Summary
Overview
Work History
Education
Skills
Timeline
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Pamela Rios

Springfield,MO

Summary

To provide the best service to patients and the organization along with billing appropriately, accurately and timely. Looking forward to establishing a career within a growing company that offers the opportunity for advancement and enables opportunities to provide excellent customer service to patients, co-workers and leaders. Clinic Manager with high level of professionalism, motivation and commitment to patient satisfaction. Over 16 years of experience facilitating staff teams and working alongside medical personnel. Strong skills in budgeting and recordkeeping.

Overview

15
15
years of professional experience

Work History

Clinic Manager

Wellness Concepts Clinic, LLC
03.2018 - Current
  • Human Resource Manger
  • Billing Manager
  • VA Manager
  • Collections
  • Oversees 19 employees,
  • Created and implemented new partnership in 2018 with Veterans Administration to provide service to those in need. This partnership serviced 326 Veterans by end of 2023 creating additional 1,830,000.00 in annual top line growth.
  • Ability to accurately bill, code and upload electronic 1500 medical claims using Medisoft Medical Billing program
  • Oversee all Medical Records for 11 Practitioners
  • A/R
  • Multi-line phone systems
  • Scheduling, checking in and checking patients out
  • Arrange 6-8 Health Fair events yearly
  • Ability to make necessary adjustments to clients accounts
  • Make and send out email and texts for discounts and current promotions
  • Workers Compensation claims
  • Accident claims including billing, medical records and negotiating with Insurance companies and Attorney’s.
  • New employee hiring

VA Specialist Insurance Biller

Ozarks Medical Center
11.2015 - 03.2018
  • Decreased AR by 75% by working with management and leadership Ability to file 837I and 837P claims along with paper claims
  • Knowledge and ability to upload to payer systems
  • Follow-up on UB and 1500 claims to VA
  • Analyze accounts balances and payment variances to determine action plan
  • Follow-up on accounts 45 days or older to accelerate payment on accounts
  • Fluent in VA and Choice Program Websites
  • Analyze incoming mail
  • Ability to Accurately send appropriate medical records by mail or upload
  • Evaluate claims accounts for appropriate modifiers
  • Ability to make necessary adjustments to patient accounts
  • Outstanding customer service on phone or walk-ins with excellent communication, direction and process
  • Currently using NEBO, Meditech 6.1 and Allscripts.

Senior Account Representative

Car-Mart
12.2014 - 12.2015
  • Oversee 512 accounts, advised clients, repossessions, collections, verified loan applications, received away for highest income tax refund money collected in region for 2015, certified Notary.
  • Met with customers to discuss and ascertain needs, tailor solutions and close deals.
  • Set and achieved company defined sales goals.
  • Assisted clients in navigating complex financial and legal processes to reduce risks.
  • Recorded accurate and efficient records in customer database.
  • Processed client payments and updated accounts.
  • Achieved or exceeded company-defined sales quotas.

Patient Accounts Representative

Air Evac Lifeteam
01.2013 - 12.2014
  • Insurance verification, Compliance with insurance billing requirements, HIPAA compliance, condolence cards to families, assisting with extra projects for head of department.

Office Assistant II

Ozarks Medical Center
05.2009 - 01.2013
  • Team leader front desk for Meditech Client server 5.4 to 5.64
  • Super User for coordinator of multiple upgrades to hospital computer systems pertaining to scheduling and admissions
  • PACS billing registration pertaining to all ultrasounds and X-rays for outside clinics
  • PACS maintenance of patient Procedural billing reports
  • Maintaining PACS work orders, monitoring and resolving any PACS related CPT modifiers for billing system
  • HIPAA Compliance.

Education

AA General Studies -

Missouri State University
West Plains, MO
05.2010

AAS Computer Information Systems -

Springfield College
Springfield, MO
10.1994

BBA - Business Administration W/Concentration On HR

Grantham University
Lenexa, KS
04.2022

Skills

  • Diplomatic and tactful
  • project planning
  • Strong MS, Excel, and Power Point
  • Accurate
  • Detailed Oriented
  • Motivated
  • Personable
  • Exceptional customer service skills and ability to work with public and co-workers
  • Exceptional phone skills, ability to work with large number of people/calls daily
  • Successful recovering urgent requests
  • Ability to multi-task in fast-paced environment
  • Flexible and versatile

Timeline

Clinic Manager

Wellness Concepts Clinic, LLC
03.2018 - Current

VA Specialist Insurance Biller

Ozarks Medical Center
11.2015 - 03.2018

Senior Account Representative

Car-Mart
12.2014 - 12.2015

Patient Accounts Representative

Air Evac Lifeteam
01.2013 - 12.2014

Office Assistant II

Ozarks Medical Center
05.2009 - 01.2013

AA General Studies -

Missouri State University

AAS Computer Information Systems -

Springfield College

BBA - Business Administration W/Concentration On HR

Grantham University

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Pamela Rios