Healthcare worker with over 17 years’ experience in the Revenue Cycle field. Versatile Managing Director with proven abilities across all levels of organizational management. Talented in developing partnerships, overseeing personnel and developing tactical plans to meet strategic goals. Proven leader and team player. Seeking career change that still allows me to use my communication skills with talking with anyone and the ability to build quality relationships with current and potential new customers.
Overview
28
28
years of professional experience
Work History
Director of Business Development
CRS Medical Benefits
05.2021 - Current
Building meaningful relationships in the Healthcare community, supporting healthcare providers in driving revenue and patient satisfaction
Responsibilities include- managing 10 hospitals, marketing, obtaining new business, training new employees, audits of associates, retention of clientele and assisting with new contract negotiations.
Executive Manager
CRS Medical Benefits, Inc
05.2019 - 05.2021
Manage daily operations of Inpatient, Outpatient and Emergency room self-pay referrals
Review Secondary Referrals from the Primary Vendor
Review Aged/High Dollar Reports to provide Client with projections and achievements
Review Monthly Reconciliation Reports
Oversee New Employee Training to ensure proper compliance with Company Policy, State and Federal Laws and ongoing training of staff for any changes that take effect
Conduct monthly audits of accounts to ensure proper documentation was submitted to the agencies for approvals and follow up is being achieved
Continuously work with Staff to improve overall productivity
Work with staff to implement goals to provide quality customer service to our clients
Provide support to staff and ensure caseloads are processed according to DCF policies
Oversee monthly scheduling and provide coverage if needed in the absence of any staff member
Receive monthly reports on employee tardiness and absences and provide the appropriate disciplinary action if needed
Report and resolve employee disciplinary problems
Attend weekly meetings between CFO, Case Management and Patient Accounts Director
Maintain good working relationships and effectively communicate with Clients, State and Federal Agencies.
Caseworker /Medicaid Eligibility Specialist
CRS Medical Benefits, Inc
05.2006 - 04.2019
Conduct interviews with patients and/or their families to assess eligibility for State and Federal Programs
File applications based on program eligibility through State and Federal Programs
Represent patients in applications and appeals filed through the State of Florida Medicaid Programs, Social Security Disability Insurance and Supplemental Security Income claims
Full understanding of Medicaid, SSA/SSI disability laws, regulations and procedures, analyzing data accumulated for disability allowances
Established professional working relationships with Social Security representatives, County Medicaid offices, Business Office Directors and Administration as well as physician offices
Compiling and submission of weekly and month end reports for our corporate office
Review of patient accounts for billing and ensure reimbursements are maintained
All administrative duties handled independently without supervision daily
Confidential handling of medical information and/or medical records to various agencies
Attend weekly meetings between CFO, Case Management and Patient Accounts Director to report on cases being maintained by our office.
Patrol Office
Eldorado Police Department
05.2001 - 05.2006
Responded to multiple calls daily, report writing, testifying in court, assist in investigations, served as FTO (field training officer), FBI certified Bomb Squad member.
Deputy Sheriff
Union Parish Sheriff’s Office
05.1996 - 05.2001
Responded to multiple calls daily, report writing, testifying in court.
Education
Criminal Justice -
South Arkansas Community College
Eldorado, AR
01.2006
General Studies -
Louisiana Tech University
Ruston, LA
01.1995
High School Diploma -
Cedar Creek High School
Ruston, LA
05.1993
Skills
I have proven to be a leader and well-liked by my peers and easily approachable Works well with others and enjoys the ability to work as a team in order to meet goals
Leadership Experience
Served as Chairman of Deacons for my church, Team leader for church security, Youth Leader.
Benefit Eligibility Specialist II at Arizona Division of Benefits and Medical EligibilityBenefit Eligibility Specialist II at Arizona Division of Benefits and Medical Eligibility
Healthcare Referral Services Assistant at Carelon Medical Benefits ManagementHealthcare Referral Services Assistant at Carelon Medical Benefits Management