Donna Szeluga
Greenville,SC
Summary
A dedicated professional committed to upholding the values of quality, integrity, and professionalism. Thrives in diverse and adaptable environments, with a proven track record of success. Brings a strong work ethic and a commitment to delivering exceptional results. Experienced in [relevant industry], adept at [specific skills or areas of expertise]. Passionate about driving innovation and fostering collaboration. Eager to contribute skills and knowledge to a dynamic organization that shares values and is committed to making a positive impact.
Overview
35
35
years of professional experience
Work History
Practice Manager/Administrator
The Pulmonary Group of WNY, LLP
Williamsville, NY
03.2006 - Current
- Management of all financial data, money market and banking accounts
- Monthly reconciliation of all accounts
- Contract negotiator for Corporation
- Corporate Consultant and recruiter of new physicians and physician extenders
- Formatted a monthly 20-page status report of income and expenses, physician total billing records, practice statistics and billing patterns
- Observed and educated providers on monthly billing practices
- Monthly executive session to educate providers on CPT and ICD-9, ICD-10 coding
- Finding new and advanced billing practices
- Tracking of date of service and date of entry statistics
- Tracking of trends and CPT fee schedule forecasting
- Compiled statistics and negotiated fee schedules to form a Pulmonary Function Laboratory
- Provider credentialing including CAQH
- Resolved and investigated billing errors totaling $650,000.00, nearly nine months later receipts of $410,000.00 were received through re-billing and negotiating with major insurance carriers
- Currently, I am beginning to develop an Independent Diagnostic Testing Facility, gathering insurance data and projecting future trends and financial patterns
- Human Resource management of worker’s compensation, NYS DBL, employee health insurance, dental insurance
- Annual reporting of forecasting CPT reimbursements, national statistics and averages
- Bi-weekly educational meeting for physicians on Medicare guidelines, new billing practices and new coding to be utilized
- Compiled government guidelines, reviewing policies and forming standard operating procedures
- Company pension administrator
- Marketing for the medical practice, Sleep Medicine and Hyperbaric Oxygen Therapy
- Purchased, organized and trained Physicians and staff, - transformed medical practice from paper charting to Electronic Medical Health Records
- Instrumental in becoming the first multi-specialty practice in Buffalo to adhere to Obamacare and 'Meaningful Use'
- Meaningful Use project speculated to bring income total of $44,000.00 per physician over a five-year period
- Training of five other medical practices on the reporting features of E-Clinical works electronic charting software
- Implementation of two new offices
- Implementation and structuring of new Primary Medicine sub group
- All credentialing and re-credentialing of facilities and physicians
- Negotiation of fee schedules
- Creation of first patient portal in Buffalo, NY
Billing Consultant
Independent Billing Service
Newfane, New York
09.1989 - Current
- Training and teaching new physician staff members on medical billing, office procedures, collections, third party, and general follow up skills
- Private Consulting with patients and medical billing resolving
- Private Consulting with physicians and facilities with regards to difficult billing issues and Electronic Health Record training
Supervisor of the Federal Employee Program
Blue Cross Blue Shield of Western New York
Buffalo, New York
06.2004 - 04.2005
- Team Leader of the Federal Employee Program
- Processed and ran daily reports and spreadsheets, as well as developing fundamentals to a staff of 15
- Government based while following stringent guidelines in a Federal Program
- FEP based software system, Lotus, Excel, FEPDIRECT, and Facets Frisco
- Increased production standards; increased of quality assurance
Director of Business
The Waters of Gasport
Gasport, New York
12.2003 - 11.2004
- All accounting practices, departmental budgets, census reconciliation, initial screening and submission for Medicare and Medicaid clients
- Residential trust accounts, admission agreements and discharge submissions
Supervisor of Claims Processing
Independent Health
Williamsville, NY
05.2002 - 12.2003
- Supervisor of 24 employees
- Processed 10 daily reports
- Member of multiple committees and meetings
- Processed and created standard operating procedures
- Problem solving of claim and authorization issues
- Team building and motivational support of staff
Customer Service Representative
Independent Health
Williamsville, NY
01.2000 - 05.2002
- Customer Service representative for provider relations
- Problem solving claims and authorization issues
- Promoted within 8 months to begin the 1st in WNY Hospital relations team
- This team was responsible for skilled nursing and all hospitals that inquire on claims issues and member/provider issues
Education
BSN - Healthcare, Business Management
University at Buffalo
12.1982
Skills
- Excel
- Facets
- IMAX
- Lytec Medical Software
- MedWisdom
- Microsoft Applications
- Peachtree Accounting Software
- POWER MEDICAL SYSTEM
- E-Clinical Software
- V9-11
Community Service
- Big Brothers and Big Sisters of Niagara County, 08/2009, Present
- United Way Volunteer, 08/2000, Present
- Camp Good Days and Special Times Volunteer, 06/2000, Present
- Roswell Park Cancer Institute Volunteer, 01/1998, Present
- Independent Health Professional Management Panel, 12/2007, Present
- Univera Advisory Panel, 01/2011, Present
- American Lung Association, 01/2015, Present
- Pancreatic Cancer Action Network, 02/2016, Present
Timeline
Practice Manager/Administrator
The Pulmonary Group of WNY, LLP
03.2006 - Current
Supervisor of the Federal Employee Program
Blue Cross Blue Shield of Western New York
06.2004 - 04.2005
Director of Business
The Waters of Gasport
12.2003 - 11.2004
Supervisor of Claims Processing
Independent Health
05.2002 - 12.2003
Customer Service Representative
Independent Health
01.2000 - 05.2002
Billing Consultant
Independent Billing Service
09.1989 - Current
BSN - Healthcare, Business Management
University at Buffalo