―TELECOMMUTER ―
Opportunity to contribute to the growth and success of a medical & healthcare
industry leader through energetic application of strong persuasion,
communication, organizational, management and technical skills
Highly accomplished, versatile and respected Licensed Practical Nurse presenting
with over 19 years of extensive accomplishments within diverse environments
utilizing exemplary management, analytical, organizational, and people skills.
Proficient in medical/health insurance billing, medical terminology and medical
coding. Demonstrated expertise in handling responsible accounts payable,
receivable, reimbursement and billing positions. Exceptional ability to
harmoniously implement streamlined operations and change management strategies to
create strong effective teams and positive work environments.
AREAS OF EXPERTISE
▪Caseload Supervision Public Health Administration ▪Contract
Negotiation▪ FISS ▪ Critical Thinking/Analytical ▪Patient &
Family Communication▪ Risk Assessment
Management▪Payroll/Billing/Reimbursement,Medicaid/Anthem/Tricare
Medicare/State Compliance▪Utilization/Authorization▪Policy &
Procedures Development▪ Multi tasking ▪ Strong Communication
Skills ▪ Accts Receivable/Reconciliation
KEY STRENGTHS
STRONG SENSE OF RESPONSIBILITY. Excellent track record of
dependability. Outstanding ability to juggle many tasks yet delivers huge
business results. Consistently recognized by colleagues for cross-discipline
talents in needs analysis, troubleshooting and problem resolution in fast-paced
environments
PEOPLE-ORIENTED SELF-STARTER. Notable communication and customer
service skills. Strong work ethic and clinical skills. Proficient in medical
terminology, processes and equipment use. As member of interdisciplinary team,
strive to provide continuum of best possible care, keeping needs of patients
foremost in mind
KEEN INTERPERSONAL SKILLS AND FRIENDLY PERSONALITY. Readily establish
rapport and sense of trust with patients of various ages, cultures, and
socio-economic backgrounds as well as with peers, physicians and support
personnel
VALUED TEAM MEMBER. Service-oriented; enjoy helping and supporting
others. Conscientious and steady. Entrusted with confidential information
NOTEWORTHY ADMINISTRATIVE SKILLS. Flexible to changing priorities. Able
to identify and resolve problems using available resources. Commended for strong
organizational skills
TECHNICAL SKILLS. Proficient in utilizing various medical software and
systems including UB92, UB04 and CMS 1500 billing forms, Microsoft Office
applications, AS 400, PA Link, HHC 3000, Payer Path and some experience with
Misys and Acurra, ICD 9, CPT and HCPCS coding
BENCHMARKS
▪ Currently work fulltime as Assistant Director of Nursing for a home
health company while being a part time billing telecommuter performing 100% of
billing and account reconciliation and maintaining an A/R with DSO < 4***-
▪ Great knowledge of principles, procedures, methods and techniques of
practical nursing and health care within the license practical nurse scope of
practice. Profound knowledge of pertinent Federal, State, and local laws, codes
and regulations regarding health care.
▪ Highly experienced in providing administrative, clinical and operating
assistance, negotiating service contracts and handing all phases of billing,
reimbursements and account reconciliation activities for Medicare, Medicaid,
Anthem and other third party payors.
▪ Played significant role in recouping over $12,000 in unpaid claims over
120dos within 2 months of hire.
▪ Commended by VP of Operations for exceptional performance as regional
payroll/billing/reimbursement manger and for developing the Best A/R for the
company by maintaining A/R less than 40dos.
▪ Great ability to establish and maintain cooperative working
relationships with those contacted in the course of work.
RELEVANT EXPERIENCE
Assistant Director of Nursing ▪ Professional Home Health Agency
▪ Norfolk, VA Apr 2008 present
Performed as office supervisor for all Virginia Beach and Chesapeake
patients and field staff and responsible in managing case conference with RNs
regarding patient care, recertification and discharge as applicable; Provided
assistance to Billing Manager when necessary
Billing Specialist (Part time) ▪ Nannie Home Health Services ▪
Franklin, VA 2007 present
Work as a telecommuter responsible in billing of all payors, including
but not limited to skill Medicaid, Medicare and Medicaid personal care and in
remitting posting and account reconciliation
Billing/Quality Manager ▪ SHC Home Care ▪ Norfolk, VA 2007 2008
Oversaw all phases of agency billing and reimbursement and handling
assurance of chart for final billing as outlined by Medicare and other payers;
Spearheaded the implementation of intake and staff utilization process
Conducted orientation to staff, owners and referral sources on home
health guidelines as necessary
Billing/Reimbursement Specialist ▪ MHH Home Health Care ▪
Chesapeake, VA Jan 2007 Sep 2007
Responsible for all third party billing and authorizations and in
submitting Medicare ADRs and appeals as necessary
Played vital role in the implementation of Medicare final billing
process, revising patient intake and authorization process
PTHC▪ Norfolk, VA 1997 - 2006
Payroll, Billing, Reimbursement Manager (PBR), 2002 2006
Branch Director , 2005
Home Care/Intake Coordinator, 2000 - 2002
F/T Field Nurse, 1997 - 2000
Provided excellent patient care, primarily with AIDS and geriatric
patients
Oversaw all areas of regional offices billing, payroll and
reimbursement, contract negotiations, account reconciliation, overpayments
Directed overall operation of the Norfolk branch, including home health
personnel, patient and vendor issues, and PBR responsibilities; Coordinated and
staff all initial referrals for home care
EDUCATION
College Network
Bachelor of Science in Healthcare Administration Current
LICENSE
Sea Isle Vo Tech
Memphis, TN
Practical Nurse License 1989
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