HEALTHCARE ADMINISTRATION
Self-motivated/ 12 Years of Successful Entrepreneurial Experience/ Commitment to teamwork, / Demonstrated initiative/ Commitment to customer satisfaction/ Ability to set and achieve goals/
20 Years of Experience working with State and Federal Government Compliance
CORE STRENGTHS
Complex Computer Systems
Detail Oriented
Organizational Skills
Time Management
Deadline Sensitive
Communication Skills
Interpersonal Skills
Relationship-Building Skills
Problem Solving Skills
Healthcare Terminology
Professional Disposition
Ability to Work Independently
Good Decision Making Skills
Multitasking
Maintain Confidentially
COMPUTER SKILLS
MS WORD, EXCEL, PUBLISHER, POWERPOINT ACCESS, OUTLOOK • WEBEX INTERNET CONFERENCING
ADOBE ACROBAT • QUICKBOOKS PRO • PRACTICE CS • LOTUS NOTES
EDUCATION
University of Tennessee, Chattanooga, TN
Degree: Bachelor of Science HEALTH AND HUMAN SERVICE / NON-PROFIT MANAGEMENT
Kennesaw State University, Kennesaw, GA
Certificate: ADMINISTRATIVE PROFESSIONAL
PROFESSIONAL EXPERIENCE
COMPLIANCE ANALYST
• Participate in tax and accounting forms design.
• Interface with state agency representatives, tax analysts and coders.
• Prepare functional test cases for state agency approval per specifications.
• Contribute to feedback and offer development ideas.
• Identify and prioritize daily responsibilities to meet agency deadlines and company software development schedule.
• Continue self-development in technical, design and analytic areas.
• Demonstrate and encourage teamwork.
SOFTWARE ADMINISTRATOR
• Created customized digital dashboards, reports and invoices.
• Entered electronic documents and firm’s categories and activities.
• Entered billable time and created client invoices each month.
• Trained clients and staff on CS Software
MEDICAL EQUIPMENT OPERATIONS
• Analyzing information and evaluating results to choose the best solution and solve problems.
• Conduct and administer fiscal operations, including accounting, planning budgets, authorizing expenditures, and establishing rates for services.
• Develop and implement organizational policies and procedures.
• Manage change in integrated health care delivery systems
• Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
• Maintained HIPAA guidelines.
• Consult with medical, business, and community groups to discuss service problems, respond to community needs, enhance public relations, coordinate activities and plans, and promote health programs
• Develop and maintain computerized record management systems to store and process data such as customer health records and information to produce reports.
• Develop instructional materials and conduct in-service and community-based educational programs
CONTRACT ADMINISTRATOR
• Developed and maintained procedures to ensure timely and accurate contract reviews.
• Monitored compliance with contract terms and conditions.
• Negotiated contract terms and conditions on a range of issues
• Maintain awareness of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes, and financing options.
CUSTOMER SERVICE
• Interviewed customers
• Responded to customer inquiries and complaints
• Obtained complete and accurate demographics, financial and insurance information
• Submitted pre-certifications
• Advised and collected all necessary customer consents.
• Instructed customers on their rights and responsibilities,
• Provided instruction for use of medical equipment and supplies,
• Instructed customers how to make returns
• Provided privacy policies (HIPPA) as well as complaint and resolution procedures.
HEALTH INSURANCE BILLING AND ACCOUNTS RECEIVABLES
• Collected co-payments and unmet deductibles,
• Posted transactions
• Established procedures for processing cash, checks and credit card receipts.
• Submitted both electronic and paper claims to payers.
• Followed up with the lifecycle of the claims adjudication and EDI process.
• Maintained knowledge of CPT, ICD9 and HCPC codes.
• Interpret and post EOB from insurance carriers for accuracy.
• Outbound calls and letters to overdue accounts.
• Forwarded non responsive accounts to out-sourced collection agency.
• Established payment plans with customers.
VOLUNTEER COORDINATOR
• Made public speeches and presentations
• Created and set up displays
• Conducted monthly volunteer orientation.
• Coo...
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