Maria Parmelee
San Francisco,CA
Summary
Highly-motivated employee with desire to learn and take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively and quickly mastering new skills. Organized and motivated, eager to apply time management and organizational skills. Seeking entry-level manager opportunities to expand skills while facilitating company growth.
Overview
15
15
years of professional experience
Work History
Patient Accounts Supervisor
Zuckerberg San Francisco General Hospital
San Francisco
11.2018 - Current
- As a supervisor monitors, reviews, supervises the daily work of the billing subordinate personnel involved in the processing of the healthcare medical claims. • Interprets, implements, and enforces policies and procedures related to billing different insurances including Medicare, Medi-Cal and other insurances like Worker's Compensation.
- Hospital services to mention few ER, Trauma, Come and Go Surgeries, Outpatient Hospital Clinics, COPC, Acute Care, Skill Nursing, Psych care, analyze and reviews, claims processing for billing various insurances to mention a few, Medicare, Medi-Cal, San Francisco Health-Plan, Medicare MSP, Secondary billing, Crossover Medi-Medi, Anthem Blue Cross Medi-Cal Managed Care, Kaiser, Worker’s Compensation for Zuckerberg San Francisco General Hospital and Trauma Center
- Work closely with various departments, HR, RIU, Medical Records, IT, Patient access, by DPH e-mail, also stay connected via Microsoft Teams chats, Epic chats, setting on-line meetings to resolve claim billing issues like an unspecified diagnosis.
- Supervise and provide support to the billing staff inquiries to resolve any act in the billing WQ in the Epic Hospital system with claim issues like claim edits preventing the claim from being submitted with billing errors to the insurance.
- Work, supervise and manage in preparing, assessing the yearly Performance Appraisal Evaluations from HR for IP/OP Units with my manager. Review and work on daily e-mails, including approved staff FMLA from HR. Work and prepare the weekly/monthly calendar for IP and OP units for time off requests.
- Analyze and review daily billing staff write-off act balances requests.
- Open IT tickets as necessary for claim issues in Epic such an update a commercial new billing address.
- Epic Claim run for hardcopy billing for HB and PB
- Monitor in Epic the staff billing work productivity
- Export excel reports from Epic for claims that have been rejected for missing the insurance id, or HCPC's that needs coding review.
- Review and evaluate accounts in order to correct and resolve any detailed issues that causes Claim edits that have return with external edits in the 835 Electronic File Transaction data shows claim is paid or denied/rejected electronically via Claim-Source
- Research and respond to inquiries from staff regarding their daily claims when an claim edit is stopping the claim from reaching the insurance payor.
- Up to 24 full-time employees supervise, manage, monitor the staff including TEX for the IP/OP billing units’ timesheets to Payroll.
- Keep everyone who is a DDE user up to date with compliance by CMS and Noridian since I was assigned as the direct contact for Direct Data Entry System for Claims processing for new and establish DDE users for ZSFGH, LHH and few UCSF users.
- Coordinate with other departments such as DoCC - Utilization Management and Admissions staff to ensure compliance and accurate documentation is obtained prior to submitting claims for reimbursement.
- Maintained up-to-date knowledge of healthcare industry changes related to coding, and compliance requirements.
- Conducted team meetings to address issues, share updates, and motivate staff.
- Created a positive work environment by addressing conflicts promptly and fairly.
- Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules.
- Assisted in hiring, onboarding, and training new administrative staff members.
- Participate in job interview panels to select 1636, 1637, 1662, 1663 employees to fill vacant positions.
- Delegate work to staff, setting priorities and goals.
- Provide leadership, insight and mentoring to newly hired employees in billing to supply knowledge of various type of billing, 1500 claim form, also known as the Professional form, and the UB04 form, also known as the CMS-1450 in the hospital healthcare billing process for the different types of insurance companies.
- Trained up to 25 new and established employees on best billing practices and protocols while managing the billing teams to maintain optimal productivity.
- Maintained confidentiality of sensitive documents and information like doctor's letter, and FMLA's at all times.
- Guided employees in handling difficult or complex problems prior to billing and inpatient act that becomes an outpatient act.
- Due to the Covid-19 Pandemic work schedules, duty assignments issued for the office billing inpatient and outpatient units-staff when working Onsite, and when working from home.
- Reviewed employees' work to check adherence to insurance billing policies like billing limitations.
- Due to the shortage for supervisor and manager performed the annual performance evaluations, providing feedback, overall rating, job duties, areas of strength and setting goals.
- Maintains records and reports such as audits from CMS.
- Work closely with my superiors in reviewing and preparing the quarterly Credit Balance reports for ZSFG, Skill Nursing Facility, Acute, Psych, FQHC, Outpatient. Once the review is completed this is sent for the Patient Financial Services, Director's signature via Docu-Sign. Then, last but not least these important documents must be sent via Certified Mail prior to the deadlines.
- Answer early or late calls from billing staff for work related, urgencies, emergencies by Epic-Chat, e-mail, cellphone, text, Microsoft-Teams.
- Weekly review the IP/OP staff weekly work productivity spreadsheet, since is a requirement for billing to submit on Fridays.
- Also, assuring the billing staff units are kept informed via e-mail of DPH policies and procedures including interdepartmental rules and regulations. Any work related and billing updates are prepared via interdepartmental office memos, sent regularly via work e-mails.
- I'm authorized to work with the following computer systems, Epic, SF Employee Portal-Self-Service, Claim-Source, Internet/Google, E-mail, DDE, Excel, Microsoft-Teams, Word, DocuSign, One Note.
Patient Assistant Supervisor
Zuckerberg San Francisco General Hospital And Trauma Center
San Francisco, CA
12.2015 - Current
- As an Assistant supervisor my duties included: Monitoring the daily claim process for Inpatient and Outpatient claims. Due to staff shortages assisted the billing manager and supervisors with special billing projects, including the follow-up unit with complex acts like a commercial insurance requesting to carve out charges from the act because is not a covered benefit. Also, an act was billed as Inpatient but because the insurance did not authorize a one-day hospital stay requested the claim to be converted to outpatient in doing this the insurance will then process the patient claim as an outpatient.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Resolved patient billing issues in line with established guidelines.
- Stayed calm under pressure to and successfully dealt with difficult situations like notifying management asap of the missing informational claim for Skill Nursing acts.
- Providing excellent customer service by promptly answering patient inquiries for Medicare Secondary Payor, and the working spouse coverage is the primary insurance.
- Trained not only new billers but also the more seasoned billers and staff from the follow-up unit as issues arise.
- Assisted in monitoring of accounts receivable reports distributed to the staff.
- Collaborated with other departments for the therapy series accounts via Excel spreadsheet sent on e-mail and One-note to validate the Physical, Occupational and Speech therapy rendered to the patient.
- Worked closely with management to resolve and prevent billing issues providing current insurance manuals materials and training so the billing issues will not continue.
- Achieved positive results by working directly with my manager to meet established billing deadlines like Come and Go, surgeries accounts holding for missing an essential revenue code like the Lens for an Ophthalmology-surgery, also, because an authorization consent form ensuring the patient was provided the surgery information before undergoing sterilization an insurance like Medi-Cal requires PM-330 Sterilization Consent Form.
- Assigned to work the daily to day Inpatient and Outpatient Timesheets due weekly to Payroll.
- Assigned to monitor absentees, sick calls, and tardiness
- Work with other departments like Medical Records, Utilization Management, Revenue Integrity Unit, Registration for Inpatient and Outpatient accounts missing the ID number.
- Sucess achieved by evaluating together with my manager employee performance by coaching and providing 1:1 additional training to improve weak areas, like billing an Emergency act and billing and Emergency - Trauma Level act to the insurances.
- Monitored workflow to improve employee time management and increase productivity.
- Boosted the billing team performance by developing training materials and conducting in-service training in the office Conference Room.
Patient Accounts Clerk
Zuckerberg San Francisco General Hospital And Trauma Center
San Francisco, CA
09.2009 - 11.2015
- As a Lead, Patient Accounts Clerk, my work duties included:
- Work daily with Inpatient and Outpatient accounts claim edits needing resolution like missing the proper Diagnosis for a patient Lab order-HCPC's, also, an act cancels as Inpatient, and the act needs to be converted to Outpatient.
- Assigned work and to run the work productivity via DSG for all the insurance carriers and distribute the work to the staff.
- Designed and created the training guides, agendas, and schedules for the billing staff.
- Assist in all the new employees training in the policies and procedures of billing.
- Provided guidance in the processing of workloads to new employees once the training was completed.
- Communicated via e-mails any changes in billing regulations from Medicare and Medi-Cal.
- Demonstrated strong organizational and time management skills while managing multiple projects for inpatient and outpatient billing claims like the Psych acts project from the follow-up unit needing assistance in resubmitting the claims. Assisted in Claim-Audit for submitting multiple claims with an incorrect code that required ASAP review from Medical-Records.
- Applied strong leadership talents and problem-solving skills to maintain billing efficiency and organize workflows, since I was assigned on the spot the Asiana-Project. I worked shoulder to shoulder with my supervisor. Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect the accounts and the patient's privacy.
Education
High School Diploma -
Mc Ateer
San Francisco, CA06-1982
Some College (No Degree) - Psychology
City College
San Francisco, CASkills
- My skills and experience for the past 5 years as a supervisor in billing is as follows: Excel spreadsheets, word processing Supervise electronic and hardcopy claims for various insurances like Medicare, Medi-Cal and Commercial Strong knowledge of Healthcare insurances like Medicare, Medi-Cal and Commercial regulations regarding Billing regulations exceptions and limitations Experience in managing and supervising up to 24 full time employees for the billing units Experienced in structure training for new and establish employees with the main focus on providing clear information with supported billing documentation related to the job
- Working experience with computerized systems such as: Epic, Experian, Fiscal Intermediary Direct Data Entry (DDE), Knowledge of electronic HIPAA transactions such as, 837 Claims, 835 EOB/ Remittance Advice, Code sets, including: ICD-10 and HCPCS codes Abide by ZSFG’s ICARE (I-Introduce, C-Connect, A-Ask, R-Respond, E-Exit) philosophy for employee and patient interactions
Custom
- Recognized by the department director for assisting in self-directive teams
- Acknowledgment received by the director for creating training sessions for new and establish employees
- Recognized by the director and my manager for leading the Asiana project.
Timeline
Patient Accounts Supervisor
Zuckerberg San Francisco General Hospital
11.2018 - Current
Patient Assistant Supervisor
Zuckerberg San Francisco General Hospital And Trauma Center
12.2015 - Current
Patient Accounts Clerk
Zuckerberg San Francisco General Hospital And Trauma Center
09.2009 - 11.2015
High School Diploma -
Mc Ateer
Some College (No Degree) - Psychology
City College