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Financial Applications Dir/Mgr Resume
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| Desired Industry: Healthcare |
SpiderID: 2142 |
| Desired Job Location: Fort Lauderdale, Florida |
Date Posted: 3/20/2005 |
| Type of Position: Full-Time Permanent |
Availability Date: 4 weeks from hire |
| Desired Wage: 95000.00 |
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U.S. Work Authorization: Yes |
| Job Level: Management (Manager, Director) |
Willing to Travel: |
| Highest Degree Attained: Bachelors |
Willing to Relocate: Yes |
Experience:
Work experience
4/2000 – Present
Bon Secours NJ Health System
Bon Secours & Canterbury Partnership for Care
* Christ Hospital
* St. Francis Hospital
* St. Mary Hospital
Jersey City and Hoboken, New Jersey
Revenue Cycle Services
Information Systems
•Director (6/2004 - Present)
•Manager (4/2004 – 06/2004)
Corporate Charge Master Coordinator (4/2004 - Present)
Responsibilities:
Managed the Patient Accounting, Registration and Medical Records systems applications utilizing the QuadraMed Affinity software products.
Responsible for all testing, implementation and training for all software updates and changes pertaining to industry and HCFA regulations.
Perform query writing for ad-hoc reports using Affinity Information Retrieval Data Base.
Managed the system applications for the electronic billing processes using the NDC/Premis and XactiMed software systems.
Managed the State Department of Health, New Jersey Discharge Data Collection process for all sites (MIDS / NJDDC).
Managed and maintained over 15 managed care contracts and 10 institutional guarantor contracts utilizing the Affinity Contract Management applications.
Implemented and maintained systematic A/R outsourcing, Bad Debt and Denial appeal process. This includes account qualification, data export to vendors, reconciliations and reporting.
Implemented and maintained HIPAA 837I/P, 835, 270/271 processes and interfaces with the registration, patient accounting and claims submission systems.
Responsible for the upkeep and maintenance of the system charge master. This included: maintaining the CDM and its integrity and consistency between facilities and other integrated systems and communicating expectations and responsibilities for all departments in the charge capture process.
7/1997 – 3/2000
The Medical Center at Princeton
Princeton, New Jersey
Patient Accounting Manager
PA / REG – Hospital Applications Coordinator (HAC)
Responsibilities:
INITIAL BILLING
Managed a staff of 3 Billers.
Managed the daily operations of hard copy, electronic billing and secondary billing.
This included outpatient, inpatient, psychiatric outpatient and inpatient, long term care, intermediate care, home care and hospice.
Systems used; QuadraMed EDI(ClaimStar) and Gaffey & Associates.
CASH MANAGEMENT
Managed a staff of 7 cash posters, EOB reviewers, cashiers.
Managed the daily operations of cash posting from direct mail, bank lockbox, 835 remittances and cashiers.
Insurance EOB review for contract payment compliance.
Credit balance processing.
HOME CARE/HOSPICE
Managed a staff of 5 Home Care Billers/Collectors
Managed all daily operations for HomeCare and in home monitoring system Accounts receivable.
OFFICE SUPPORT
Clerical, File Clerks and EOB maintenance.
Managed a staff of 3 clerical employees.
Insurance and Patient Correspondence.
EOB scanning, requests and file maintenance.
Medical Records requests and delivery.
SYSTEMS MANAGEMENT
Registration and Patient Accounts applications using the QuadraMed Affinity product.
Managed a staff of 3 systems analysts.
Managed and implemented conversion and balance forward from AS/400 based “home developed” system to the QuadraMed Affinity products for Patient Services, Patient Registration, Patient Accounting and Contract Management with a front-end interface from the Ulticare(HDS) system. The conversion included Outpatient and Inpatient acute care, Outpatient and Inpatient Psychiatric, Long Term Care, Intermediate Care (SNF), Home Care, Hospice, Community Institutional Contracts and in home health emergency response and monitoring system.
Patient Accounting and Registration HAC for Registration, Patient Accounting, Contract Management.
835 electronic remittances from Medicare and Medicaid.
Registration, Correspondence, and Remittance Advice document imaging and archival applications using the QuadraMed EDM and COLD VIEW systems.
6/1996 – Present
Oliver a bistro
Bordentown, New Jersey
Partner/Owner
Restaurant in historic Bordentown New Jersey.
Developed Coffee & Sandwich Shop into full service restaurant.
After 1 year resigned as silent partner to resume healthcare career path.
7/1994 – 6/1996
The Florida Institute of Health
Fort Lauderdale, Florida
Business Office Manager
Billing System Conversion Coordinator
(Concurrent positions)
Managed the billing, follow-up and collections of two-physician office within a forty office IPO.
Updated and conversion of group offices from ledger card, pegboard systems and various other computer systems to a standard billing and scheduling vendor software This was in preparation for all forty-group offices to achieve a Central Billing Office.
10/1990 – 6/1994
Waden E. Emery III, M.D., P.A
Fort Lauderdale, Florida
Office Manager
Neurology, Neuropsychology and Physical Therapy practice.
Managed the initial setup from office space, professional staff credentialing, hiring of support staff and policies and procedures of this practice.
Continued to managed the operations of fourteen clerical employees, neurologist, neuropsychologist, doctor of osteopathic medicine, two registered physician’s assistants, registered physical therapist, two physical therapy aides, billing manager and full time bookkeeper.
Managed all duties relating to scheduling, accounts receivable, accounts payable, payroll as well as personal finances for two physicians.
Maintained over forty-five managed care, workmen’s compensation and no-fault contracts.
Structured, wrote and maintained all office policy and procedures.
Responsible for all personnel decisions, including policy, evaluations, hiring and terminations.
Responsible for systems management between the office and computer administration software company. This included scheduling, patient accounts, collections, accounts payable and a complete integration of medical transcription using WordPerfect and the Patient Accounting Information System.
Responsible for marketing the practice to various specialty clinics, insurance companies and attorney’s offices.
7/1988 – 10/1990
Physicians Outpatient Diagnostic Center
Plantation, Florida
Billing and Collections Manager
Managed the operations of ten employees within the accounts receivable department.
Liaison between the billing office, scheduling office and the computer administration software company.
Skills:
APPLICATION EXPERTISE
QuadraMed Affinity
NDC / Premis EDI
NDC / OMEGA
QuadraMed QEDI (Claimstar)
XactiMed
QuadraMed QEDM
Gaffey & Associates EDI
Microsoft Excel
Microsoft Word
Microsoft Power Point
Microsoft Access
Microsoft Visio
Microsoft Project
Monarch
Mercury Interactive / WinRunner
Additional Information:
Over sixteen years of Healthcare Patient Financial Administrative experience and Systems Applications Management.
Progressive positions of responsibility and leadership. Extensive experience, strength and skill with Operations, Auditing, System Maintenance, System Implementation and Personnel Training.
Candidate Contact Information:
This candidate has chosen not to make contact information available on this page.
Click "Contact Candidate" to send this candidate a response. |
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