Summary
Overview
Work History
Education
Skills
Additional Information
Timeline
Generic

April Blanton

Vinton,Ohio

Summary

The following are some highlights of my qualifications: Service-oriented representative with 11-year background in qualifying Experience include analyzing, explaining, applying, or interpreting laws, rules, regulation or policies. Core competencies include strong analytical thinking, excellent communication, and effective time management skills. Handles tasks with accuracy and efficiency. Proficient in interviewing applicants’ assistance, evaluating information and determining eligibility. Accustomed to working with personal, employers and financial records to gain complete picture of each individual or family. Knowledgeable about strategies for collecting current and accurate data. Assisting individuals in establishing their entitlement to receive benefits; adjudicating, authorizing or reconsidering claims; explaining benefit entitlements or requirements to the public; evaluating benefit program operations to assess the integrity and quality; or interpreting benefit program requirements to formulate policies, procedures, or guidelines. Experience researching third party sources, Experience with physician or facility reimbursement policy and coding, experience with clinical editing tools, physician, and facility reimbursement policy, as well as additional experience with provider contracting Handles the administration and control of the accounts receivables. Oversees staff in communications with insurance companies, third party payers, and clients or client representatives, in resolving problems, researching discrepancies, authorizations, DME billing and securing reimbursement consistent with company objectives. Directs billing area functions which include supervising and accumulation of data and the accurate invoicing of all client services. Clinical audits of all patient care, charts. Efforts ensure maximum reimbursement from national and private insurance companies, governmental payers, and clients or client representatives. 5 years’ experience working remotely as needed. Manages the verification of amounts billed and the resolution of discrepancies with branch staff and/or the accounting unit.

Overview

9
9
years of professional experience

Work History

Office Manager/Coordinator

Kindred At Home
Huntington, WV
10.2014 - 07.2020
  • Monday-Friday 8:00A.M.-5:00P.M
  • Average hours worked 40-60 hours per week Manages and oversees branch office personnel and functions in accounting, patient medical files, payroll, billing, accounts receivables, and data processing operations that are consistent with regulatory compliance and corporate policies, procedures, and standards
  • Abides by and demonstrates the company Mission – Vision – Values through both behavior and job performance on a day-to-day basis
  • Directs billing area functions which include supervising and accumulation of data and the accurate invoicing of all client services
  • Clinical audits of all patient care charts
  • Efforts ensure maximum reimbursement from national and private insurance companies, governmental payers, and clients or client representatives
  • Manages the verification of amounts billed and the resolution of discrepancies with branch staff and/or the accounting unit
  • Administers the processing of the temporary employee payroll
  • Oversees the verification of submitted hours worked against branch records
  • Notifies the appropriate branch or accounting unit personnel of discrepancies
  • Initiates corrective action so that payroll processing deadlines are met
  • Supervises staff in updating information for employee files in assuring the timely and accurate maintenance of pertinent data
  • Handles the administration and control of the accounts receivables
  • Oversees staff in communications with insurance companies, third party payers, and clients or client representatives, in resolving problems, researching discrepancies, and securing reimbursement, consistent with company objectives
  • Manages the handling of input, verification, and transmission of information for payroll, billing, and data maintenance
  • Identifies, researches, and resolves processing problems, balancing the system input and output to assure the accuracy of results
  • Accountable for the correctness of all data entered, maintained, and transmitted in the system
  • Initiates data back-up and restore procedures, while establishing a disaster plan for system continuation or alternate processing under extraordinary conditions
  • Supervision includes the Accounting Coordinator, Medicare Accounting Coordinator, , Receptionist, Client Service

Charge Nurse

River Park Hospital
Huntington, WV
10.2012 - 09.2014
  • Assumes responsibility for the medication program including: ordering, delivery and administration of IM and oral medications and necessary Medical supplies, working directly with the State Aftercare and local pharmacies
  • Perform charge nurse responsibilities to include: write daily schedule, run shift change report, coordinate staff breaks, find replacements when staff call-out, ensure beds are changed and ready for new admissions, and make sure groups are starting on-time
  • Carry out triage duties by acting as liaison with regional CSBs to screen referrals for admission by consider factors such as medical issues, proper medications, behavioral issues, withdrawal risk from substances, and funding sources
  • Assists clients and their case managers needing referral to other medical facilities
  • Maintains complete and current clinical records and service provider data
  • Monitors the ordering and tracking of atypical medication and controlled drugs
  • Reviews laboratory results and reports variances to doctors
  • Teach
  • Assessed need for, ordered, obtained and interpreted appropriate lab tests
  • Counseled and educated patients about reproductive health issues and wellness
  • Expertise in STDs, HIV and family planning
  • Organized and led number support groups per time period in subjects related to physical and emotional health to ensure long-term patient well-being
  • Oversaw and managed number clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism
  • Processed monthly reports for department performance
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans
  • Ensured HIPAA compliance
  • Participated in unit-based Quality Assurance Program
  • Coordinated Quality Improvement Activities (QIA's) to identify performance areas for improvement
  • Trained new staff on quality control procedures
  • Followed infection control procedures
  • Assisted patients with daily functions
  • Measured urine and delivered specimens to lab
  • Performed pregnancy tests and sent specimens for laboratory testing
  • Collected blood, tissue and other laboratory specimens and prepared them for lab testing
  • Performed monthly inventory and maintained office and medical supply counts
  • Routinely retracted patient throat cultures and prepared for lab submission
  • Specialized in the nursing care of patients with chemical dependency
  • Strong leader for nursing personnel assigned to the unit/shift
  • Precisely completed appropriate claims paperwork, documentation and system entry
  • Professionally and courteously verified appointment times with patients
  • Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, test results, home care forms)
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation
  • Adeptly managed a multi-line phone system and pleasantly greeted all patients
  • Verified patients' eligibility and claims status with insurance agencies
  • Entered orders into the EMR system efficiently and without errors
  • Prepared patient charts accurately and neatly for the clinic
  • Prepared patient charts, pre-admissions and consent forms as necessary
  • Determined prior authorizations for medication and outpatient procedures
  • Performed qualitative analysis of records to ensure accuracy, internal consistency and correlation of recorded data
  • Researched questions and concerns from providers and provided detailed responses
  • Maintained strict patient and physician confidentiality
  • Updated patient financial information to guarantee accuracy

Rural Carrier Associate

United States Postal Service
10.2020 - Current
  • Monday-Sunday 7A.M
  • 5:30P.M
  • Average Hours worked 30-60 hours per week
  • Deliver mail to customers along a prescribed route and on a regular schedule; collect monies and receipts for accountable mail
  • Provide routine information concerning postal matters and provides requested forms to customer
  • Return mail collected, undeliverable mail, and submits monies and receipts to post office.

Education

Certificate in Communications/Certificate in Natural Science/LPN Certificate: Nursing -

Ashland Community And Technical College - 1400 College
12.2010

Skills

  • Directs billing area functions which include supervising and accumulation of data and accurate invoicing of all client services
  • Clinical audits of all patient care charts Efforts ensure maximum reimbursement from national and private insurance companies, governmental payers, and clients or client representatives
  • Manages verification of amounts billed and resolution of discrepancies with branch staff and/or accounting unit
  • Handles administration and control of accounts receivables
  • Communications with insurance companies, third party payers, and clients or client representatives, in resolving problems, researching discrepancies, and securing reimbursement
  • Identifies, researches, and resolves processing problems, balancing system input and output to assure accuracy of results
  • Accountable for correctness of all data entered, maintained, and transmitted in the system

Additional Information

Currently working on my certifications for CPC with eventual certifications for CPMA.

Timeline

Rural Carrier Associate

United States Postal Service
10.2020 - Current

Office Manager/Coordinator

Kindred At Home
10.2014 - 07.2020

Charge Nurse

River Park Hospital
10.2012 - 09.2014

Certificate in Communications/Certificate in Natural Science/LPN Certificate: Nursing -

Ashland Community And Technical College - 1400 College

Similar Profiles

CREATE PROFILE
April Blanton