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
2018.01 - 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
2017.01 - 2018.01
- 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
2014.01 - 2017.01
- 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
2011.01 - 2014.01
- 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, TX06.2005
Certification - Medical Billing/Medical Specialist
Kaplan College
San Antonio, TX02.2009
BA- In Progress - Business with Health Services Management
DeVry University
Virtual12.2024
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
2018.01 - Current
UM Coordinator Lead
Well Med Healthcare
2017.01 - 2018.01
Lead Referral/ Authorization coordinator
Ageless Living Home Health LLC
2014.01 - 2017.01
Lead Service Representative
MCNA Dental
2011.01 - 2014.01
High School Diploma -
Lanier High School
Certification - Medical Billing/Medical Specialist
Kaplan College
BA- In Progress - Business with Health Services Management
DeVry University
Similar Profiles
Susanna RoscoeSusanna Roscoe
Remote Prior Authorization Specialist at River Kids Pediatric Home HealthRemote Prior Authorization Specialist at River Kids Pediatric Home Health
SAMANTHA SNORTONSAMANTHA SNORTON
Director of Nursing at Pediatric Home HealthcareDirector of Nursing at Pediatric Home Healthcare
Noni StrogenNoni Strogen
Home Health LVN at Affinity Pediatric Home HealthcareHome Health LVN at Affinity Pediatric Home Healthcare