Anisha James
Lewisville
Summary
Dynamic and results-driven healthcare leader seeking a role that leverages critical thinking and decisive judgment to enhance patient care, improve quality metrics, and elevate patient satisfaction. Proven ability to foster a collaborative environment, empower coworkers, and promote an engaged workplace culture. Strong track record in building and maintaining relationships with a diverse range of stakeholders in fast-paced settings, ensuring effective communication and teamwork. Committed to driving excellence in healthcare delivery through innovative solutions and strategic partnerships.
Overview
24
24
years of professional experience
Work History
Manager-Physician Relations
Ascension Medical Group
10.2023 - Current
- Develops strategies with physicians and leadership to increase admissions and revenue for the medical group. Determines which physicians to promote/pursue and identifies new opportunities for growth and access. Develop and implement measurement systems to determine the impact of physician recruitment programs. Evaluates physician progress and compliance.
- Establishes standards for ongoing physician performance expectations. Partners in the development of marketing plans and strategies for various facilities and/or product lines with the goal of increasing physician utilization of Network facilities and improving payer mix. Determines where to focus marketing/physician relations efforts based on utilization analysis.
- Meets with representatives of target populations regarding network services and programs. Provides information and promotes the utilization of programs and services. Identifies and coordinates resolution of problems to improve physician utilization and patient satisfaction.
- Manages staff relations including performance management, staff satisfaction and conflict management. Performs and oversees scheduling, recruitment and payroll.
- Women's Health
Practice Manager
Ascension Medical Group
01.2022 - 10.2023
- Determine work priorities, assign and schedule workloads, monitoring quantity and quality of work.
- Provide support for 5 Physicians and 1 Nurse Practitioners, operating out of 3 outpatient clinic locations.
- Managed and supported all staff; total of 15.
- Daily collaboration with our Physician lead to discuss process improvements real time.
- Develop our monthly hospital call and clinic schedule.
- Collaborate with and support the Maternal Fetal Medicine and Urogynecology service line.
- Develop, implement and monitor operational policies and procedures. Ensure compliance with applicable regulatory requirements and standards.
- Develop and maintain positive working relationships with team members and physicians to ensure optimal patient care is provided in a timely and efficient manner.
- Coordinated and completed onboarding for 3 new physicians in FY23, establishing clinic operations and processes.
- Prepare, implement and monitor operational budgets, by implementing cost-effective measures.
- Work with other managers and directors in order to implement systems of quality improvement measures.
- Monitor financial aspects of the department and assume responsibility for on-site collection/billing.
- Foster relationships with our external partners at Fort Hood to ensure patients have access to quality care and services.
- Collaborate with the Ascension Williamson hospital leadership and labor and delivery team.
- Women's Health
Practice Manager
Ascension Medical Group
12.2020 - 01.2022
- Determined work priorities, assigned and scheduled workloads, in addition to monitoring quantity and quality of work.
- Provided support for 5 Physicians and 2 Nurse Practitioners, operating out of 4 outpatient clinic locations.
- Managed and supported all staff; total of 15.
- Collaborated with and supported the Maternal Fetal Medicine and Urogynecology service line.
- Developed, implemented and monitored operational policies and procedures. Ensured compliance with applicable regulatory requirements and standards.
- Developed and maintained positive working relationships with team members and physicians to ensure optimal patient care is provided in a timely and efficient manner.
- Coordinated and completed physician onboarding, establishing clinic operations and processes.
- Prepared, implemented and monitored operational budgets, by implementing cost-effective measures.
- Worked with other managers and directors in order to implement systems of quality improvement measures.
- Monitored financial aspects of the department and assumed responsibility for on-site collection/billing.
- Fostered relationships with our external partners at Communicare to ensure patients have access to quality care and services.
- Collaborated with the Ascension Hays leadership and labor and delivery team.
- Women's Health
Office Manager - Administrative Support
Seton Family of Hospitals
12.2018 - 12.2020
- Determines work priorities, assigns and schedules workloads and monitors quantity and quality of work.
- Provide support for 7 outpatient clinics, including 2 satellite clinics with a total of 10 Physicians, and multiple residents that rotate throughout the department throughout the Fiscal year.
- Develops, implements and monitors operational policies and procedures. Ensures compliance with applicable regulatory requirements and standards.
- Develops and maintains positive working relationships with team members and providers to ensure optimal patient care is provided in a timely and efficient manner.
- Work with a therapist and clinical manager to improve patient care and clinical efficiencies for Physical Therapy, and Occupational Therapy. Interviews/hires new employees and conducts development planning, training and performance evaluation activities for assigned staff.
- Prepares, implements and monitors operational budgets, and implements cost-effective measures. Assists with staffing and monitors facilities, supplies and equipment necessary for effective services within the area of responsibility.
- Works with other managers and directors in order to implement systems of quality improvement measures.
- Monitors financial aspects of the department and assumes responsibility for on-site collection/billing.
- Use the root cause analysis process to identify and develop process improvement techniques.
- Formulates productivity reports and standards of measurement to be utilized for budgeting decisions. Ensures that department functions are carried out in a timely manner and according to required deadlines. Processes various types of data and prepares reports.
- Coordinates activities for area of responsibility that align with departmental/network plans/goals. Serves as a resource to various client groups.
- Performs other duties as assigned.
- Assisted with the implementation of the Athena EMR system.
- Physical Medicine and Rehabilitation/Pain Management/Outpatient Rehabilitation Services/Orthopedic Surgery/Sports Medicine
Patient Service Specialist
Baylor Scott and White Health
05.2017 - 12.2017
- Interviews patients to obtain demographic and insurance information necessary for medical record identification and bill processing.
- Inputs patient registration information into computer registration system and verifies accuracy of information.
- Provides accurate patient, medical, financial, or procedural information to patients.
- Discusses financial arrangements and issues with patients and/or family members.
- Facilitates patient and information flow by directing patients to correct locations, arranging patient transport, answering incoming telephone calls, and providing clerical support.
- Prepares required forms orders and maintains inventory of supplies as required.
- Analyze unpaid third-party claims and delinquent accounts to determine appropriate follow-up actions to ensure payment.
- Acts as a mentor to other department PSS employees and provides training on application, website and other resources.
- Rheumatology Department
Contact Center Specialist I
Baylor Scott and White Health
10.2016 - 05.2017
- Responsible for professionally and enthusiastically answering incoming calls and electronic requests from patients, family members and other external parties to register new patients, schedule healthcare appointments, answer questions, handle complaints, troubleshoot problems and provide information on behalf of the institution. Identifies and resolves discrepancies or missing information and accurately enters data into the electronic medical record system.
- Verifies insurance coverage or determines patient self-pay responsibility and provides cost information.
- Schedules an appointment for the patient or family member with a financial counselor if appropriate.
- Interprets physician orders to schedule appointments and ancillary tests.
- Communicates appointment details and any required preparation for testing along with necessary paperwork and payment to facilitate on time arrival, appointment preparedness and optimal reimbursement.
- Writes clerical and clinical patient related messages from patients, family members and other healthcare professionals to administrative and provider staff.
- Identifies emergent patient situations based on caller information and coordinates immediate triage.
- Contact Center
Patient Access Supervisor
St. David's Hospital
06.2016 - 10.2016
- Staff and order supplies according to budget guidelines and department needs.
- Assist with the processing of payroll for direct reports by maintaining employee edit requests, PTO requests, etc.
- Maintain accurate attendance records for employees.
- Maintain QA statistics (including patient Wait times, etc.) and report results to the Director.
- Assist with and/or performs employee evaluations.
- Directly oversee the daily activities of the registration areas to ensure department standards are met. Continually educates registration staff of any changes pertinent to their roles.
- Update collection system and requests rebill when appropriate.
- Review daily pre-service log to ensure accounts have been activated.
- Work closely and professionally with nursing and ancillary departments in an effort to maintain a teamwork approach.
- ER Department
Office Manager - Administrative Support
Seton Family of Hospitals
07.2014 - 06.2016
- Determines work priorities, assigns and schedules workloads and monitors quantity and quality of work.
- Provide support for 2 outpatient clinics with a total of 4 Physicians, 7 Residents, and 1 Physical therapist. Develops, implements and monitors operational policies and procedures. Ensures compliance with applicable regulatory requirements and standards.
- Interviews/hires new employees and conducts development planning, training and performance evaluation activities for assigned staff.
- Prepares, implements and monitors operational budgets, and implements cost-effective measures. Assists with staffing and monitors facilities, supplies and equipment necessary for effective services within area of responsibility.
- Works with other managers and directors in order to implement systems of quality improvement measures.
- Monitors financial aspects of the department and assumes responsibility for on-site collection/billing.
- Formulates productivity reports and standards of measurement to be utilized for budgeting decisions. Ensures that department functions are carried out in a timely manner and according to required deadlines. Processes various types of data and prepares reports.
- Coordinates activities for area of responsibility that align with departmental/network plans/goals.
- Serves as a resource to various client groups.
- Performs other duties as assigned.
- Assisted with the implementation of the Athena EMR system.
- SBS' Physical Medicine and Rehab
Customer Service Rep 501
Seton Family of Hospitals
08.2010 - 07.2014
- Schedule patient appointments.
- Prepare and maintain medical records.
- Receives, assists, and discharges patients in person and on the telephone.
- Collects fees and maintains accounts receivables.
- Performs a variety of clerical duties utilizing the billing department when necessary.
- Assists in responding to patient and third-party inquiries received by phone and mail.
- Sorts, codes, files, and retrieves and purges patient charts, accounts and documentation, as directed by supervisor.
- Enters data information into a database such that patient information is complete and accurate.
- Files, retrieves and delivers health care information to and from patient areas.
- Performs duties with competency and efficiency in an independent and consistent manner, with minimal supervision.
- Cross-trained and provided back-up for other customer service representatives when needed.
- Schedule and provide pre op instructions for patients having outpatient procedures.
- Support the medical assistant in obtaining prior authorizations for outpatient procedures-10 or more a day.
- SBSI Physical Medicine and Rehab
Pharmacy Services Specialist II
Regence BlueCross and BlueShield
03.2006 - 06.2010
- Handled over 1500 different pharmacy benefit designs.
- Provided information, education, and assistance to pharmacies, members, and a variety of other callers on recorded phone lines regarding benefits, claims, and eligibility. Handled multiple computer billing systems at a time-10 or more.
- Investigated and resolved all prescription medication program issues, such as benefits, procedures, claims payments, pharmacy billings, eligibility problems, denied coverage and prior authorizations.
- Loaded member eligibility and personal health information into a complex Prescription Benefit Management System.
- Handled difficult upset members in a professional and compassionate manner. Prepped pharmacy claims for processing.
- Addressed up to 20 website inquiries per day, responding to different member concerns in an efficient manner. Researched member plan and provided members with information about safe, effective, and low cost medication alternatives.
- Cross-trained and provided back-up for other pharmacy services representatives when needed.
- Call Center
Medical Receptionist
North County Internal Medicine
03.2003 - 12.2005
- Answered multiple phone lines-more than 5 at a time.
- Scheduled appointments.
- Sorting mail.
- ICD9 coding.
- Prepared charts and medical case histories.
- Formatting memos.
- Preparing messages for doctors and staff.
Medical Receptionist
Cassidy Medical Group
01.2002 - 03.2003
- Patient registration and documentation.
- Appointment scheduling.
- Maintaining records/color coding and filing.
- Financial management.
- Record keeping and banking.
- Insurance billing.
- Preparing well written messages for doctors and staff.
- Responding to and resolving patient inquiries by phone.
- Supported and performed front office duties for multiple specialties ranging from Pediatrics, OBGYN, Family Practice, and Internal Medicine.
Education
High School Diploma -
Oceanside High School
Oceanside, CA01.2000
Master of Health Administration - undefined
University of Phoenix
01.2021
Bachelor of Science - Management
University of Phoenix
01.2019
Skills
- Lotus Notes
- Microsoft Excel
- Microsoft Outlook
- Microsoft Word
- Type 55 WPM
- 10-Key
- EPIC
- Athena
- Cerner
- Premier Inflow
Accomplishments
Improved FY25 Time of Service Collections scores by 10% overall
Timeline
Manager-Physician Relations
Ascension Medical Group
10.2023 - Current
Practice Manager
Ascension Medical Group
01.2022 - 10.2023
Practice Manager
Ascension Medical Group
12.2020 - 01.2022
Office Manager - Administrative Support
Seton Family of Hospitals
12.2018 - 12.2020
Patient Service Specialist
Baylor Scott and White Health
05.2017 - 12.2017
Contact Center Specialist I
Baylor Scott and White Health
10.2016 - 05.2017
Patient Access Supervisor
St. David's Hospital
06.2016 - 10.2016
Office Manager - Administrative Support
Seton Family of Hospitals
07.2014 - 06.2016
Customer Service Rep 501
Seton Family of Hospitals
08.2010 - 07.2014
Pharmacy Services Specialist II
Regence BlueCross and BlueShield
03.2006 - 06.2010
Medical Receptionist
North County Internal Medicine
03.2003 - 12.2005
Medical Receptionist
Cassidy Medical Group
01.2002 - 03.2003
Master of Health Administration - undefined
University of Phoenix
Bachelor of Science - Management
University of Phoenix
High School Diploma -
Oceanside High School
Career Overview
Dedicated, and Multi-task-oriented healthcare leader - looking for a position that will allow me to utilize my critical thinking and decisive judgment skills to provide excellent patient care with a goal to improve quality metrics and patient satisfaction.
Degree
MHA