Objective:
 

Re: Claims Examiner Position To Whom It May Concern:


Work Desired:Full Time - Permanent
Citizenship:US Citizen
Resident Of:State: California - Area Code: 626
Willing To Relocate:Yes
Posted By Candidate:1+ Year Ago
Experience:More than 3 years of work-experience
Technical Skills:, Project Management
Work Experience:
LINDA L. SVASTITS
13225 Quapaw Road
Apple Valley, CA 92308
(760) 961-0009
(760) 680-3466 (Cell)

Claims Examiner  *  Worker  's Compensation

Dynamic Management and Claims Professional with more than 20 years of
increasingly responsible experience building and managing multi-site healthcare
operations. Recognized for consistent success in developing the systems,
processes and methodologies to reorganize/revitalize practice operations,
increase revenues and enhance profit performance. Strong provider relations,
private medical and worker  's compensation claims processing and administration,
planning, grievance resolution, quality assurance, auditing, consumer finance,
organization development, MIS and general / operations management qualifications.
Possess strong cross-functional commu  nications, both written and verbal,
resource allocation and project management skills. 

CORE COMPETENCIES:

Practice Management & Business Administration

Internal and external practice/claims consultant to both single practice and
multi-site/multi-doctor dental and medical operations providing expertise in
operations management, administration, insurance billing and coding, workers  '
compensation claims, ACOEM Guidelines & AMA Guides, UR peer to peer reviews,
nurse case manager reviews, grievance resolution, quality assurance, auditing,
consumer finance, accounting, human resources, MIS, regulatory affairs,
resources/facilities management, insurance administration and excellent
troubleshooting skills. 

 *  Personally manage all support staff and physicians, assigning work
priorities, responsible for all claims administration, employment recruiting,
training and reviews, payroll preparation using Quick Books and Paychex.

 *  Created innovative practice management models and methodologies to
strengthen quality of care.

 *  Expert qualifications in private medical and workers  ' compensation
insurance claims administration. accounts receivable, accounts payable, billing /
rebilling, claims processes, reimbursement, banking, accounting/financial
analysis, financial reporting, cost/benefit analysis. Managed over $100,000
monthly operating budget.

 *  Restructured patient accounting operations and designed/implemented
policies, procedures and proc  esses that improved collections, reduced
outstanding debt and strengthened bottom-line profitability.

 *  Personally managed aged receivable accounts, established case presentations
and coordinated financial arrangements. Represented all practices in legal
proceedings and lien negotiations. Consistently exceeded collection goals.

Customer Service & Client Relations

Independently managed relationships with up to 35,000 patients. Served as the
direct liaison to maintain cooperative relationships, resolve billing and
operating problems, and outperform competitive organizations. Actively involved
in developing marketing programs to capture new business opportunities.

 *  Launched a comprehensive marketing and business development campaign to
revitalize existing client relationships. Recaptured more than 60% of lost
business within four months. 

 *  Delivered strong and sustainable improvements in client service,
satisfaction and retention.

CAREER PROGRESSION:

Office / Business Administrator Advanced Chiropractic Rehab 2004 to present
Office Manager Eric Meyer, DDS 2001 to 2004
Office Manager / Administrator Stephen Bowen, DDS 1999 to 2001
Office Administrator Mark George, DDS 1994to 1999
Office Administrator Stuart Rubin & Associates 1992 to 1994
Operations Manager / Administrator Sunset Dental Group 1990 to 1992
Office Operations Manager / Supervisor Harold Nemetz & Associates 1988 to 1990
Regional Director / Office Manager The Dental Group 1984 to 1988

EDUCATION & CERTIFICATIONS:

Work Injury Network, ACOEM and AMA Guides Training in Worker  's Compensation,
2004-2009

California State Real Estate License, 2005

International    Who  's Who    of Professional Management, 1997 Award

Certified Chiropractic Assistant, Los Angeles College of Chiropractic, 1994

Continuing Professional Education & Seminars, 1987  *  2008, sponsored by
Patient  's Choice Network / Work Injury Network; Career Track, Fred Pryor, Dunn
& Brad  street, McVey & Associates, Steven Covey, Academy of Management Sciences,
Cerritos College, Rio Hondo College, etc. Topics include:

 *  Practice Management  *  Medical Terminology
 *  Health Insurance & Collections  *  Hyperbaric Medicine
 *  Patient-Centered Care  *  Auditing for Success
 *  Effective Communication  *  Sales & Marketing Techniques
 *  Supervision & Leadership  *  Prioritizing Daily Tasks
 *  Implant Dentistry  *  Invisalign Certification

 

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