Dawauna Sharpe
Columbus,OH
Summary
Highly skilled Business Office Manager with background in overseeing operational efficiencies, managing staff and ensuring smooth-running office environments. Strengths include strategic planning, budgeting, project management and team leadership. Previous roles have resulted in improved productivity, streamlined processes and cost reductions. Demonstrates strong communication skills combined with ability to handle multiple tasks simultaneously.
Overview
10
10
years of professional experience
Work History
Business Office Manager
Trilogy Health Services
Gahanna, OH
10.2022 - Current
- Plans, supervises and coordinates the business office operations of the health campus
- Oversees billing for the health campus in accordance with current accounting principles and in conjunction with company policies and procedures
- Oversees and supervises the business office staff and administrative functions for the health campus
- Establishes and maintains filing systems for accounts receivable, accounts payable, resident information, personnel information, etc
- Ensures daily and weekly Key Statistics Reporting is completed timely and accurately per policies and procedures
- Creates and sets-up new residents in the Accounts Receivable system
- Provides back-up assistance for AP/Payroll functions
- In conjunction with the Executive Director, supervises the processing of accounts payable and payroll within the required deadlines
- Manages the set-up and maintenance of resident’s files in accordance with company standards
- Manages setting up new residents in the Accounts Receivable system
- Maintains census records in Accounts Receivable system for accurate billing
- Manages month-end billing processes for all payer classes in an accurate and timely manner according to monthly AR calendar
- Assists with posting payments received appropriately to the correct resident account/cash receipt journal
- Reconciles cash receipts journal to the monthly deposit log; send a copy to the Home Office at each month end
- Supervises and maintains resident files and resident trust accounts
- Records deposits, make payments as appropriate, reconciles the resident trust account monthly, and sends a copy of the reconciliation to the Home Office
- Allocates interest earned to the resident accounts timely and accurately
- Issues resident trust statements in accordance with regulations
- Monitors and collects accounts receivable
- Prepares monthly report for quarterly AR reviews with Executive Director and Business Office Support
- Supervises the scheduling of office personnel, work assignments, etc
- Assists in the standardization of the methods in which work will be accomplished
- Ensures consistent adherence to established procedures for cost control regarding supplies and purchase order policies and procedures
- Monitors, maintains and ensures office supplies inventory
- Inventories supplies to provide an adequate but not over-stocked inventory
- Attends and participates in annual company required in-service training programs
- Minimal travel including overnight stay as necessary
Billing and Credentialing Provider Enrollment Manager
MARYHAVEN INC
Columbus, OH
12.2020 - 10.2022
- Responsible for all aspects of the provider enrollment credentialing and re-credentialing processes with payers, including Medicaid, Medicare, Managed Care, and private insurance
- Responsible for ensuring all provider credentials are accurate and up-to-date with all applicable health plans payers
- Perform the administrative and technical duties necessary to complete the provider enrollment process with insurance payers
- Complete and review provider applications with accuracy and thoroughness, contact providers for application information when necessary, contact government agencies and managed care companies to obtain status and resolve discrepancies related to provider applications, and follow-up with providers and assist with completing applications
- Complete on-going communications with providers and payers to ensure applications are being processed
- Ensure timely submissions of all re-appointments and re-credentials, verifies all licenses are current, and maintain internal files, including copies of current credentials
- Maintain accuracy of and update of provider credentials in the electronic health record system
- Provide superior customer service at all times to internal and external contacts including customers, providers, representatives, and co-workers
- Act as liaison between The Director of Operations, Billing Manager and payers, identify delays with payers, escalate and communicate delays or issues timely to the Director of Operations
- Billing for all payer types such as: Commercial, Medicaid, Medicare, Managed Care, Private Pay payments and work denied claims
- Verify client insurance coverage
- Communicate with staff and update EHR and Spreadsheets
- Other duties as assigned
Billing and Credentialing Manager
Access Advantage
Columbus, OH
12.2016 - 11.2020
- SNF Billing
- Verified insurance eligibility and information with 100% accuracy
- Estimated financial out of pocket costs for out/in-patient services
- Billed medical procedures and diagnostics following coding guidelines with proven results
- Ensured claims submission with 48 hours of receipt
- Posted and reconciled insurance and patients' payments
- Researched and resolved incorrect payments, EOB rejections and other issues with outstanding accounts
- Ensure accuracy of insurance claims
- Verify corrected ICD-10 and CPT codes for a verity of specialties
- Set up new patient's accounts
- Retrieve Electronic Remittance Advice
- Submitting secondary claims upon processing of primary insurance
- Processed monthly patient's statements
- Resolved patients billing inquiries
- Re-submitted insurance claims as necessary
- Knowledgeable in timely filing restrictions
- Follow HIPAA regulations
- Experience with HMO's insurance
Medical Billing Supervisor
Sedgwick
Columbus, OH
08.2014 - 12.2016
- Process bills in accordance with multi state schedule, rules, regulations and guidelines
- Review operative reports to determine if surgery services were appropriately billed
- Reviews complex medical, legal and consult services, Contact client or facility to obtain additional or missing information
- Handles provider appeals and contractual disputes
- Assist bill review Supervisor with workflow management, coaching and mentoring of staff
- Assist with process, procedures and system training for new staff
- Utilizing ICD 9, ICD 10, CPT and HCPCS Codes
Education
MBA -
Franklin University
Columbus, OH01-2000
BA - Health Information
The Ohio State University
Columbus, OH01.1998
Skills
- Healthcare Management
- Insurance Verification
- Leadership
- Customer service
- Medicare/Medicaid
- Quality assurance
- Revenue cycle management
- Payroll
- Accounts payable
Timeline
Business Office Manager
Trilogy Health Services
10.2022 - Current
Billing and Credentialing Provider Enrollment Manager
MARYHAVEN INC
12.2020 - 10.2022
Billing and Credentialing Manager
Access Advantage
12.2016 - 11.2020
Medical Billing Supervisor
Sedgwick
08.2014 - 12.2016
MBA -
Franklin University
BA - Health Information
The Ohio State University