Pamela Jimenez

• Ensured compliance with grant requirements through diligent monitoring of program activities and timely submission of reports.
• Facilitated transparent communication among stakeholders by providing regular updates on grant-funded projects'' progress.
• Increased collaboration between departments by leading interdisciplinary teams in developing comprehensive grant strategies.
• Boosted staff knowledge on best practices in grants management through targeted training sessions and workshops.
• Managed complete grant lifecycle from preparation through final close-out.
• Maintained detailed records for audit purposes while ensuring confidentiality of sensitive information related to grants and donors.
• Coordinated efforts with finance department for accurate budgeting, forecasting, and expenditure tracking related to grants.

• Performed targeted collections on past due accounts aged over 90 days.
• Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts.
• Managed efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
• Submitted alternate billing for clients belonging to special demographics using CARE software portal, reconciled EOBs or denied claims and conducted accounts receivable follow-up.
• Used data entry skills to accurately document and input statements.
• Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Filed and updated patient information and medical records.
• Reviewed patient diagnosis codes to verify accuracy and completeness.
• Orchestrated medical coding, payment posting, accounts receivables and collections.
• Liaised between patients, insurance companies and billing office.
• Sets up file and initiates billing for new admissions.
• Verifies eligibility and obtains payer service authorizations or approvals.
• Collects census, periodic service records or other billing documentation.
• Reviews documentation for accuracy.
• Matches individual service plan to authorizations and tracks utilization to minimize over and/or under provision.
• Prepares and submits accurate, authorized and timely billing to the Shared Service Center or state billing personnel.
• Handles rate renewals and adjustments.
• Acts as liaison with payer and manages respectful relations with local government, managed care organizations and other payers.
• Communicates with payer, case managers and financial workers to manage eligibility, make corrections and resolve issues or disputes.

• Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
• Located and measured medications according to prescription information, making modifications as instructed by pharmacists and providers.
• Counted and labeled prescriptions with correct item and quantity.
• Coordinated with insurance representatives to process claims and calculate correct co-pay information for patients.
• Liaised with other pharmacies to eliminate issues related to product expiration.
• Prepared bills for insurance companies and submitted required paperwork.
• Restocked automated medication dispensing equipment.

• Delivered individualized patient care by recording vital signs, documenting observations, administering treatments and evaluating patient needs.
• Obtained client medical history, medication information, symptoms and allergies.
• Oversaw and maintained patients' rooms, group living areas and nurse stations.
• Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.

• Fielding phone calls and directing them to the appropriate person, providing updates to patients, acting as the lead resource for administrative and secretarial support and maintaining office files both hard copy and electronic
• Verify insurance eligibility, obtain required documentation and process orders
• Work with physician offices, patients and healthcare professionals to obtain necessary billing documentation
• Liaised with customers, management and sales team to better understand customer needs and recommend appropriate solutions.
• Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
• Calculated correct order totals, updated accounts and maintained detailed records for inventory management.
• Optimized customer support by establishing collaborative service environment.
• Maintained up-to-date knowledge of product and service changes.
• Educated customers about billing, payment processing and support policies and procedures.
• Recommended products to customers, thoroughly explaining details.
• Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
• Interceded between DME technicians & the driver during arguments and diffused tense situations.
• Knowledge of HCPCS codes

• Knowledge of ICD-10 codes

•Proficient with Microsoft Office (Word, Outlook, Excel)

• Knowledge of Brightree software
• Double-checked customer orders and information before filling out order forms to prevent unnecessary delays and errors.