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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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