Candice L Williams

Works under supervision and works in a developmental capacity performing assignments and completing training to gain the knowledge and skills necessary to track the performance of current year expenditures compared to the operating budget. Participates in training for the justification and prioritization of unfinanced requirements. Training to provide management with financial information such as: financial reports showing the status of receipts, obligations, and expenditures; comparisons of actual performance to the financial plan and identification of variances. Completed the training to become certifying official for authorizations and vouchers. Provides DTS support to travelers. Primary Agency Program Coordinator (APC) with responsibility for the 2d Theater Signal Brigade units. Responsible for travel program implementation and overall administration of the Government Travel Card (GTC) Program and Defense Travel System (DTS). Serves as the liaison between cardholders and DFAS/Citi Representatives. Alternate Lead Defense Travel Administrator (LDTA) and responsible for collecting all financial data and reports from the Financial Management Systems(e.g. DTS, CITI, GFEBS, etc); summarizing and comparing the data with source documents; routing all documents to the appropriate POC;and tracking progress of payments for unliquidated obligations. Attends weekly/bi-weekly meetings with Resource Manager to discuss funds execution, planning changes, etc. to ensure funding is adequate to support the mission requirements. Provides management with financial information such as: financial reports showing the status of receipts, obligations, and expenditures; comparisons of actual performance to the financial plan and identification of variances. Attended meetings with supervisor that works closely with the Contracting Office Representative (COR) and Contracting Officer (KO) to ensure contract invoices are processed in time to prevent Prompt Payment Act violation. Processes Sales Orders (SO) and Military Interdepartmental Purchase Request (MIPR) for BASECOM.

Performed comprehensive review of military pay documents, reviewed forms, orders, and vouchers for service members, ensuring quality checks and compliance with Government Accountability Office (GAO), Department of Defense (DoD), and Department of Army (DA) policies, pay entitlement laws, regulations, precedent decisions and procedures to determine eligibility of military pay entitlements using current and superseded rules and regulations governing each type of pay. Prepared Requests for Personnel Actions, Travel Orders and Training Requests. Examined travel vouchers for accuracy, reports discrepancies to appropriate supervisor and requests appropriate approvals. Maintained a master file of original documents and receipts for travel vouchers approved by the Chief. Provided SmartVoucher (travel voucher) training to users, assisted with completion of travel order and vouchers, and kept personnel informed on Defense Finance and Accounting Services (DFAS) updates/ issues and travel policy. Reported problems to DFAS Help Desk via the Case Management System (CMS) and followed up on corrective actions as needed. Certifying official for authorizations and vouchers. Maintained records, files, transactions and audit trails for associated travel. Identified causes of problems or areas in need of improvements, and the type(s) of corrective action(s) or remedy needed. Reviewed all travel orders for compliance with Army and USAREUR-AF travel policy and communicated needed corrections. Routed travel orders to approving official. . Received and resolves problem cases involving over payment or under payment of members for prior periods of service. Determined validity of pay change documents and researches actions, corrected questionable items. Received and analyzed problems relating to military pay. Interpreted advisory and reject messages from Defense Finance and Accounting Service (DFAS) to determine and initiate the appropriate actions. Used automated systems to extract a variety of financial data and utilize a variety of miscellaneous reports and analysis to track, monitor and report the status of accounts. Performed analysis, conducted investigations, performed research, and reviewed pay accounts to settle complicated, numerous, and problematic situations affecting benefits and entitlements such as: special actions, pre-deployment and reintegration processing, customer service, Travel, limited disbursing Inspector General (IG) inquiries, account reconciliation, leave, retirement and debt adjustments. Determined the source of the problem and independently determined detailed standard and/or work around procedures for complex military pay actions, followed through to resolution in any or all of the interrelated automated databases, and reconciled system errors, and audited pay records across significant periods of time to determine validity of claims of under or over payments. Prepared required reports for the supervisor . Stayed abreast of new regulatory changes and policies. Mentored other technicians in processing proper payments to military members. Identified areas that negatively impact the accurate and timely processing of military pay and provided recommendations to Chief for improvement. Conducted operational reviews, perform various functional studies, assess regulatory compliance, and accomplish quality assurance functions for USAEUR-AF.

Conducted and led separation interviews for military personnel leaving the Army; ensuring separation support documentation are verified daily. Audited and verified all payments/pay changes are correct to ensure the soldier is paid correctly. Ensured separating military personnel are professionally out-processed and receive the finest service possible, to include pre-auditing of departing members. Ensured all pay accounts 120 days from date of separation and post-audits 20 days after date of separation are done timely. Reviewed and processed short notice separations immediately and sends separation worksheets and documents to the PCE. Advised Soldiers of their rights regarding adjudication of request for waiver, remission or cancellation of debts. Responded to military pay inquiries ranging from standard actions to the most difficult and unusual actions involving bonus eligibility, combat zone special pays and tax exclusions, locality pay, overseas entitlements, hazardous duty pay, severance pay, incapacitation pay, capitalized interest, incorrect service computation data, and other controversial complex pay and entitlement issues. Provided technical support to Army Finance offices on processing entitlement and administrative actions for service members.

Exercised sound independent judgment in planning, organizing, and coordinating administrative activities and in devising and implementing methods necessary to correct deficiencies, resolve problems, and improved procedures. Read and interpreted regulations and changes in procedures and prepares and disseminates office operating procedures and updates as required to ensure accuracy.

Received requirements and distributes to proper source with explanation of additional attachments to ensure proper comments and actions. Set suspense dates and follows up to ensure timely completion.

Utilized travel and financial management automated system to track and prepare government travel vouchers for payment. Audited documents and government travel vouchers for legality, propriety, completeness of documentation and compliance with Joint Travel Regulations (JTR), local regulations, GAO manuals, and Army regulations. Maintained control for compliance with Fiscal Law, DodFMR, program targets and other limitations. Actively enforced the fraud, waste and abuse prevention program. Maintained system files and archive data, to include accounting citation information. Prepared daily disbursing payment upload files and reports.

Performed data entry of military pay information into the Defense Joint Military Pay System.

Performed duties as Lead Health Insurance Technician, in the Outpatient Billing and Collection of the Third Party Collections Program (TPCP), Uniform Business Office. Led the Medical Insurance Technicians (OA), GS-0503-06 and the billing clerk, GS-0503-05 in performing their duties. Upon presentation to the Uniform Business Office, checked individual patients for eligibility of care and determined the reason for the visit. Provided the service member, spouse, or family member with forms, initial guidance, counseling, appropriate information for insurance enrollment, and provided proper instruction. Provided oversight and assistance when established guidelines are not clear or require significant deviation. Balanced, distributed and coordinated the work of assigned insurance technicians. Assigned and explained work to subordinate employees. Coordinated to meet deadlines, providing a continuous smooth flow of work through the office and expedites process of priority cases. Participated in meetings with other personnel and sections to discuss changes in procedures. Assigned and reviewed work accomplished by personnel. Reviewed work for completeness, accuracy and compliance with regulatory requirements. Kept supervisor informed daily of employees participation and concerns. Participated as a member of the TPC selections panel when needed. Oriented and trained new employees.

Used automated systems to extract a variety of financial data and utilized a variety of miscellaneous reports and analysis to track, monitor and report the status of accounts.

If information being sought is outside the medical purview, refers the service member or family member to the appropriate POC for assistance. Reviewed all service member and family member electronic health records using Essentris and MHS Genesis.

Used a computer terminal to input, access, and output bar code scanned medical records for patients.

Monitored the training program, ensuring personnel are advised of available training. Advised employees and supervisor of confirmation of training. Maintained a training library and records of all training completed. Ensured subordinate submitted time/leave using DMHRSI and the ATAAPS timekeeping system.

Assist with the coordination with various medical providers and support staff for case adjudication for JAG cases and rejected medical claims; assist in reviewing documentation in accordance with written policies and regulations.

Provided a variety of general office administrative, clerical, and office automation duties in support of PAD(Patient Administration Division). Received calls, greeted visitors, determined nature of call or business of visitors. Ascertained which should be referred to supervisor or other staff personnel or which can be handled personally. Responded to non-technical requests which can be provided based on personal knowledge or from records and files. Maintained records and files, as appropriate.

Assured that TPCP process are built around sufficient internal controls that meet generally accepted standards. Identified sources of reimbursable earnings and ensuring accurate billing, collecting and reporting of these earnings to the Medical Services Account Office (MSAO) monthly.

Developed office procedures to ensure effective and efficient operations regarding the administrative and clerical work. Informed and instructed officials, specialists and secretarial/clerical personnel in subordinate offices concerning such procedures.
Used word processing software to input/edit correspondence, and reported which included a wide variety of technical terminology; formats/prints (through use of automation printing equipment) to final form in accordance with regulatory requirements. Used reference sources such as technical dictionaries, correspondence regulations and manual/automated spell checks to assure proper arrangements, grammatical and spelling accuracy of the final copy.

Was responsible for ensuring subordinate records of billed claims have adequate audit trails; identifying accounts from aged receivable reports requiring additional actions; and reviewing status of delinquent bills. Directed daily operations for all aspects of outpatient TPCP account management assuring that billing and collection procedures comply with policies and procedures directed by higher authority. Assured that all information required by private insurers be provided to ensure maximum TPCP reimbursement to the hospital. Challenged questionable reductions and denials on reimbursement received.

Used electronic mail and other coordination tools, takes action to meet appropriate administrative deadlines and maintain communication with appropriate staff. Received calls and directs to the appropriate person needing their attention or actions. Ensured that all materials and equipment for conferences, training forums, and other meetings are available. Made copies of materials for management, staff, and patients. Prepared/sent information to numerous internal and external patients via hard copy or email.

Discussed inaccuracies, deviations from procedures and omissions with the originator or subordinate clerical staff to ensure corrections or obtain necessary materials. Signed receipts and obtains receipts when picking up and delivering accountable mail.

Explained and answered questions regarding the TPC Program to patients and their insurance companies including options, entitlements, billing procedures, benefits and rights. Received and validated insurance registration information received at the time of the patient's visit. Called numerous insurance companies to verify insurance coverage, amount of coverage, existing rules and regulations pertaining to the patient's policy. Assisted patients in completing insurance forms. Completed Insurance Verification Form and enter necessary data to identify insurance and benefits to start billing activities into Composite Health Care System (CHCS) and Armed Forces Billing and Collection Utilization Solution (ABACUS) . Was responsible for insurance verification and admission demographics for pre-certification cases. Sought assistance from the Legal Officer to process TPCP outpatient insurance claims that require legal interpretations and/or intervention.

Performed duties as interim Lead Health Insurance Technician, in the Outpatient Billing and Collection of the Third Party Collections Program, Uniform Business Office. Led the Medical Insurance Technicians (OA), GS-0503-06 and the billing Clerk, GS-0503-05 in performing their duties. Provided oversight and assistance when established guidelines are not clear or require significant deviation. Balanced, distributed and coordinated the work of assigned Insurance Technicians. Assigned and explained work to subordinate employees. Coordinated to meet deadlines, provided a continuous smooth flow of work through the office and expedited process of priority cases. Participated in meetings with other personnel and sections to discuss changes in procedures. Assigned and reviewed work accomplished by personnel. Reviewed work for completeness, accuracy and compliance with regulatory requirements. Audited work daily performed appropriate International Classification of Diseases (ICD-10) and Current Procedural Terminology (CPT-4) codes, clinical rate, payments posted to accounts and denied or reduced payment compliance guidelines.

Analyzed Accounts Receivable for assigned claims in a timely manner to determine status of claims errors or obstacles that could delay/prevent payment. Resolved issues related to improperly coded or formatted bills claim appeals and denials. Corrected billing documents to facilitate payment of disputed or rejected bills. Maintained suspense records on all claims and correspondence. Initiated inquiries either telephonically or by letter with insurance companies after pre-established time frames in order to determine why subject bills have not been paid. Reviewed each bill based on current coding information, procedures and guidelines of the insurance industry. Returned to Clinical Coders encounter for approval/disapproval of codes, diagnosis and procedure. Ensured that services provided are entered with the correct MEPRS code since this code is the key to charge generated per visit and maintained in accounting record. Medical and MEPRS codes(s) and validity of bill are subject to audit by DOD, MEDCOM or health insurance industry. Requested and reviewed medical documents relating to accidents/injuries for the (MACP). Verified amounts received against amounts billed. Computed percentage of bill paid; closed the account when less than received amount is deemed correct, or re-billed the insurance company for the difference with appeal letter. Reconciled payments received, write-offs posted to computer ledgers. Reconciles daily amount posted to Treasury Office deposit. Reviewed insurance payments; sends questionable payments/denials back to insurance company for review for additional reimbursement. Reconciled account balances during daily audits of closed accounts. Corrected billing documents, when necessary, to enhance payment of denied or compromised bills. Reviewed accounts receivable reports to analyze claim rejection trends. Reviewed Explanation of Benefits (EOB) for appropriateness to the claim submitted. Identified ways to decrease turnaround time and increase collections. Reviewed partial payment(s) for appropriate disposition on the part of the insurance company. Conducted regular reviews of receivable to identify positive or negative trends that are further reflected through financial resources in terms of gains or losses.
Advised UBO Manager of unusual trends for non-payment by insurance companies. Provided input, In writing, to the UBO manager for analytical and evaluative methods to improve the TPCP. Assisted in defining the processes necessary to improve and upgrade automation systems based on historical data and practical experience. Applied third party billing and accounting principles to define process requirements. Based on analysis of electronic billing/accounting programs and system requirements made recommendations for changes in programs currently in use. Sought assistance from the Legal Officer to process TPCP outpatient insurance claims that require legal interpretations and/or intervention.

Assured that Third Party Collection Program (TPCP) processes are built around sufficient internal controls that meet generally accepted standards. Assured that all information required by private insurers be provided to ensure maximum TPCP reimbursement to the hospital. Challenged questionable reductions and denials in reimbursement received. Reviewed insurance bills and/or medical claims containing problems that could not be resolved by lower graded clerks/technicians. Ensured that bills submitted to insurance carriers are limited to medical care for services provided to non-active duty eligible beneficiaries who covered by private insurance plans. Returned bill lacking required information to responsible clerk/technician for follow-up correction.

Reviewed payments and Explanation of Benefits (EOB) received from the insurance companies. Researched and follows-up unsatisfactory third party response (i.e. claim denials, inadequate payment, and non-response to bill) in order to ensure maximum patient account reimbursement to the hospital. This included telephone contacts, letters, and any steps necessary for satisfactory resolution of the claim. Ensured compliance for valid denials with all requirements of federal, Department of Defense, MEDCOM, and Winn Army Hospital instructions pertaining to payment and follow up of claims. Documented all information received from the insurance company. Determined from insurance policy benefits whether denied claims should be written off, appealed for further action, or referred to the legal office for further collection action. Screened hospital admissions, emergency room treatment reports and EMS trip reports to obtain information on potential inpatient claims and tort liability claims.

Directed daily operation for all aspects of outpatient TPCP account management assuring that billing and collection procedures comply with policies and procedures directed by higher authority.

Reviewed each encounter for consistency, accuracy, and completeness of data (i.e., ICD-10 codes, diagnosis; Evaluation and Management Codes; CPT-4 codes, procedures). Researched CHCS, ALTHA and patient records, reconstructs incorrect or missing medical information required to prepare a valid insurance billing when data received is incomplete. Determined if the encounter is a billable visit as defined by DOD guidelines and inputs data in ABACUS accordingly. Verified charges calculated per clinical service (MEPRS Code), Pharmacy charges, or high cost procedures.

Ensured that each insurance technician is properly trained to work independently in all TPC functions including but not limited to Billing, collection, research, systems, etc. Information taken from medical treatment records; ensured that each technician exercised judgment as to what information is pertinent. Processed a variety of medical data that pertains to possible Third Party Liability cases. Prepared paperwork and ensures compliance with the Privacy Act, Medical Recovery Act, HIPPA Privacy Act and Army DOD regulations to maintain secure information. Ensured timely work-up on all cases. Forwarded Monthly Accounts Receivable to the UBO Chief for reviewing, analyzing, and managing.

Maintained appropriate accounting records and prepared financial reports connected with Third Party Collection Program and Medical Service Account dining hall collections and all other collections within the Winn Facility.

Posted payments received from the insurance companies to appropriate computerized ledgers and subsidiary ledgers. Verified amounts received against amounts billed. Computed percentage of bill paid; closed the account when less than the received amount is deemed correct, or re-billed the insurance company for the difference with an appeal letter. Reconciled payments received, and write-offs posted to computer ledgers. Reconciled daily amount posted to Treasury Office deposit.
Ensured all charges are properly identified. Posted receipt of payments to the appropriate account. Initiated follow-up on all bills that were not paid in full to ensure the maximum amount authorized was paid.
Contacted insurance companies/MSA patients, staff, and providers by phone or fax to resolve outstanding payments due. Worked with patients to set up payment terms if necessary, in the cases of large bills. Worked directly with patients, insurance and attorney representatives, and other staff members.
Balanced daily business transactions which include processing Dining Facility collections, collections from attorneys and insurance companies for copy charges, patient payments for outstanding bills and payments from Medical Health Insurance companies on behalf of patient beneficiaries. Prepare SF215 (deposit ticket) and made deposits to local bank. Inputted processed SF215 data into the OTCnet system after bank deposit has been completed.
Responsible for verification of other health insurance and MSA accounts to include all billing, collection and claims follow up for assigned beneficiaries MSA accounts and the outpatient Third Party Collection Program. Processed UB92s through Armed Forces Billing And Collection Utilization Solution, electronic invoices through ABACUS, all medical treatment provided, all pharmaceuticals provided, and for laboratory and x-ray procedures ordered by providers. Received all payments from MSA, dining hall, copying charges and insurance companies, prepared money for deposit and balances accounts on a rotating basis.
Registered patients into the hospital information system and initiates a Defense Enrollment Eligibility Reporting System check to verify eligibility for care. Advised sponsor family member found not eligible in DEERS and provided basic information on requirements for DEERS eligibility. Directed patients to DEER enrollment office and maintain a suspense file for billing purposes for non-complaint patients. After the patient is determined eligible for care, full registration information is entered into CHCS covering the sponsor and all information of a dependent and their military status. Reviewed for accuracy patients registration forms used during periods of down-time on Composite Health Care System and back enters all data collected into CHCS when the system is back on-line. Verified all personnel data in correct in computer system.

Reviewed payments and Explanation of Benefits (EOB) received from the insurance companies. Researched and followed-up unsatisfactory third party response (i.e. claim denials, inadequate payment, and non-response to bill) in order to ensure maximum patient account reimbursement to the hospital. This includes telephone contacts, letters, and any steps necessary for satisfactory resolution of the claim. Operated a customer service window to service patients. Checked identification of patrons, screened delivery notices and retrieve mail from mailroom. Responded to customer inquiries concerning undeliverable, forwarded, or returned to sender mail and determined the ultimate destination of mail that was returned by using DEERS and CHCS to update correct mailing address. This required constant updating of rosters and files. Ensured compliance for valid denials with all requirements of federal, Department of Defense, MEDCOM, and Winn Army Hospital instructions pertaining to payment and follow up of claims. Documented all information received from the insurance company. Determined from insurance policy benefits whether denied claims should be written off, appealed for further action, or referred to the legal office for further collection action. Screened hospital admissions, emergency room treatment reports and EMS trip reports to obtain information on potential inpatient claims and tort liability claims.
Interacted with Admission's office, CHCS and DEERS for information to complete or change registration and make all corrections identified from DEERS and other data source. Applied temporary indicators to patient registration fields, in order to alert the hospital to restrictions and deter fraud. Continuously updated patient information as required.

Researched new insurance registrants or CHCS appointment history report to capture new and old billable visits. Retrieved medical records.

Reviewed patient's computerized data after their admitted to the medical facility. Reviewed criteria under which the patient was admitted to insure proper eligibility and billing, such as director transfer admission, patient category and patient eligibility. Collected required data to complete forms, entered data into system, ensured that necessary forms are completed in accordance with specified guidance and materials is assembled, separated and disseminated for expeditious processing. Guidelines include established operation instructions, hospital and department standard operating procedures and numerous procedural guides in the form of correspondence and other manuals.
Familiar with medical terminology and an understanding of the organization's programs and operation. Timely and accurate completion of data input and the accuracy of collected patient information will be reflected on several generated documents and reports, which are used to monitor specific items by a variety of agencies. Patient treatment could be adversely affected by incorrect procedures throughout the admission and process disposition. Reviewed all information to insure proper data collections is reflected on all bills being processed, and patient notification letters and any other documents that affects patient care.