An Accomplished Agency Director experienced in running successful operations. Knowledgeable about recruiting and training employees, developing business plans and administering finances. Solid interpersonal, program management and leadership skills developed over 15+ years of progressive health insurance billing and collection experience.
Hiring, training, and supervising administrative staff
Managing finances, including budgets and payroll
Collaborating with medical personnel to develop and assess business strategies
Ensuring practice complies with industry regulations to included human resources administration and management to include FMLA, HIPAA, ADA, etc.
Interacting with patients and addressing any concerns or complaints
Organizing patient records
Conducting regular staff meetings and performance reviews
Working as a team to ensure the practice runs effectively and meets objectives
Performed new applicant primary source verification
Updated database for currency and accuracy
Provided quality analysis and oversight
Coordinated with physicians and medical staff administrators
Review client bills for accuracy and completeness and proactively obtain any missing payer information for inclusion
Post adjustments, transfer of responsibility, and refunds, when needed, and update accounting records accordingly
Prepare invoices, reconcile billing, compile reports and other documents using billing software, and field related questions from internal teams and customers
Submit insurance claims and follow up on unpaid, rejected, or denied claims to resolve and resubmit when required
Prepares patient statements for charges not covered by insurance
Insureds statements are mailed on a regular basis
Work with patients to establish payment plan for past due accounts in accordance with provider policies
Provide necessary information to collection agencies for delinquent or past due accounts
Posts insurance and patient payments using medical claim billing software
Perform “soft” collections for patient past due accounts by contacting and notifying patients via phone or mail
For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer
Follows HIPAA guidelines in handling patient information
Create insurance or patient aging reports using a medical practice billing software
Create managed care authorization request and limits to coverage such as the number of visits
Verified patient benefits eligibility and coverage
HUMAN RESOURCE IN ACCOUNTING - Accounting And Computer Science
Skinner Business School
Garden City, NY
06.1985
Skills
Interoffice Correspondence
Reporting Requirements
Setting Budgets
Staff Support
Hiring and Onboarding
Individualized Care Plans
Workflow Schedules
A/P and A/R Expertise
Personnel Management
Financial Administration
Collections
Monthly Reconciliations
Leadership Training and Development
Develop Policies
Unemployment Claims
Recruitment and Hiring
Payroll Coordination
Compensation and Benefits
Insurance Claims Analysis
Protected Health Information
Customer Experience
EMR Systems
ICD-10 Requirements
Inpatient Coding
Past Due Account Management
Filing Appeals
Denial Appeals Process
Certification
Privacy Compliance Problem Anticipation and Resolution Administering Payroll
Employee Performance Reviews Performance Monitoring and Evaluation
Finance and Accounting Oversight Records Organization and Management Hiring and Onboarding
Customer Care Revenue Growth
HUMAN RESOURCE IN ACCOUNTING - Accounting And Computer Science
Skinner Business School
Privacy Compliance Problem Anticipation and Resolution Administering Payroll
Employee Performance Reviews Performance Monitoring and Evaluation
Finance and Accounting Oversight Records Organization and Management Hiring and Onboarding
Customer Care Revenue Growth
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