update daily call outs and issuance of the point system policy
- Assist on teams questions and concerns about scheduling, diagnosis and or scope or practice
Physician Billing Revenue Cycle Manager
Nicklaus Children's Health System
01.2018 - 01.2020
- Reporting to the Administrator Director of Revenue Cycle, responsible for the leading and planning of Physician Billing Revenue Cycle for Pediatric Specialist of America
- Which includes charge capture, A/R management, compliance/quality assurance, charge reconciliation and effective billing processes across multiple location and specialties
- Oversee the daily operations of the billing department, including but not limited to claim submission, clearinghouse, payer reconciliation, unbilled claims and payer rejections
- Work with the managers and other departments to analyze and recommend change regarding issues related to non-payment of claims or payer rejects trends/edits identified in the electronic billing system
- Works with clients to ensure all data elements needed for bill creation are consistently provided as part of the data capture and provide timely feedback for corrective action
- Daily monitoring and resolution of the bill hold file in the billing system
- Daily resolution of electronic billing errors
- Monitors benchmarks and performance monthly to provide an incentive or perform disciplinary action as required
- Implements and monitors all revenue cycle policy and procedures
- Evaluates new processes and makes recommendations for change
- Establishes and maintains insurance payer, employer, vendor and provider representative relationships including the coordination of meetings to improve dialog and processes
- Maintains a working knowledge of insurance carriers, payers and processes utilized within the revenue cycle timely and consistently reports project status to senior leadership
- Participates in all educational activities, and demonstrates personal responsibility for job performance
- Organizes work/resources to accomplish objectives and meet deadlines
- Work on multiple projects/initiatives at a time
- Maintains applicable continuing education requirements necessary to maintain skillset and certifications
- Organizes work/resources to accomplish objectives and meet deadlines
- Maintains stable performance under pressure or opposition
- Handles stress in ways to maintain relationships with clients and co-workers
- Maintains a professional image and provides excellent customer service
- Implementation of Cerner Patient Accounting
- Attend department meetings and education sessions.
UHI Finance Manager
University of Miami
01.2016 - 01.2018
- Reporting to the Director of Finance, in developing and implementing the process to meet internal and external client expectations and patient satisfaction
- We coordinate health care services, establishing pricing and collections of funds from non-contracted payors; from more than 6,000 patients from 90 different countries
- Work closely with the CBO in regards to the billing of International Patients, including special billings for International Kids Foundation, Embassies and BMT patients
- Responsible for all day to day billing functions
- Case Rate creation for the Bundled, Deposits and Deductible Agreements created by the UHI coordinators for self-pay patients
- Ensuring that the UHI W/Q's are worked and charges are cleared from the W/Q daily
- Researching daily billing questions from UHI Coordinators, pertaining to manual billing statements
- Serve as a liaison between the UHI and CBO and Clinical Departments
- Oversee reconciliation and control of the consecutive pre-numbered agreements
- Manage three Insurance Verification Representatives
- Maintain AR at 120 days
- Monthly Distributions
- Review/Adjust bi-weekly employees' time thru Workday.
Billing and Collections Manager
University of Miami
01.2014 - 01.2016
- Reporting to the Director of Finance, responsible for the leading and planning of Physician Billing Revenue Cycle for the Department of Radiation Oncology
- Which includes charge capture, A/R management, compliance/quality assurance, charge reconciliation and effective billing processes across multiple location
- Oversee the daily billing and collection operating activities and make necessary improvements based on the operational needs or demands
- Provided UChart Training and support in Charge Capture and Registration to the billing staff and division administers on an ongoing basis
- Manage and monitor the job performance of the billing staff
- Develop and implement new processes to improve quality of work, streamline effectiveness and create effective efficiencies
- Analyze operational reports and prepare monthly summary of departmental performance
- Meet with Division Administrators and Staff periodically
- Continuously review and evaluate system processes to ensure quality assurance in all billing aspect
- Meet quarterly with the Office of Compliance to ensure all policies and procedures are being met and communicated to faculty and staff
- Strategically plan and prioritize billing operations based on the needs and demands of the Department.
Supervisor
Central Business Office
01.2011 - 01.2014
- Reporting to the CBO Manager, responsible for the daily collections' operations and account receivable for all UMMG clinical departments
- Supervisor the collections staff ensures maximum efficiency and adherence to all UMMG policies and procedures
- A/R management and compliance/quality assurance
- Ongoing involvement with clinical departments to help maximize appropriate reimbursement, monitoring denial trends of all payers and accounts receivable balances
- Supervises daily Charge Edit team to ensure maximum efficiency
- Provides guidance and direction to staff, covering all aspects of billing and collection standards/procedures
- Provided UChart Training and Support in Claim Edits, Registration and current EDI clearing house
- Ensures that the claim edits either internal or payer based are followed up appropriately until final resolution
- Analyze monthly edit payer rejection report and report trends back to leadership
- Maintain current knowledge of UChart modules, exercise authority for account adjustments and write-offs
- Serve as a liaison with UMMG Managed Care Contracting offices, single case negotiations
- Serve as a liaison with the Clinical Practice Manager in coordination multidiscipline/multi-sites practices for the department.
Supervisor Billing and Collections for Third Party Billing
University of Miami
01.2007 - 01.2011
- Supervise 5 Insurance Collectors
- Supervise 1 Charge Entry Staff
- Supervise 1 Reconciliation Staff
- Annual Employee Evaluations
- Bi-Weekly Time and Attendance Reports
- Weekly Productivity Reports
- Manage all staff occurrences on a bi-weekly basis
- Review/Adjust bi-weekly employees' time thru Kronos
- Review and approve Department refunds (Insurance, Patients and Compliance refunds)
- Request refund checks (Check writer)
- Distribute staff Correspondence
- Analyze AR reports with senior management
- Back-Up for Optometry Charge Entry
- Clean out credit balance reports
- Review/Clean suspense account
- Assist collectors in sending out secondary insurance claim with EOB
- Train new staff
- Assist Manager with the Case Management department as needed
- Coordinate insurance seminars/training for staff
- Liaison between Self-pay and Third Party
- Assist the CHDS Director Finance with FRS/Clearing Account reconciliation
- Assist collectors with appeals when needed
- Assist CBU with their Pilot Project
- Assist HFS with the IDX Legacy Project.
Supervisor Self Pay, Patient Financial Services
University of Miami
01.2006 - 01.2007
- Supervise 17 call center Self-Pay AR Medical Collectors
- Supervise 1 Insurance Verification Representative
- Act as a liaison to offer support to 2 on-site Hospital Financial Counselors
- Analyze and monitor/Report Weekly Staff Productivity
- Daily monitor call volumes to ensure proper coverage
- Assist manager with Annual Employee Evaluations
- Review/Adjust employees' time thru Kronos
- Review EOB's sent by patients concerns
- Distribute Correspondence
- Resolve patients' complaints for UMMG/UMHC/ALBEH
- Reviewed and adjusted Bankruptcy Accounts
- Bad address reports
- Reviewed approval/denial of Fee Reduction Applications
- Collections Agency Liaison
- Coordinate Staff Coverage/Assignments
- Created department self-pay volume reports/graphs/spreadsheets to analyze patient and revenue volume.
Education
Psychology - Bachelor's Degree -
University of Miami
Miami, FL05.2019
Transferred To Universty of Miami -
Miami Dade Community College
Miami, FLAcademic High School Diploma -
American High School
Chicago, ILSkills
- EPIC
- Cerner
- Workday
- NICE
- Bilingual English/Spanish
- Proficient in Word, Excel, Power Point and Outlook
Timeline
Supervisor, Contact Center
University Of Miami
01.2022 - Current
Physician Billing Revenue Cycle Manager
Nicklaus Children's Health System
01.2018 - 01.2020
UHI Finance Manager
University of Miami
01.2016 - 01.2018
Billing and Collections Manager
University of Miami
01.2014 - 01.2016
Supervisor
Central Business Office
01.2011 - 01.2014
Supervisor Billing and Collections for Third Party Billing
University of Miami
01.2007 - 01.2011
Supervisor Self Pay, Patient Financial Services
University of Miami
01.2006 - 01.2007
Psychology - Bachelor's Degree -
University of Miami
Transferred To Universty of Miami -
Miami Dade Community College
Academic High School Diploma -
American High School
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