Summary
Overview
Work History
Education
Skills
Timeline
Generic

Margaret Mermea

Berne,TX

Summary

Skilled and dedicated with experience in coordinating, planning, and supporting daily operational and administrative functions. Highly focused and results-oriented in supporting complex, deadline-driven operations; able to identify goals and priorities and resolve issues in initial stages. Highly competent who can be trusted with even the most confidential projects. Excel in turning disorganized environments into smooth-running operations and overhauling administrative processes to improve accuracy and efficiency.

Overview

13
13
years of professional experience

Work History

Administrator/Therapy Account Manager

Texas Kids Home Therapy/Pediatric Home Healthcare
01.2018 - Current
  • Serve as point of contact related to client concerns and needs along with building client relationships
  • Maintain accurate client records, track contract updates and renewals
  • Oversee high volume departments ensuring that KPI's are being met and updating processes as needed to ensure workflow while monitoring agency regulatory compliance statistics along with handling of self-reporting cases
  • Track gross revenue and budgets to ensure business growth.

UM Coordinator Lead

Well Med Healthcare
01.2017 - 01.2018
  • Receives and responded to escalated Care Coordination inquiries from various venues
  • Coordinates and assist with initial screening of complex case screening and UM requests
  • Conducts outbound calls for program requirements
  • Completes effective data entry of in-bound and/or outbound call contact information into software applications
  • Train and mentor new employees.

Lead Referral/ Authorization coordinator

Ageless Living Home Health LLC
01.2014 - 01.2017
  • Responsible for coordinating specialty care for patients in need of therapy as requested by the primary care physician
  • Scheduling, tracking referrals, case management and providing reports
  • Obtaining prior authorization for initial treatment and continued treatment
  • Following up with primary care physicians and parents on referrals
  • Obtaining benefits from insurance and explaining coverage to parents
  • Projections/actuals for therapy
  • Managed caseloads for therapists
  • First of the month eligibility checks/ switches
  • Medical order processing
  • Help resolve parent complaints/Concerns.

Lead Service Representative

MCNA Dental
01.2011 - 01.2014
  • Collected customer feedback and made process changes to exceed customer satisfaction goals
  • Provided accurate and appropriate information in response to customer inquiries
  • Addressed customer service inquiries in a timely and accurate fashion
  • Always maintained up-to-date records
  • Properly directed inbound calls in phone queues to improve call flow.

Education

High School Diploma -

Lanier High School
San Antonio, TX
06.2005

Certification - Medical Billing/Medical Specialist

Kaplan College
San Antonio, TX
02.2009

BA- In Progress - Business with Health Services Management

DeVry University
Virtual
12.2024

Skills

  • Business Development and Planning
  • Staff Development
  • Excellent Communication Skills
  • Revenue Growth
  • Client Relations
  • Strong Lead Development Skills
  • Customer Relationship Management
  • Strategic Planning
  • Compliance Requirements
  • Staff Management
  • Employee Mentoring
  • Database Management
  • Internal Auditing
  • Prioritizing Workflows
  • Issue Resolution

Timeline

Administrator/Therapy Account Manager

Texas Kids Home Therapy/Pediatric Home Healthcare
01.2018 - Current

UM Coordinator Lead

Well Med Healthcare
01.2017 - 01.2018

Lead Referral/ Authorization coordinator

Ageless Living Home Health LLC
01.2014 - 01.2017

Lead Service Representative

MCNA Dental
01.2011 - 01.2014

High School Diploma -

Lanier High School

Certification - Medical Billing/Medical Specialist

Kaplan College

BA- In Progress - Business with Health Services Management

DeVry University
Margaret Mermea