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Yyyyyy x. yyyyyy

132 Sable Trace Trail Xxxxxx, XXXXXX xxxxxx xxx-xxx-xxxx abc@xyz.com

 

Managed Care Expert

 

Driven, confident and ambitious professional with experience working in the healthcare industry for over 15 years. Started in the field in a front office capacity and continued to grow into leadership positions of progressing responsibility, including an eventual corporate role and current operation at the executive level. Self-motivated, seeking to maintain continued growth. Skilled in serving as a trainer for over 50 facilities across the U.S. Thrive while working in a supportive capacity to develop training materials, as well as pioneer new policies and procedures. In pursuit of a challenging, exciting new career role as a Corporate Trainer or Director that will allow for ongoing professional advancement.

 

Career Highlights

 

         Deliver supportive training for the Tenet Central Billing Office (CBO) rexxxxxxrding old AR in the previous electronic medical record software

         Supervised and guided Tenet s Urgent Care operations to achieve collection objectives using sound delivery of high-caliber patient care using customer service best practices

         Vastly streamlined Tenet s front office registration operations across more than 40 Urgent Care Centers in AZ, CA, XXXXXX, MI, MS, TN, and TX; served to notably slash registration times and bolster levels of efficacy

         Oversaw the Kronos system for Radiology technicians at the Imaging Center during tenure as Tenet s Timeshare Office Coordinator

         Offered ongoing daily support, coaching and training to Conifer s new hires and current personnel, the latter in the form of professional development and the former via introductory trainings

         Enxxxxxxged as an active participant of numerous Banner Baywood facility and system improvement teams

         Skills include: Operations Management, Accounts Receivable, Attention to Detail, Team Leadership, Process Improvement & Implementation, Customer Service, Billing, Communication, Regulatory Compliance, Conflict Management, Mentoring

 

Professional History

 

 

Tenet Health/United Surgical Partners International | Managed Care Coordinator, 2017-Present

         Aid over 55 Urgent Care facilities and Central Billing Offices (CBOs) with claims resolutions and managed care matters

         Develop and utilize documentation best practices to boost operational success; update and maintain a contract spreadsheet for each Urgent Care facility, along with contract summaries for the CBOs

         Assess more than 50 managed care contracts to drive accuracy in claims processing; including under/over-payments

         Escalate insurance under-payments to a Corporate Negotiator or directly to the insurance carrier

         Provide CBOs with updates to payment policies that directly impact their respective daily functioning

 

Tenet Health | Business Office Operations Manager, 2014-2017

         Served as an intermediary between urgent care centers, third-party billing providers and collection agencies to resolve patient liabilities

         Completed accuracy reviews for unpaid balances; released to collection agency and applied adjustments as needed

         Identified and assessed accounts with patient/insurance credits; sent them to a third-party billing company to be processes

         Traveled to train and mentor, as well as audit all 50 Urgent Care locations; focused on proper use of the electronic medical records (EMR) system, accurate interpretation of insurance benefits and suitable patient collection methods

         Reviewed and interpreted Explanations of Benefits (EOBs)

         Collaborated with partner collection agency to validate precision of current balances; posted monthly received payments.

         Authored, implemented and virtually trained detailed front office training manual for nationwide roll-out for 50 Urgent Care Centers across AZ, CA, XXXXXX, MI, MS, TN and TX

         Authored and executed operational documents to be nationally introduced at all 50 Centers; included Process of Daily Reconciliation, Cash Pay Agreement, Out-of-Network Policy/Protocol, as well as Occupational Medicine Inter-Company Protocol

         Partnered with National and Regional Directors of Operations to discuss accounting, third-party billing and collection agency matters

         Fielded patient questions and concerns by assessing their charts to note payment postings, as well as rectify issues related to posting errors or incorrect CPT codes

 

Urgent Care Manager, 2013-2014

         Managed two Urgent Care Centers, each with up to 20 staff including X-ray Technicians, Licensed Practical Nurses (LPNs), Medical Assistants, along with front office staff members

         Managed front office duties e.g. maintaining patient flow, confirming insurance benefits, patient liability collection and daily settlement

         Ensured compliance with policies, procedures, standards and regulations by educating personnel on proper protocols

         Developed employee schedules to ensure smooth, well-orxxxxxxnized workflows; also handled annual review processes

         Controlled all front and back office inventory; replenished stock levels as items ran low

         Completed weekly and monthly accounting reconciliations as well as twice-daily bank deposit processes

         Approved and processed monthly vendor invoices; carefully validated all charge amounts, added appropriate cost center codes and sent completed items to Corporate Accounts Payable for timely processing

Yyyyyy x. yyyyyy

Continued

 

Timeshare Office Coordinator, 2012-2013

         Fulfilled administrative and guest relations operations in a timeshare office setting; included scheduling surgical, pre-operation, radiology, physical therapy, spine center evaluation and spine therapeutic injection cases

         Completed physical therapy registration, insurance verification and pre-authorization for Wellness Center patients in a timely, thorough fashion; also collected patient liabilities at the time services were rendered

         Authored and executed visit tracking sheets for frequent physical therapy patients

         Completed evaluation of inventory daily and placed supply orders if needed

         Upheld mutually positive working relations with referring physicians and their teams, as well as with patients and their families

         Replied to Wellness and Imaging Center phone lines to reply to patient and stakeholder inquiries and concerns

 

Conifer/Tenet Health | Patient Access Supervisor, 2010-2012

         Supervised a dynamic team of 10 in fielding front office registration processes; maintained a seamless patient flow, confirmed insurance benefits, collected patient liability and fulfilled day-end settlement duties

         Ran daily point-of-service reports for staff, used to courtesy-call patients and quote liability prior to service arrival

         Monitored staff s daily productivity, including point-of-service collections

         Delivered superb service to patients and assisted staff in resolving escalated disputes when needed; heightened team morale levels to ensure the utmost in both patient and team satisfaction

         Reconciled and prepared daily bank deposits with exactness and attention to detail

         Strongly enforced and adhered to departmental policies, practices and work regulations

 

Transportation Specialist, 2009-2010

         Served as a Programs Manager/Transportation Specialist in the Foreign Borders Division for the Federal Motor Carrier Safety Administration

         Xxxxxxrnered certification as a Contracting Officer and Technical Representative

         Oversaw enforcement programs within the Division; authored policies and advised other Divisions on protocols related to foreign commercial motor vehicles

 

Banner Baywood Medical Center | Patient Access Supervisor, 2006-2010

         Led a team of 17 in fulfillment of front office registration duties such as patient flow maintenance, verification of insurance benefits, pre-certification processes, patient liability collection, financial counseling and daily settlement at the close of the business day

         Also managed functions for the inpatient admitting team, including point-of-service collections and related objectives; held staff accountable in their respective roles and related responsibilities

         Upheld positive continued communications with patients, staff including Physicians, as well as additional third parties

         Created documents, letters, spreadsheets, reports, presentations and annual budgeting initiatives

         Worked in a Hospital Patient Services capacity to offer necessary documentation used to process patients AHCCCS Medicaid applications

         Monitored employee time and attendance and followed up on those found responsible for inability to follow related policies

         Controlled department inventory and placed orders as supplies ran low

 

Earlier Roles

 

Outpatient/Inpatient/Labor and Delivery/Wound Care Account Representative, Banner Baywood Medical Center, 2003 2006

Emergency Room Registration Specialist, Paradise Valley Hospital, 2000 2003

 

Education & Involvement

 

Degree, Business Management, Chattahoochee Technical College (December 2018)

Courses, Paradise Valley Community College

 

 

 

 

 

 

 

 

 

 

Yyyyyy x. yyyyyy

132 Sable Trace Trail Xxxxxx, XXXXXX xxxxxx xxx-xxx-xxxx abc@xyz.com

 

 

March 19, 2018

 

 

Hiring Agent Name

Title

Company Name

Address

City/State/Zip Code

 

 

Dear [Hiring Agent Name],

 

I am pleased to submit my application materials for the (INSERT TITLE OF TARGET POSITION) vacancy and am submitting my documents for your review. As illustrated in the accompanying resume, my professional qualifications include the following accomplishments:

 

  • As a management-level professional, I bring to any position years of progressive healthcare administration experience. I have a diverse career that spans over 15 years and is heavily steeped in my skills as it pertains to training, mentorship, administrative operations management and staff supervision.

 

  • Over the course of my impressive career, I ve proven myself adept in guiding and inspiring my peers and supervised staff teams to achieve success. I lead by example and am able to develop and sustain lasting relationships with stakeholders at all levels, both individually or within a team setting.

 

  • I hold a track record of delivering guidance in deadline-driven, fast-paced environments that call for flexibility, time management and the ability to work well under pressure. I am often rexxxxxxrded by others as a valuable trainer and mentor. This will serve me well in any executive-level position as I aim to grow and continue in this career trajectory.

 

  • Other core competencies include Critical Thinking, Patient Relations, Communication, Billing, Collections and many others. My diversity of experience includes actively identifying both points of progress, as well as areas for improvement in any operational capacity.

 

  • Independent of my professional history, I am currently completing my degree at Chattahoochee Technical College with an expected graduation date of December 2018. I am an eager learner in the workplace as well, always willing to expand my knowledge base via professional development and continued education.

 

I am a focused, capable and highly experienced applicant committed to supporting the long-term goals of an innovative, reputable firm. I am confident that I could be a valuable asset to your orxxxxxxnization, and look forward to interviewing with you in the near future.

 

Yours Truly,

Yyyyyy x. yyyyyy

Enc. Resume

 

 

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