Candace Fondren
Batesville,Mississippi
Summary
Experienced professional seeking a full-time role in Revenue Cycle Management, Office Management, or Food Service within a Metropolitan Area. Dedicated to delivering exceptional customer excellence and care. Committed to utilizing skills and expertise to contribute to the success of the organization. Eager to leverage experience in these fields to drive operational efficiency and exceed customer expectations.
Skilled Retrieval Specialist focused on maximizing patient care and outcomes. Top-notch communicator with excellent time management, administrative and customer service skills.
Resourceful Specialist offering expertise in problem-solving, data analysis and customer service. Adept at quickly learning new technologies and processes for driving success. Proven track record of successfully managing multiple projects and developing innovative solutions.
Forward-thinking Operations Specialist bringing 15 years of expertise in Management, Billing and Coding and Quality Assurance for Healthcare sector businesses. Cultivates rapport with individuals to optimize project goals and output, resolve complex problems and deliver innovative improvement strategies. Proficient in Microsoft word, excel and powerpoint .
Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Management position. Ready to help team achieve company goals.
Overview
32
32
years of professional experience
Work History
Remote Medical Records Retrieval Specialist
Optum – United Health Group
02.2024 - Current
- Procure medical records and documentation for patient care
- Collecting medical records from health care providers (such as physician’s offices or hospitals) and performing data entry services to securely store relevant information in a database
- Facilitate secure remote access for health care providers, billing departments, or insurance claim processors
- Communicate with medical offices concerning patient data
- Follow up on records not ready for retrieval
- Ensure to follow HIPPA guidelines.
- Assisted in compliance audits, demonstrating adherence to industry regulations regarding medical record management.
- Trained new Medical Records Retrieval Specialists, ensuring a thorough understanding of company policies and procedures.
- Diligently tracked and reported metrics related to medical record retrieval efforts, providing valuable insights into operational performance.
- Enhanced patient care by accurately and efficiently retrieving medical records for healthcare providers.
- Contributed to improved patient outcomes by ensuring the confidentiality and security of sensitive medical data.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Assisted in preparation of medical records to release to other medical facilities requesting for patient history and information.
- Maintained patient confidence by keeping patient records information confidential.
- Maintained patient records in compliance with security regulations.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Verified accuracy of patient information in medical records.
- Scanned and uploaded up to 75 medical records into electronic medical records system daily.
- Input data into computer programs and filing systems.
- Followed exact procedures for handling transfers and other releases of medical records.
- Sorted and distributed more than 75 incoming and outgoing medical records.
Owner
Candace Fondren Catering, LLC
09.1992 - Current
- Own and operate private Catering Business
- Ensure successful operations of catering functions, including, labor, cost control, food preparation, set-up
- Responsible for daily operations and Customer Service
- Skilled in preparing a wide range of menu options
- SERV safe Certified
- Provide hospitable service and menu options to clientele
- Adhere to health and safety guidelines
- Set-up workstations and event space
- Pricing, purchasing and prep experience
- Handle set-up and breakdown of event space
- Maintain a clean and sanitized work area
- Train staff on prep and breakdown of an event.
- Developed and maintained strong relationships with clients, resulting in repeat business and referrals.
- Increased customer satisfaction by implementing efficient business processes and providing exceptional service.
- Consulted with customers to assess needs and propose optimal solutions.
- Established foundational processes for business operations.
Payer Enrollment Coordinator
Region One Health
01.2023 - 02.2024
- Responsible for all aspects of payer enrollment for 300 plus providers ( Physicians, PA's, Nurse Practitioners) analysis and tracking of enrollment into all pertinent insurance networks
- Collect and verify necessary documentation from Providers
- Maintain an accurate and up-to-date record of Provider credentials
- Ensure timely and accurate processing of payer enrollment for the enrollment and credentialing program
- Update provider CAQH profiles for Insurance enrollment
- Update provider NPI information in the NPPES system for payer enrollment
- Manage Provider profiles and communicate to obtain missing or additional information
- Ensure all provider information is correct and updated
- Team player and key member of the revenue cycle team.
Revenue Cycle Manager
Aaron E. Henry Community Health Service Center-Clarksdale, MS
02.2015 - 01.2023
- Responsible for overall operations of the billing and revenue cycle for the agency and ensures productivity is maximized
- Help with developing department goals in conjunction with establishing, implementing, and revising policies and procedures for department operations in alignment with the Help to implement Community Health Center’s strategic goals and objectives
- Work with Insurance company Representatives on implementing and insuring HEDIS Measures are met with Bi-Weekly meetings
- Provide necessary feedback on HEDIS and quality measures to ensure billing is correct
- Implement goals and strategies for Providers and Nurses to help meet the goals for HEDIS and Quality for maximum payment
- Assist CFO with organizing meetings with Front Desk staff and Office Managers
- Communicates with Office Managers and Providers concerning all billing issues
- Attends Providers Meetings when necessary to keep them abreast of any and all changes concerning billing and coding, and HEDIS Quality measures
- Ensure all claims are filed in a timely manner and payments received
- Manage 3-person team of billers for Medicare, Medicaid, Other Third-Party Insurance
- Review unpaid claims for payment
- Credential new providers and sites into Insurance networks
- Keep current providers credentialing updated
- Re Credential sites and providers on anniversary dates
- Meet with billing staff to ensure Providers are par with Insurance Networks
- Help to create policy and procedures for Billing department and Client Care staff
- Keep providers and other ancillary staff up to date on insurance policy
- Make sure collections were at a maximum
- Meet with Insurance companies on HEDIS measures and ensure team was implementing quality measures for payment as well as patient care
- Keep supervisor advised on any and all updates that affect billing cycle
- Identifies, facilitates, and evaluates financial practices and goals according to established standards
- Plan, research and request purchases for department capital and operational equipment and supplies
- Selects and hires quality employees and direct staff
- Schedules work to facilitate effective and efficient department operations
- Provides leadership, vision, development and implementation of long-term departmental goals for the organization
- Investigates and takes appropriate timely action(s) to resolve department, personnel, and customer concerns, complaints and problems
- Ensure department employees are in compliance with all regulatory and licensing agencies
- Reviews and approves bad debt accounts receivable aging monthly
- Assist with year-end Audit
- Makes sure staff is compliant with State and Federal regulations related to the revenue cycle functions, such as collection practices, patients’ rights
- Helped to set-up and Implement new Electronic Health Records and Practice Management System
- Train new hires for Office Management and Front Desk
- Instrumental in implementation of new Practice Management and EHR System.
Office Manager – Batesville Clinic Site
Aaron E. Henry Community Health Service Center-Clarksdale, MS
06.2011 - 02.2015
- Responsible for overall operations of 15 person Clinic (Medical and Dental) to ensure daily operations runs as it should
- Coach and supervise (3 ) front desk team; making sure there is a smooth transition of patients from the waiting room nursing staff
- Maintain provider schedules; adjusting as providers request time off to ensure clinic is covered
- Problem solves patient issues, as well as provider and other office staff concerns
- Work clinic aging with billing staff
- Work with Billing staff concerning credentialing, ensure providers remain par and in network
- Assist and complete all credentialing documents that come via mail, keep Billers updated on such documentation
- Weekly Clinical Report; keeping track of provider patient load and finance
- Process and record daily deposits
- Schedule and oversee meetings on an as needed basis
- Schedule calendar of events
- Develop night clinic schedule on monthly basis
- Track and maintain staff time and attendance; limit overtime and monitor attendance, vacations and sick time off
- Patient outreach and Marketing to bring more clientele into the Clinic
- Ensure productivity of clinic increases
- Work with local agencies and area technical Institutions to utilize Interns for completion of their Internship Programs
- Nursing staff
- Maintain provider schedules; adjusting as providers request time off to ensure clinic is covered
- Problem solves patient issues, as well as provider and other office staff concerns
- Work clinic aging with billing staff
- Work with Billing staff concerning credentialing, ensure providers remain par and in network
- Assist and complete all credentialing documents that come via mail, keep Billers updated on such documentation
- Weekly Clinical Report; keeping track of provider patient load and finance
- Process and record daily deposits
- Schedule and oversee meetings on an as needed basis
- Schedule calendar of events
- Develop night clinic schedule on monthly basis
- Track and maintain staff time and attendance; limit overtime and monitor attendance, vacations and sick time off
- Patient outreach and Marketing to bring more clientele into the Clinic
- Ensure productivity of clinic increases
- Work with local agencies and area technical Institutions to utilize Interns for completion of their Internship Programs.
Billing Associate
Aaron E. Henry Community Health Services Center
10.2009 - 05.2011
- Responsible for all Medicaid Billing
- Work all Medicaid related denials for correct reimbursement
- Work outstanding aging- bringing accounts current up to 45 days
- Electronic / and Manual Auto posting of Medicaid remittances
- Partner with Office Mangers on denials and making necessary changes for corrected claims
- Make necessary adjustments to claims after posting
- Help team to meet goals for aging
- Meet weekly with CFO and COO and billing staff to make improvements or adjustments to billing procedures, implementing goals for team
- Prepare credentialing for 25 Medicaid Providers.
- Evaluated aging reports to identify members to be included in monthly outbound collection calls.
- Reviewed full history of past due accounts and contacted client or attorney regarding collection, implementation of payment plan or pursuit of legal remedies on unpaid accounts.
- Researched portals issues related to non-payment within e-billing vendor portals.
- Improved billing accuracy by thoroughly reviewing invoices and cross-referencing data with client accounts.
- Increased revenue recovery by initiating collection efforts on delinquent accounts, including sending formal notices and coordinating with legal departments when necessary.
Education
Associate of Applied Science - Office Administration, Excel, Business Math, Operating Systems, Records Management, Professional Development, Word Processing, Integrated Computer Applications, (Power Point), PageMaker, Communication Technology, Access, Peachtree, Business Communications, Administrative Office Procedures
Northwest Mississippi Community College
Senatobia, Mississippi05.2004
Skills
- Conscientious role model with an assertive leadership style
- Proven track record in planning and organization with more than 15 years’ experience
- Proficient in electronic and hardcopy filing, scheduling, supervisory skills, Xerox copier, 10 key calculator, PBX multi-line phone systems, type 45 wpm
- Proficient in EHR/EMR, Electronic Practice Managements Systems
- Proficient in electronic medical reimbursement and billing and coding, of Medicare, Medicaid and Private Insurance
- Electronic Posting
- Exceptional customer service and front desk experience
- Valuable people skills through meeting patient needs
- Enthusiastic and eager to take on new tasks
- Office Assistant /Administrative Assistant Skills
- Can adjust to any given setting with minimal or no supervision
- Works well with others and alone
Timeline
Remote Medical Records Retrieval Specialist
Optum – United Health Group
02.2024 - Current
Payer Enrollment Coordinator
Region One Health
01.2023 - 02.2024
Revenue Cycle Manager
Aaron E. Henry Community Health Service Center-Clarksdale, MS
02.2015 - 01.2023
Office Manager – Batesville Clinic Site
Aaron E. Henry Community Health Service Center-Clarksdale, MS
06.2011 - 02.2015
Billing Associate
Aaron E. Henry Community Health Services Center
10.2009 - 05.2011
Owner
Candace Fondren Catering, LLC
09.1992 - Current
Associate of Applied Science - Office Administration, Excel, Business Math, Operating Systems, Records Management, Professional Development, Word Processing, Integrated Computer Applications, (Power Point), PageMaker, Communication Technology, Access, Peachtree, Business Communications, Administrative Office Procedures
Northwest Mississippi Community College
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