ROSALIND ARMAND
Lake Worth,FL
Summary
To obtain a secure position in atmosphere that offers daily challenge with opportunities for advancement. Reliable business professional with experience in project management, substance abuse billing process improvement and financial analysis. Proven track record of successfully streamlining business operations and reducing costs. Adept at analyzing data to identify trends and developing strategies to improve efficiency.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Billing Liaison
Harmony Health Group
11.2022 - 10.2023
- Maintain professional relationship with billing company and in order to obtain information for billing and collection.
- Consult with payers regarding pay-for-performance measures and what fee schedule works best for the group.
- Create and maintain licensing, credentials and insurance records
- Conduct research on updated state and federal regulations and policies.
- Properly review and analyze all contract language.
- Release information to requesting agencies and public inquiries when required by law
- Help develop internal credentialing processes
- Monitor license and credential expiration dates and advise staff members of required 'renew by' dates
- Ensure facility and staff members are maintaining compliance with regulatory and accrediting institutions
- Review claims for completeness, print necessary claim and documentation required for submission to payers, and to meet performance-based goals
- Preparing patient charts and gathering information and documents from patients
- Ensuring that medical records are organized, accurate and complete
- Creating digital copies of paperwork and storing records electronically
- Safeguarding patient records and ensuring that everyone complies with HIPAA standards
- Transferring data into facility's main system database
- Processing records for admitting and discharging patients
- Collaborate with Billing Company to resolve claims issues and provide instruction and services regarding claims submission policies and procedures to ensure prompt and accurate claims adjudication
- Meet with billing company to discuss claims payment policies and procedures and resolve claims issues
- Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes.
- Successfully communicated with entities inside and outside of business.
- Liaised between internal departments and external partners to promote efficient communication and collaboration.
- Gathered, organized and input information into digital database.
- Responded to inquiries from internal personnel and outside clients immediately, facilitating quick resolution of issues
- Liaised between internal departments and external partners to promote efficient communication and collaboration
- Collaborated with other departments, identifying and addressing areas needing improvement
- Collected and analyzed data to identify trends and opportunities for improvement
- Maintained database systems to track and analyze operational data
- Trained team personnel on liaison activities and protocols, mentoring and coaching to improve skills
- Successfully communicated with entities inside and outside of business
- Collected and analyzed data and feedback to identify opportunities to improve relationship between the facilities and billing company.
Billing Liaison/Supervisor
Guardian Recovery Network
03.2017 - 11.2022
- Maintain professional relationship with billing company and in order to obtain information for billing and collection
- Understand all payer requirements for prior authorization, claim form completion and coordination of benefits.
- Consult with payers regarding pay-for-performance measures and what fee schedule works best for the group
- Evaluation of the existing contracts along with the identification of current payers majorly dealt with.
- Properly review and analyze all contract language,
- Perform verification of insurances to include gathering benefit and all plan information
- Act as patient advocate when discussing all options for outstanding balance resolution
- Research verbal and written providers' claims inquiries
- Collaborate with Billing Company to resolve claims issues and provide instruction and services regarding claims submission policies and procedures to ensure prompt and accurate claims adjudication.
- Perform(SWOT) analysis of the facilities to understand the top specialties billed the most.
- Meet with billing company to discuss claims payment policies and procedures and resolve claims issues
- Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes.
- Consult with payers regarding pay-for-performance measures and what fee schedule works best for the group.
- Identify potential and documented eligibility issues and notify applicable departments to resolve
- Identify authorization issues and trends
- Other responsibilities as assigned
- Oversees preparation of statements and bills
- Maintains maintenance of client records related to invoicing and bill payment
- Reviews work of billing staff to ensure accuracy, resolving inconsistencies as needed
- Creates and provides prioritized list of clients to be invoiced to team members
- Supervises daily cash transactions including accurate and efficient payment processing, balancing and reconciliation.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Coordinated individual duties after careful evaluation of each employee's skill level and knowledge.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
- Optimized organizational systems for payment collections, AP/AR, deposits, and recordkeeping.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager
- Improved office operations by automating client correspondence, record tracking and data communications
Account Manager
Infinity Behavioral Health
05.2014 - 03.2017
- Acts as liaison between Company and accounts with their portfolio.
- Coordinates with Company departments to optimize client satisfaction and resolve issues
- Conducts in-service training and education for clients
- Meets with local clientele in person monthly and has monthly phone conferences with all other clientele to review numbers and resolve issues
- A minimum of quarterly meetings with out of state clientele is also required
- Handles all high-level issues including customer concerns, analysis of payer mix, A/R, review of monthly reports, and participates in monthly on-sites with Junior Representative
- Determine if clients are losing referrals because of not participating with certain insurance plans
- Trains on, reviews, and participates in standing weekly calls with clients shared with Junior Representative
- Coordination of A/R collection and communication (internal/external)
- Management of in-network (INN) contract negotiations
- Management of changes-ownership and address/CD/MD changes
- Resolves any issue that arises, escalates trends, and micro issues to Director
- Maintains ownership and management relations
- Coordinates internal and external staff trainings
- Reviews agenda for weekly conference call
- Ensures all claims, billing, UR, and VOB action items are prepared for call
- Ensures all claims, billing, UR, and VOB follow-up items are ready for discussion during call
- Ensures agenda for weekly call and monthly onsite are comprehensive.
- Addressed problems with accounting, billing, and service delivery to maintain and enhance client satisfaction.
- Perform(SWOT) analysis of the facilities to understand the top specialties billed the mos
- Coordinated with internal teams to facilitate prompt delivery of client projects.
- Built relationships with customers and community to promote long term business growth
- Fostered lasting relationships with customers through effective communication and quick response, resulting in long-term loyalty and expanded client base
Director of Billing and Collections
Hyperion Billing Solutions
05.2012 - 05.2014
- Perform responsibilities of receiving and input charges into epic system
- Process excellent customer service skills, have knowledge of Medicare/Medicaid Guidelines
- Negotiate and Renegotiate insurance agreements also 3rd party such as Multiplan, Viant .
- Calculate each payers’ reimbursement rates as a percentage of Out of Network reimbursement rates
- Medical terminology/CPT codes/ICD 9 & 10 codes
- Ensure that charges in record are verify and accurate as well as make corrections, as required
- Responsible for obtaining, reviewing, reconciling and logging charge batches
- Coding & Billing (Post Electronically & Manually medical Staff Credentialing
- Billing, UB 92 &HCFA, verify insurance/ EOB's
- Supervise Staff of 20
- Review staff aging in weekly basis
- Assist clients in daily basis with questions in regard to their accounts
- Corporate Trainer (Train new hire orientation on assigned systems)
- Conduct review & updated training classes
- Post payments/ Post Adjustments
- Bill out claims for inpatient/outpatient
- Conduct monthly meetings with CFO
- Send monthly reports to CFO by end of each month
- Sent out Appeals & Corrected Claims Refunds/ Correspondence
- Invoice Outstanding Balances
- Etc
- Any miscellaneous work that needs assistance
- Assist when new clients coming on board.
- Negotiated to collect balance in full.
- Negotiated re-payment plans by identifying causes of delinquent payments to assist in recovery of debt and meet realistic time frames.
- Researched billing errors and discrepancies to initiate corrective action.
Home Health Aide
Caregivers of America
01.2010 - 05.2012
- Assist patients with their medication-verify that correct dosage is being taken
- Assist with certain treatments as prescribed by physician and supervised by the nurse
- Schedule doctors' appointments and ensure that they are kept
- Refill patients' prescription with the pharmacy; giving accurate prescription number and dosing
- Contact patients' insurance companies to verify balance on card for payment and follow up with them on patients' condition
- Encourage them to be as independent as possible
- Report any changes in the patient's condition to the nurse.
- Assisted patients with dressing, grooming and feeding needs, helping to overcome, and adapt to mobility restrictions.
Customer Service
SOURCE INTERLINK
01.2007 - 01.2009
- Quality Control
- Shipping and Replenishment
- Finishing-ensured that all products are in order and accounted for
- Receptions Duties
- Collecting Patients Information
- Billing and Coding
- Data entry (Medical Manager) spread sheet, word processing, Microsoft Word & Excel.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences
Education
Master of Science - Health Administration
Northcentral University
Phoenix, AZ09.2019
Bachelor of Science - Health Administration
City College
Fort Lauderdale, FL09.2015
Associate of Science Degree in Allied Health-Billing and Coding -
City College
Fort Lauderdale, FL06.2011
Diploma in Pharmacy Technology -
Everest University
Pompano Beach, FL06.2008
Skills
- MIcrosoft , QuickBooks, Microsoft Excel, PowerPoint, Peachtree, Accounts Payables2/Receivables, K-NAPP and PKMS Software, Dazos, Computerized Office Management Med iSOFT, DaqBilling, Collaborate MD, Crystal Report Knowledge of pharmacology, phlebotomy, and clinical laboratory procedures, Billing and Collections Fluent in English, Creole and French Experience with patient registry, Substance Abuse billing and Collections
- Medical billing experience
- Liaison experience
- Billing systems and software
- Billing and coding
Certification
- Certified Coding Specialist (NRCCS)
- CPR
- Domestic Violence
- HIV/AIDS
- OSHA
- HHA
Awards
Dean's List-Winter 2010
Timeline
Billing Liaison
Harmony Health Group
11.2022 - 10.2023
Billing Liaison/Supervisor
Guardian Recovery Network
03.2017 - 11.2022
Account Manager
Infinity Behavioral Health
05.2014 - 03.2017
Director of Billing and Collections
Hyperion Billing Solutions
05.2012 - 05.2014
Home Health Aide
Caregivers of America
01.2010 - 05.2012
Customer Service
SOURCE INTERLINK
01.2007 - 01.2009
Master of Science - Health Administration
Northcentral University
Bachelor of Science - Health Administration
City College
Associate of Science Degree in Allied Health-Billing and Coding -
City College
Diploma in Pharmacy Technology -
Everest University
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