Experienced Respiratory Therapy Referrals Manager with over 20 years of expertise in respiratory care coordination, medical billing, data management, and compliance oversight. Skilled in managing referrals, generating reports, processing claims, and ensuring regulatory adherence across multiple programs and patient populations. Proven ability to lead departmental operations and collaborate with physicians, insurance providers, and health plans.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Respiratory Therapy Referrals Manager
Integrated Home Care Services
Miramar, FL
12.2015 - Current
Referral & Intake Oversight Summary:
Lead a team of ~15 respiratory professionals, managing daily operations and patient care.
Handle intake and prescription processing for respiratory DME equipment, including oxygen and sleep therapy.
Ensure timely equipment setup by verifying documentation and coordinating with physician offices.
Maintain accurate referral logs and perform data entry into internal systems.
Communicate with physicians and case managers to confirm orders and resolve issues.
Monitor referral volume and generate reports to support planning and compliance.
Monthly Program Management: Ventilator Program
Oversee care for ~40 invasive and ~200 noninvasive ventilator patients.
Generate and analyze monthly compliance reports detailing therapy settings, prescription status, and patient progress.
Distribute reports to physicians and MD offices to ensure timely clinical updates and informed decision-making.
Maintain accurate patient records and ensure all documentation meets regulatory and internal standards.
Conduct ongoing in-services to train staff and reinforce compliance protocols and data accuracy.
Neb Closet Program
Coordinate statewide distribution of nebulizer compressor setups to multiple MD offices.
Ensure bi-monthly equipment delivery and support for in-office patient visits.
Track inventory, delivery schedules, and usage reports to maintain program efficiency.
After-Hours Service Program
Manage call volume, response tracking, and follow-up for urgent respiratory needs.
Maintain daily spreadsheets and reports to ensure all patient calls are addressed promptly.
Monitor service trends and escalate unresolved issues to leadership for resolution.
Respiratory Therapy Intake & Referral Lead
Univita Health
Miramar, FL
12.2010 - 08.2015
Collaborated with admissions, discharge planning, and clinical teams to verify connection with key professionals involved in case upon release of client information.
Processed patient intake information and updated medical records prior to treatment.
Completed insurance verifications and claim forms for patient intake and processing.
Communicated with patients to ensure quality of care and develop care plans.
Scheduled evaluations and procedures for patients.
Biller & Coder
ADP Processing
Miami, FL
06.2003 - 12.2010
Communicated with insurance representatives to complete claims processing or resolve problem claims.
Submitted appeals using provider portals and phone communication.
Contacted insurance providers to verify insurance information and obtain billing authorization.
Coordinated communications between patients, billing personnel, and insurance carriers.
Reviewed claims for coding accuracy.
Handled billing, waivers, and claims for private and commercial clients.
Input details into accounts and tracked payments.
Applied HIPAA privacy and security regulations while handling patient information.
Completed and submitted appeals for denied claims.
Medical Referrals and Diagnostics Coordinator at Health First Family Care CenterMedical Referrals and Diagnostics Coordinator at Health First Family Care Center