Wanza Swann
Upper Marlboro,MD
Summary
Experienced Office Management and Administration Professional experienced optimizing productivity, efficiency and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Billing & Collections Manager
Medical Center Orthotics & Prosthetics (MCOP)
02.2020 - Current
- Maintains knowledge and manages all positions within billing department including claims processing, payment posting, insurance claim follow-up, patient collections, and complex insurance/patient cases.
- Trained and mentored new employees on collection methods, documentation requirements and performance strategies. Assists with recruitment, discipline, and termination of any billing department staff members.
- Respond to practitioner, patient, and staff members grievances, complaints, and inquiries by employing active listening and interpersonal skills.
- Generated and mailed updated statements monthly and processed demand letters.
- Contacted customers to collect outstanding payments via one-time or negotiated installment methods.
- Performs daily posting and reconciliation of insurance and patient payments. File appeals and reconsideration request for denied claims.
- Maintains in-depth knowledge of all insurance compliance and rule changes. Maintains all insurance fee schedules.
- Performs monthly billing audits to ensure timely and accurate processing of payment posting, and collections activity within company.
- Meets with Director of Operations monthly or as needed to discuss difficult claims, analyze accounts, AR reports, and collections statistics by payer.
- Maintains detailed knowledge of practice management and other computer software as it relates to job functions.
- Works with Accounting Manager to ensure timely end of month close (goal is 2-3 days)
- Generating over 2.5 million annually in collections.
- Researched accounts and completed due diligence to resolve collection problems.
- Reviewed, researched and corrected discrepancies and customer concerns.
- Documented interactions in computer database and updated information.
- Assessed processes and procedures, complying with CMS, and HIPAA regulations.
Office Manager
Orthotic Prosthetic Center- Merged With MCOP 2/20
06.2004 - 05.2021
- Managed day-to-day operational functions by establishing goals, objectives, standards of performance, policies, and procedures.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews for staff.
- Responded to practitioner, patient, and staff members grievances, complaints, and inquiries by employing active listening and interpersonal skills.
- Maintained positive patient relations by addressing problems head-on and implementing successful corrective actions.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Performed insurance verifications and obtained authorization.
- Provided proper scheduling of patients, ensuring timely, and effective allocation of resources and calendars.
- Submitted Electronic and manual claims and followed up on claims with various insurance payers (Medicare, all Medicaid plans, United Healthcare, CareFirst BCBS
- Filed appeals and reconsideration request for denied claims
- Generating over 1.5 million annually
- Responsible for all insurance payers and patient payment applications, adjustments, bank deposits and daily / monthly reconciliation reports
- Prepared patient and insurance refunds on weekly basis
- Prepared months end close AR and sales reports using Microsoft Excel
- Maintained and updated all insurance payers, government (SAM, Department of Labor, and Vet Admin), and credit card vendor contracts and fee schedules
- Served as system administrator for all insurance payers and government websites
- Developed internal requirements which complied with HIPPA and CMS standards to minimize regulatory risks and liability.
- Maintained Facility Accreditations for three locations.
Education
High School Diploma -
Skills
- Ability to work in demanding environment
- Excellent interpersonal and communication Skills
- Research and resolution of complex billing issues
- Payment posting and adjustment for insurance and patient accounts
- Audits of claims and insurance/patient payments
- Excellent Customer Service
- Microsoft Office
- Problem solving
- Critical Thinking
- Document Review
- Month-End Closing Procedures
Certification
Certified Physician Practice Manager by AAPC– CPPM
Timeline
Billing & Collections Manager
Medical Center Orthotics & Prosthetics (MCOP)
02.2020 - Current
Office Manager
Orthotic Prosthetic Center- Merged With MCOP 2/20
06.2004 - 05.2021
High School Diploma -
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