- Medical Coding and Compliance Manager Relations: Establishing and maintaining harmonious professional relations by demonstrating respect for and sensitivity to others.
- Learning Support/Continuous Learning: Creating a learning environment by promoting training and professional development.
- Numeracy: Using numbers and thinking in quantitative terms to complete tasks.
- Organizational Knowledge: Understanding the role of the department and job functions within the organization.
- Problem Solving: Ensuring that decisions are made based on policies, rules and organizational directives and solving the emerging problems.
- Relationship/Network Building: Building and maintaining effective and constructive working relationships, partnerships or networks of contacts with people who are, or might someday be, instrumental in achieving work-related goals.
- Self Confidence/Self Esteem: Believing in one's own capability to select an effective approach to accomplish a task or activity in increasingly challenging circumstances.
- Teamwork/Cooperation: Readily sharing information, knowledge and personal strengths. Seeking to understand and building on differing perspectives of others to enhance team efficiency and quality outcomes.
- Values and Ethics: Serving the Company with integrity and respect in personal and organizational practices. Includes respecting democratic, professional, ethical and people values. Building respectful, bilingual, diverse and inclusive workplaces. Ensuring decisions and transactions are transparent and fair. Holding themselves, their employee and their department accountable for their actions. Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization. Apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Ability to deal with nonverbal symbolism (formulas, scientific equations, graphs, musical notes, etc.,) in its most difficult phases. Ability to deal with a variety of abstract and concrete variables. Mathematical Skills Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry. I am capable to talk and listen to hear and carry conversations with others, whether it is phone related or in person.
Hi, I’m
Wanda Denise Dean
Summary
Overview
23
years of professional experience
Work History
Uropartners, LLC
Compliance Manager
12.2022 - Current
Job overview
- I am the point person for all coding related issues or questions in the billing department
- I am responsible for assisting in developing workflows and providing guidance to team to promote success
- I am accountable for assisting internal and external staff with account specific inquiries
- I am also responsible for managing the day to day operations for our billing and coding teams Essential Duties and Responsibilities
- Continuous audits as necessary to promote compliance throughout the organization
- Review and analyze data to ensure compliance by reviewing denials and creating a plan of action to improve
- Create an annual goal related to coding/compliance that is achievable throughout the organization
- Oversee processes on billing and coding teams to improve workflows when necessary
- Provide leadership and guidance to billing teams
- Assist in creating and maintaining a high performance environment characterized by positive leadership and a strong team orientation
- Assist in developing necessary job guides and workflows related to billing office functions
- Collaborate with peers to improve communication with staff related to revenue cycle initiatives
- Detect errors in billing processes and make appropriate corrections
- Implement quality billing practices and procedures
- Provide guidance or support in any area that requires additional assistance
- Other duties as assigned
- Great understanding and excellent knowledge of all billing processes
- Honest, ethical and compassionate behavior, takes responsibility for own actions and be forthright about errors or uncertainty, display flexibility, function effectively under stress, adapt to changing environment, and function as an active cooperative member of the revenue cycle team
- Knowledgeable in current computer applications including new computer software and computer systems
- Proficient in ten-key, Microsoft Office programs including, but not limited to Outlook
- Word and Excel
- Excellent in verbal skills when handling situations where information is being relayed to customers, clients or employees
- Proficient in written communication and mathematical skills with accuracy and attentiveness
- Ensuring decisions are made based on policies, rules and organizational directives and solves emerging problems in a timely manner
- Communication: Using language as a flexible tool to share and collect information, exchanging ideas and openly exploring a variety of perspectives adjusting style and content to each unique individual, audience and circumstance
- Computer Use: Using computers and other forms of technology
- Conflict Resolution: Facilitating the prevention and/or resolution of conflict while preserving working relationships
- Creative Thinking: Discovering new opportunities and solutions for problems by looking beyond current practices and using innovative thinking
- Decision
- Making/Decisiveness: Making and taking responsibility for, and demonstrating commitment to appropriate decisions in a timely manner
- Ensuring that decisions are made based on policies, rules and organizational directives and solving the emerging problems
- Document Use: Finding, understanding or entering information (e.g
- Text, symbols, and numbers) in various types of documents, such as tables or forms
- Engagement: Mobilizing people, organizations and partners in developing goals, executing plans and delivering results
- Laying the groundwork for success by building coalitions with key players and building momentum by communicating clearly and consistently
- Using negotiation skills and adaptability to encourage recognition of joint concerns, collaboration and to influence the success of outcomes
- Innovation/Initiative: Using information from a variety of sources, identifying immediate action needed to address current issues, seizing the opportunity to enhance performance and advance horizontal/vertical goals
- Attending to imminent issues while maintaining an awareness of emerging opportunities
- Interpersonal
Near North Health Service Corporation
04.2020 - Current
Job overview
- Utilizing Athena, Claims Remedy, Citrix, Vis-reporting, Alliance/Chicago and Visualutions
- Software and clearing house
- Manage patient billing and insurance claims for a medical facility
- Creating reports, analyzing data
- Identifying lost revenue
- Collecting payments
- Implementing revenue cycle management (RCM) strategies to minimize losses
- Resolving revenue cycle problems
- Supervise and oversee staff in duties pertaining to patient billing
- Communications with health insurance
- Collections
- Cash Posting
- Account management
- Contract analysis.
Psycynergy Psychological Services
Patient Revenue Manager, OMT Assistant Director/Psychologist
10.2013 - 04.2018
Job overview
- Analyze coding issues/questions from both a compliance and reimbursement perspective
- Develop and implement a system for documenting and communicating responses to all coding, reimbursement and compliance questions
- Provide compliance/documentation education sessions to physicians and other staff, as requested
- Provide accurate and up-to-date information on regulatory and D- Distinguished;
- Provide coding expertise for all compliance and reimbursement issues
- Prepare reports and graphics for presentations
- Maintain attendance lists for all presentations and logs of issues raised and identified for future research and response
- Submit annual updates of the IDX BAR system CPT4 and ICD-9 code dictionaries, working with the Physicians Information Group and appropriate representatives from the abstraction, reimbursement, billing and divisional areas
- Participate in the rejections and claims review process to ensure both compliance and the maximization of appropriate Departmental reimbursement
- Participate in regular meetings with billing, abstraction and reimbursement staff to review claim rejections and develop appropriate strategies for addressing them
- Review requests from insurers and patient families for copies of patient medical charts and/or changes in codes/fees
- Prepares and submits clean claims to various insurance companies either electronically or by paper
- Answers questions from patients, clerical staff and insurance companies
- Identifies and resolves patient billing complaints
- Prepares, reviews and sends patient statements
- Evaluates patient's financial status and establishes budget payment plans
- Reports status of delinquent accounts
- Reviews accounts for possible assignment and makes recommendations to the patients, also prepares information for the collection agency
- Performs daily backups on office computer system Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
- Processes payments from insurance companies and prepares a daily deposit
- Participates in educational activities and attends monthly staff meetings
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
- Frequently compose and finalize complex correspondence, legal documents, meeting minutes, reports and other-format documents, using experience and judgment to determine what should be included in each document
- Manage multifaceted department logistics and calendars for meetings and conferences, including travel and catering
- Provide administrative support to Board and committee meetings
- Perform office duties in support of the President/CEO with general guidance in terms of overall objectives
- Manage department records and archiving, including corporate governance and policy and procedure documents
- Provide supervision, leadership, motivation and direction to staff consistent with
- Foundation values and a culture of service
- Prioritize the success of the team through effective utilization of individual skills and frequent, substantive discussions on work plans, strategic initiatives, skill development and performance
- OTHER DUTIES AND RESPONSIBILITIES:
- Assist with fiscal year budget preparations and forecast
- Provide back up for other specific tasks as needed, particularly for the support of the Board Participate in ongoing training and education
- Transition from ICD9 to ICD10
- Perform other duties as assigned Medicare collection/ billing specialist Using coded data to produce and submit claims to insurance companies
- Working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid Reviewing and appealing unpaid and denied claims
- Verifying patients' insurance coverage Answering patients' billing questions
- Handling collections on unpaid accounts
- Managing the facility's Accounts Receivable reports
New Hope Community, Inc
OMT Assistant Director/Psychologist
04.2016 - 12.2016
Job overview
- Provide resources, support, and leadership to Service
- Managers as assigned
- Provide information and knowledge management, including information dissemination and briefing services to the Director of Service
- Actively and effectively participate in meetings with community partners and funders, internal agency-wide meetings e.g.) Service
- Directors, Accreditation, Management, and Program meetings including communicating regularly with the CEO/Director/ and CMO
- Compile and analyze data
- Assist in identifying appropriate codes for specialized services
- Support, provide analysis for and advise senior management regarding revenue and reimbursement issues
- Work with Reimbursement to perform research and provide recommendations on fees and the use of procedure codes in a timely manner
Hospital and Physician
Senior Medical Biller and Coder/ Executive Assistant
04.2012 - 07.2013
Job overview
Reliant Health Care Management Inc
10.2010 - 06.2012
Job overview
- Market services and products by mailings, phone calls, presentations
- Interview potential practices about current billing situation with Medicare, Medicaid, Commercial, WC and PI insurance to provide billing cost analysis
- Provide billing services and soft collections for hospital and Physicians utilizing EMR software and Claimtek Medical Billing Software
- This includes sending out statements and following- up with patients and insurance companies
- Prepare monthly reports for clients
- Assist in managing business operations- prepare letters, contracts, forms, bookkeeping, inventory, and customer service
- Assist Jeff Zeimet of Healthcare Solutions
- Team in managing and organizing sales Leads
- Script will be provided for calling old and new leads
- Leads will be contacted through either the phone or email
- Prepare mailers to send to existing clients
- Accounting Principles
Party, Phoenix Physician Services, Corvel Corp
Third, Public Aid Biller
10.2003 - 10.2010
Job overview
- Billing and correcting IDPA claims through major hospitals and Private Physician Groups
- Utilizing software such as SMS
- Medisoft
- Meditech, IDX, EPIC, ECARE Florida Shared, Meditouch, AllScripts and a host of others that has been either non-billed or consist of minor errors
- This is usually a cleanup project and a temp assignment located
Medicare
Pharmacy Biller
01.2003 - 05.2003
Job overview
- Responsible for the timely submission of technical or professional medical claims to insurance companies including physician offices, hospitals, nursing homes, or other health care facility
- Follow up on unpaid claims (In-Patient and Outpatient) within standard billing cycle time-frame
- Check each insurance payment (Hospital and Physician) for accuracy and compliance with contract discounts Call insurance companies and patients regarding any discrepancy in payments if necessary Identify and bill secondary or tertiary insurances All accounts are to be reviewed for insurance or patient follow-up Answer all patient or insurance telephone inquiries pertaining to assigned accounts Review patient bills for accuracy and completeness and obtain any missing information Knowledge of insurance guidelines especially Medicare and state Medicaid, Supervision over a staff of 13
- Wide range of spreadsheets and reports
- Refund request for
- Corvel from companies like Gallager Bassett, United Heartland, RESCO, etc
- All claims handled were workmen's compensation from several states
- Knowledge or various state laws was initiated
- Heavy volume of PPO hospital and Physician claims and contracts involved utilizing the
- MedPro Billing Software Consistent contact with attorneys' offices, IDOT and VOVC cases
- Strong research skills for auto accidents recoveries
- Developed a strong patient and client relationship through problem repair.
North Bridge Staffing Group
Medical Office Manager, Medical Billing Specialist, Medcheck Supervisor
01.2003 - 01.2003
Job overview
- Still Registered Medicare Support Assignment with Northwestern Hospital assisting director of
- Medicare billing with a clean-up project Numerous spreadsheets and Medicare re-calculations re- entered Evaluating EOB(s) and payment Posting
- Payment review was an ongoing task of mine
Dr. Andrew Davis Chicago
12.2000 - 12.2002
Job overview
- A/R and A/P Patient and insurance billing Patient Scheduling Oversee all office functions and organization Office payroll Prepared reports on a daily activities and progression
- Prescription refills, blood pressure counts
- Lab readings, MRI, Monograms, EKG s, Echo cardiogram and CT scans scheduling Electronic billing on Medix Systems
- High volume of work done on Word perfect, Excel and Outlook programs Maintained patient charts, referrals, pre-certification, medical records request and patient billing Insurance billing for Internal Medicine, Radiology, Cardiology
- Private Physician, DME, Home Health and Hospitals consisting of Medicare, Medicaid
- Commercial Insurance Third Party claims, Probate, Workmen's Compensation Billing (self-pay and third party insurance) for Hospital and Physician Claims appeals, Pre-Audit/ Inspection review of Trial Master File (TMF) documentation
- Undertaken at the client company or at the office
- Review of client documentation with respect to content, cross-section referencing and compliance with appropriate regulations
- Maintenance of TMF and Investigator Site Files ordering durable medical equipment for patients and VOVC claims were a large percentage of billings
- Mental Health
- Assist in ensuring the development, implementation and evaluation of programs and services in
- Mental Health and Addictions
- Facilitate and support an integrated program evaluation for
- Mental Health and Addictions
- Prepare service reports for The Board of Directors, as assigned
- Assist in the development and maintenance of integrated policies, procedures and practices that ensure that Mental Health and Addictions Services are providing services through best practices and in compliance with relevant legislation (e.g
- Child, Youth and Family Services Act, Mental
- Health Act, Personal Health Information Protection Act) and in compliance with funder service agreements
- Work with Director, Managers and staff to enhance clinical models and approaches by applying a cultural context
- Assist in reviewing staff Performance Evaluations
- Responsible to ensure timely billing and collections from insurance companies for services rendered by the medical team
- Responsible for submitting medical claims to insurance companies and payers such as MCOs, Medicare and Medicaid
- Responsible for the financial and enrollment credentialing process needed for In
Education
New Skills Academy
Tennessee State University
Masters from Health Care Corporate Administrations
University Overview
Office Manager and
Bachelors from Health Care Management
University Overview
Associate from Health Care Management
University Overview
Ashworth College
Ashworth College
Associate from Business Administration
University Overview
Skills
- CPT Coding
- ICD-9 AND ICD-10
- Knowledge Management
- Medical Office Experience
- ICD-10
- Allscripts
- Medical Office Management
- Triage
- Medical Coding
- Epic
- Medical Billing
- Revenue Management
- Patient Care
- Hospital Experience
- Insurance Verification
- Medical Terminology
- Office Management
- Accounts Receivable
- Management
- Transcription
- Medical Records
- Recruiting
- EMR Systems
- HIPAA
- Vital Signs
- Personal Assistant Experience
- Behavioral health
- Communication skills
- Microsoft Excel
- Athenahealth
- Supervising experience
- Individual / Group Counseling
- Medical Scheduling
Timeline
Compliance Manager
Uropartners, LLC
12.2022 - Current
Near North Health Service Corporation
04.2020 - Current
OMT Assistant Director/Psychologist
New Hope Community, Inc
04.2016 - 12.2016
Patient Revenue Manager, OMT Assistant Director/Psychologist
Psycynergy Psychological Services
10.2013 - 04.2018
Senior Medical Biller and Coder/ Executive Assistant
Hospital and Physician
04.2012 - 07.2013
Reliant Health Care Management Inc
10.2010 - 06.2012
Third, Public Aid Biller
Party, Phoenix Physician Services, Corvel Corp
10.2003 - 10.2010
Pharmacy Biller
Medicare
01.2003 - 05.2003
Medical Office Manager, Medical Billing Specialist, Medcheck Supervisor
North Bridge Staffing Group
01.2003 - 01.2003
Dr. Andrew Davis Chicago
12.2000 - 12.2002
New Skills Academy
Tennessee State University
Masters from Health Care Corporate Administrations
Bachelors from Health Care Management
Associate from Health Care Management
Ashworth College
Ashworth College
Associate from Business Administration
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