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Click here or scroll down to respond to this candidate Candidate's Name
Street Address Pleasant Valley Lane
Arlington, TX Street Address
PHONE NUMBER AVAILABLE
EMAIL AVAILABLE
Objective: Seeking a position with increasing responsibility where I can utilize my skills as a
Business Office Manager. I also have vast training in Human Resources, Insurance Claims and
Authorizations. I hope to gain new experience while providing excellent assistance in multiple
sectors of healthcare and/or business administration.
Professional Skills:
Human Resources Business communications
Business Office Management Microsoft applications
Claims Fee Negotiations Basic & Intermediate Anatomy and
Contracts and Proposals Physiology
Processing DME, Pharmacy, and Filing & Organizing
Medical Insurance Claims Knowledge of policies/procedures
Payment posting and processing and Clinical Policy Bulletins for the
Patient Registration & Check -In following insurances: Medicare,
Appointment Scheduling & Benefits Medicaid and Commercial Insurance
Verification, Extensive knowledge of the
Obtaining Precertification & following EHR systems: PCC,
Authorizations Eclipsys, Advantix, Riversoft,
Billing-ICD-9, ICD-10, HCPCs, and Meditech,, Kinnser, and Kantime
CPT Codes
Education
Plainview High School
Aug. 96 May. 00
Wayland Baptist University
Aug. 00 Mar. 02
Beta Tech University
Aug. 03- Mar. 05
Tarrant County College (Associates Degree)
Mar. 14 May 16
Employment:
Trinity Healthcare Residence Business Office Manager
September 2016- Current
Enter census changes and updates daily, enter patient demographics, handling 3618/3619 forms
in Simple LTC, make daily deposits and withdrawals, make collection calls, file and organize
paperwork, maintain patient trust funds, complete and submit Medicaid applications with
residents, complete and submit rep payee forms, review aging balances and discharges with
Administrator, attend daily meetings with other department heads.
Jordan Health Services Therapy Coordinator/Office Manager
March 2014- September 2016
Primarily responsible for obtaining authorizations for pediatric clients needing therapy provided
in their home on a weekly basis, hire PPV and Contracting therapist, processed payroll,
scheduled therapy visits, prepare contracts for corporate approval, responsible for ordering office
and testing materials for staff, contact commercial insurances to obtain authorizations, appeal
denials and negotiate approved visits. Keeping staff/clients updated with changes in policies and
guidelines within insurance companies.
Cook Childrens Northeast Hospital -Patient Access Specialist/Precertification and
Receptionist
May 2012-March 2014
Primarily responsible for registering account information for patients visit, obtaining patient
demographic and third party information with a high degree of accuracy and privacy. Processing
payments and posting in system. I demonstrate timely completion, preparation, and deployment
of legal, ethical and compliance related documents that must be presented and explained to the
patient at the time of registration. I am responsible for maintaining knowledge of JCAHO,
Patient Rights and Responsibilities, HIPAA, and departmental/System policies and procedures. I
perform front office intake functions. Obtain Authorizations for patients having High Tech
Radiology performed at the facility.
HCC/FDS EZ-DME Product Specialist
July 2011 to May 2012
Provide telephone and dial-in technical support services to end users for a variety of proprietary
software applications, including but not limited to: Pharmacy and Durable Medical Equipment
Claims to Medicare, Medicaid, and Commercial Payers.
Profero Solutions- Baylor Hospital / Eclipsys Project EHR Consultant
March 2011 to May 2011
Supported Baylor staff with the Go-Live of a new electronic medical and health record program
named Eclipsys, worked specifically with scheduling and registration in patient access with staff
in the visual function center
Valley Ranch Urgent Care Front Office Medical Staff
August 2010 to Jan 2011
Checking and Registering Patients in Misys system, verification of patients insurance and
eligibility, preparing super bill for Nurse, posting payments in the Misys system, disputing
denied claims with insurance carriers, dropping electronic claims to paper for resubmission
Multiplan- Claims Fee Negotiator
March 2010 to June 2010
Routing of faxes, Handling fax error queue to determine why faxes didn't transmit and resolving
the issue in order to successfully send out the fax document. Provider research including
contacting providers to obtain or verify validate phone number, fax number, address and tax id
numbers. Data entry of paper claims received from clients. Back up on handling of provider
matching on claims. Understanding client settings, priority clients, due dates and turnaround time
including the impact on negotiations Telephone skills and etiquette Working knowledge of MS
word, excel, internet and Google searches Detail oriented Flexible & multitasked; need to switch
job functions throughout the day and adapt quickly Some understanding of HCFA 1500 and UB
claim forms
Aetna Medical Provider Service Rep
August 2007 to November 2009
Answer questions and resolve issues based on phone calls, letters, faxes and electronic
submissions from providers. Provide Eligibility, benefit, and claim status to providers on a high
call volume level.
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