Misty Hooks
Tifton,GA
Summary
Experienced administrative professional with 15+ years in healthcare administration, revenue cycle management & provider credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans.
Overview
25
25
years of professional experience
Work History
Assistant Practice Administrator/Billing Supervisor/Credentialing Specialist
Centers for Pain Management of Georgia & Surgery Center at Cypress Pointe
02.2017 - Current
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions for Clinic and Ambulatory Surgical Center.
- Identify billing system improvements by monitoring medical billing procedures with Prime Suite & Intergy, to ensure processes are working efficiently.
- Established strong relationships with referral sources to increase patient volume at the practice consistently over time.
- Responsible for building EHR Medical Record templates for both practices.
- Serve as primary contact to insurance companies
- Managed financial aspects of the practice, including budgeting, billing, and insurance claims processing.
- Oversee workflow process guidelines to facilitate timely receipt of payment from insurance providers and individual payors including contacting payers and appealing claims to ensure timely resolution
- Ensure monthly and annual reports are provided to Providers which include identifying outstanding issues and status of resolutions.
- Collaborated with physicians to develop strategic plans for expanding the scope of services offered by the practice.
- Updated physicians’ and nurse practitioner’s contracts with insurance companies and negotiation of any new insurance contracts and fee schedules.
- Credentialing physicians with affiliated hospitals
- Negotiated contracts with vendors for cost-effective procurement of medical supplies and equipment.
- Responsible for renewing and maintaining records for physician’s federal and state license (e.g., DEA, Georgia controlled substance, state medical license)
Insurance Rep /Business Administrator-Human Resources
United Obstetrics & Gynecology
04.2010 - 01.2017
- Responsible for entering patient demographics, medical insurance, verifying coverage and benefits, posting primary/secondary insurance and patient payments, working rejections, edits and denials
- Reviewed and submitted medical records
- Processed and reconciled corporate accounts payable and receivables
- Maintained employee’s healthcare, 401K and supplemental insurance benefits
- Projected Profit and Losses and produced financial reports
- Implemented Paychex payroll system to track employee work hours, trends and processed overall payroll
- Updated physicians’ and nurse practitioner’s contracts with insurance companies-Credentialing physicians with affiliated hospitals
- Responsible for renewing and maintaining records for physician’s federal and state licensures
- (e.g., DEA, Georgia controlled substance, state medical license, malpractice insurance, long term/disability insurance)
Front Service Area Supervisor
K-Mart
01.2009 - 04.2010
- Supervise customer service staff responsible for processing all checkout procedures
- Responsible for handling the front-end check-out counter, service desk and the employees who cashier, wait on customers; train new employees; settle customer disputes; answer questions, meet with management regarding issues that need intervention.
Insurance Reconciliation Clerk/Front End Manager
Moon’s Pharmacy
03.2007 - 03.2009
- Performed a variety of complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of several third party billing records including Medicaid/Medicare
- Provided resolutions of a variety of problems; following up on submitted claims and patient billing; resubmitting claims and resolving AR problems
- Diabetic Shoe Fitter Certification.
Electronics/Sales Manager
Staples Office Supply Superstore
10.1999 - 03.2007
- Continuously upgraded service levels by improving operating efficiencies, and building better relationships and solutions for customers
- Supervised, trained, developed, coached and communicated with all associates as well as assess performance levels to achieve store level earnings and sales goals
- Payroll processing
- Stayed current on new technologies and ensured associates understanding.
Education
Business Administration -
Abraham Agricultural College
Tifton, GeorgiaGraduate -
Tift County High School
Tifton, Georgia01.1992
Skills
- HIPAA Compliance
- Team Leadership
- Operations Management
- Complex Problem-Solving
- Scheduling Coordination
- Patient Relations
- Revenue Cycle Management
- Medical Billing
- Credentialing Management
- Electronic Health Records
Timeline
Assistant Practice Administrator/Billing Supervisor/Credentialing Specialist
Centers for Pain Management of Georgia & Surgery Center at Cypress Pointe
02.2017 - Current
Insurance Rep /Business Administrator-Human Resources
United Obstetrics & Gynecology
04.2010 - 01.2017
Front Service Area Supervisor
K-Mart
01.2009 - 04.2010
Insurance Reconciliation Clerk/Front End Manager
Moon’s Pharmacy
03.2007 - 03.2009
Electronics/Sales Manager
Staples Office Supply Superstore
10.1999 - 03.2007
Business Administration -
Abraham Agricultural College
Graduate -
Tift County High School
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