John J. Laboy
Charleston,SC
Summary
Driven person committed to giving patients thorough care and support with administration. Able to manage internal databases and information systems, organize and arrange medical records, and coordinate benefits and services with medical providers. Specializes in keeping track of supplies and equipment. Consistently recognized for leadership and strong effort levels that influence project performance, motivated by superior quality, integrity of data, and execution guidelines. Regarded as an influential instructor who can both personally and professionally grow people. Goal-driven Healthcare Administration professional well-versed in recruiting, training and managing employees to provide exceptional resident services. Highly organized and hardworking with excellent planning and program management skills.
Overview
26
26
years of professional experience
Work History
Sr. Patient Coordinator
Tri-county Radiology
03.2023 - Current
- Use data to do analytical tasks and charting tasks related to patient information!
- Interviewed patients to collect data and insurance details
- Document insurance data, personal information, payment methods and other important patient information
- Coordinate care for patients including overseeing admissions and managing workflows
- Manage patient accounts with contact information, insurance, and financial information in a confidentially
- Schedule patient visits and answer questions, including billing and preparations
- Ensure services comply with state and federal regulatory requirements.
Business Office Manager
Promedica Hospice
09.2021 - 03.2022
- Liaising with healthcare professionals to improve administrative processes
- Responsible for billing, payroll, A/P and A/R functions, for all product lines
- Knowledge of clerical responsibilities for all product lines
- Knowledge of state & federal regulations regarding billing, aged-accounts, and denials of claims
- Maintain physician license verification book
- Prepare reports for the Administrator and/or Director of Professional Services as needed
- Participate in agency quality improvement activities
- Responsible for oversight of set up of new patient charts
- Process timecards for productivity and complete paperwork
- Promote positive inter-agency communication
- Provide role modeling of teamwork, accountability, and a positive attitude
- Increased public understanding of services and assure development by using all resources
- Supervise staff including oversight of productivity, accuracy, systems needs and staffing needs
- Responsible for interviewing, selection, orientation & training of Team Coordinators
- Evaluate, counsel, and implement appropriate disciplinary action, as necessary.
Program Coordinator I
Absolute Total Care
07.2018 - 09.2021
- Liaising with healthcare professionals to improve administrative processes
- Train and mentor other Program Coordinators to enable the continuous development of others
- Coordinate, maintain and submit various reports for several departments
- Research business initiatives through data analysis
- Manage escalated issues from internal and external sources
- Ensure assignments are compliant with legislative, regulatory, and accrediting body requirements
- Conduct performance improvement projects and report on certain performance measures
- Research complex issues across multiple databases
- Worked with staff to clear up member concerns
- Identify trends related to member queries that led to developments in quality performance standards
- Coordinate services with community-based organizations
- Training new staff members and evaluating staff performance
- Ensuring compliance with health industry regulations
- Conduct Health Risk Assessments and the data entry of results into network systems
- Lead in the development and maintenance of databases
Preauthorization Coordinator
Early Autism Project
03.2018 - 07.2018
- Office Closure)
- Obtained prior authorization of services to be rendered as required by patients plans
- Completed and manage all paperwork or supportive documentation required for accurate billing
- Collaborated in weekly meeting in providing updates on all authorizations acquired and renewed
- Researched complex issues across databases and work with support staff to settle patient issues
- Translated and explain information regarding eligibility requirements.
Customer Service Rep
Palmetto Health
02.2016 - 03.2018
- Analyzed customer service inquiries related to benefits, eligibility, coding and claims requests
- Researched all issues across multiple databases and work with support staff to solve patient issues
- Communicated and reinforce organizational culture and value
- Promoted change through establishment and sharing of best practices
- Managed escalated issues from internal and external sources
- Interfaced at all organizational levels to ensure an accurate form, contract task, and claims operations
- Monitored team processes and outcomes, while recommending process improvements based on trends
- Assisted the leadership team in the development and training of new processes and systems
- Safeguarded claims were processed in compliance with state and federal regulations
- Educated providers regarding policies & procedures related to referrals and related topics.
Bi-lingual Customer Service Rep
Medical University Of South Carolina
06.2014 - 02.2016
- Resolved customer service / provider inquiries related to: benefits, eligibility, coding and claims
- Communicated and reinforce organizational culture and value
- Coordinated receipt of provider/producer data with outside vendors and other entities
- Ensured compliance with state and federal regulations
- Reviewed claims processed incorrectly and gathered information pertinent to all claims.
Customer Advocate
Verizon Wireless
09.2012 - 05.2014
- Interpreted and describe information regarding eligibility requirements
- Analyzed customer questions regarding bills, payments, and plan options
- Isolated patterns relating to questions that resulted in new processes in terms of quality standards
- Utilized negotiation and problem-solving skills to resolve customer concerns
- Managed follow-up of members and providers regarding ongoing concerns
Customer Service Specialist II
Healthcare Management Administrators
12.2009 - 02.2012
- Initiated and monitored standards of performance
- Interpreted and explained information such as benefits, claims and eligibility requirements
- Performed provider orientations and educations, including writing and updating orientation materials
- Educated providers regarding procedures related to referrals, claims submission, and related topics
- Isolated trends related to all queries that led to process advances in quality / performance standards
- Investigated claims processed incorrectly and gathered information pertinent to claims
- Resolved and handled multiple task to achieve target and team goals
Customer Service Lead
Regence BS of Washington
04.1998 - 11.2005
- Interpreted and defined information such as benefits and eligibility
- Manage team members performance
- Provided training and onboarding to new hires
- Worked with various auditing entities to review reimbursement and provider data accuracy
- Assisted the leadership team in the development and training of new processes and systems
- Assisted internal team members with enrollment-related questions and issues
- Supervised resolutions of member/provider questions regarding benefits, claims and enrollment
- Educated providers regarding policies related to referrals, claims submission, and related topics
- Performed provider orientations and education, including writing and updating orientation materials
- Investigated reviewed complex claims processed incorrectly
- Conducted audits and provided feedback to reduce errors and improve performance
- Communicated daily with team and providers regarding ongoing concerns
- Examined claims, and contractual data to provide updates to physicians and members.
Education
Master of Science - Health Services Administration
Strayer University
Columbia, SC06.2023
Bachelor of Arts - Business Admin
Strayer University
Columbia, SC06.2021
No Degree - Military
United States Marine
Parris Island, SC08.1989
Skills
- Medical Terminology
- Benefits & Eligibility
- Internet/Web Applications
- Audit & Compliance
- Records Management
- Quality Performance
- Employee Development
- Judgment & Decision Making
- Epic / Trucare / Omni/ QRIS
- Analytical Skill
- Critical Thinking
- MS Office
- Conflict Resolution
- Inventory Management
- EPIC EMR
- Quality Assurance
- Patient Care Coordination
- Customer Service
- Operational Requirements
- Patient Support
- Insurance Practices
- Multitasking Abilities
- EMR Systems
- Medical Services Administration
- Weekly Payroll
- Insurance Form Processing
- Medical Equipment
- Front-End Operations
- Patient Health Information Access
- HIPAA Guidelines
- Scheduling
- Medical Terminology
- Verbal and Written Communication
- Administrative Supervision
- Healthcare Operations
- Clinic Administration
- Process Improvement
- Patient Rapport
- Patient Assessments
- Patient Registration
- Claim Processing
- Patient Care Plans
Languages
Spanish
Native or Bilingual
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
The real test is not whether you avoid this failure, because you won’t. It’s whether you let it harden or shame you into inaction, or whether you learn from it; whether you choose to persevere.
Barack Obama
Timeline
Sr. Patient Coordinator
Tri-county Radiology
03.2023 - Current
Business Office Manager
Promedica Hospice
09.2021 - 03.2022
Program Coordinator I
Absolute Total Care
07.2018 - 09.2021
Preauthorization Coordinator
Early Autism Project
03.2018 - 07.2018
Customer Service Rep
Palmetto Health
02.2016 - 03.2018
Bi-lingual Customer Service Rep
Medical University Of South Carolina
06.2014 - 02.2016
Customer Advocate
Verizon Wireless
09.2012 - 05.2014
Customer Service Specialist II
Healthcare Management Administrators
12.2009 - 02.2012
Customer Service Lead
Regence BS of Washington
04.1998 - 11.2005
Master of Science - Health Services Administration
Strayer University
Bachelor of Arts - Business Admin
Strayer University
No Degree - Military
United States Marine
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