Manager, Hospital Outpatient Facilities

Boca Raton Regional Hospital

Boca Raton, Florida

December 2017- May 2019

• Responsible for managing the daily activities of 28 employees in hospital and outpatient facilities
• Implement and promote strong patient satisfaction through project management, department analysis, statistics and resources
• Implement new policies and/or procedures for all outpatient services
• Manage hospital patient and doctor flow of all tests and procedures for effectiveness
• Facilitate the collection of comprehensive accurate patient data including assessments and reporting to ensure an effective process that supports a financially viable organization
• Monitor and control all registration and scheduling activities in regards to productivity and telephone volumes
• Conduct and direct the process of interviewing, hiring, evaluating, rewarding, and disciplining of employees
• Manage computer and/or software programs for optimal scheduling of hospital tests and/or procedures
• Act quickly and professionally toward resolving any problems relative to patient servicing and/or hospital concerns
• Serve as a facilitator, educator, and a key provider in the delivery of healthcare systems necessary to support quality patient outcomes
• Attend and conduct meetings with administration and Compliance to improve quality of services

Supervisor, Patient Access

University of Miami Healthcare Division/School of Medicine/Sylvester Comprehensive Cancer Center

Miami, FL

December 2015-December 2017

• Responsible for the supervision of the daily activities of 24 employees in 2 Satellite facilities
• Management functions of planning, organizing, controlling and scheduling for daily expected clinic volumes including efficient and cost-effective management of registration area including administration and managers meetings
• Ensures all staff adhere to all established policies and procedures related and monitor compliance
• Monitoring staff productivity and quality of work through proactive reviews of attendance, Claim Edits, data entry, bypass warnings, past due balance collection, copay collection, charge entry, scheduling accuracy, Press Ganey scores etc.
• Perform year end evaluations and new hire 90-evaluations and staff schedules
• Coordinating of patient care - scheduling of all walk in, add on and follow up appointments in accordance with established guidelines
• Seeks feedback from physicians and/or clinical department in an effort to identify performance improvement initiatives
• Serve as Patient Advocate and Service Ambassador by providing a favorable first Impression and proactive attention to internal and external customers in order to meet or exceed expectations, address, concerns and optimize experience
• Obtain all applicable referral/authorizations/pre-certifications, verify and document pertinent insurance eligibility verification information (i.e. CPT codes, service description, reason for visit, etc.) and confirm non-emergent visits cleared prior to services rendered in order to avoid denials and ensure financial reimbursement
• Surgery coordinating and scheduling of patients through OR and other ancillary facilities
• Perform ancillary/clinic support duties such as treatment plans, test results requests and preparing charts/medical records
• Ensure claims have been submitted accordingly by reviewing/verifying insurance claims after denial
• Comply with all standard operating procedures established to support key metrics and quality assurance initiatives that contribute toward prompt billing and increased cash flow

Senior Clinical Administrative Coordinator (Auditor)

United Healthcare/Optum

Florida/Telecommute/Travel

January 2015 – December 2015

• Quality improvement & intervention to close HEDIS gaps including medication adherence
• Audit medical records to highlight Medicare Star opportunities/HEDIS Measures for Provider
• Partner with clinicians and non-clinicians to manage patients healthcare needs
• Maintain relationships with providers, non-clinicians and clinicians by conducting site visits
• Manage and assist patients in navigating their network of providers and wellness benefits while providing follow-up and specialist appointments
• Coordinate Social Worker & diabetic referrals
• Organize data collection, data entry, quality monitoring and documenting case information
• Initiate ongoing support and education to team members, providers and members on UHC benefits
• Comply with corporate requirements related to industry regulations/responsibilities
• Conduct on-site audits and initiate the submission of audit documents for CMS compliance

ISS (In School Suspension) Teacher

Clay County Schools

Keystone Heights, Florida

March 2011 – January 2013

• Served as a Substitute Teacher for Kindergarten through 12^th grade classes within Clay County School District
• Coordinated and maintained classroom environment conducive to learning for the students
• Maintained, organized and reported attendance and tardy records of the students, issued class passes, referrals, and excuse notes
• Organized and coordinated parents activities, switchboard operator, ensured students and staff received up to date information for daily activities, monitored and trained student workers

Patient Access Specialist

Gwinnett Medical Center

Lawrenceville, Georgia

May 2007 – April 2009

• Conducted patient interviews on date of service through Emergency Services and/or Traumas; entered registration data into the hospital registration systems; obtained pertinent demographic information; obtained patient financial information for pre-certification and authorizations
• Coordinate receipt of signed consent forms for treatment, testing and identification; obtained insurance information and verified any Medicare/Medicaid CMO patients coverage status via Georgia Health Partnership website
• Supported Emergency Room Department as a Financial Counselor based on operational need; obtained and processed payments from patients on their accounts via cash, credit, debit, and check transactions
• Organized records of monetary transactions and updated registration to reflect payments during collection; registered patients submitting lab specimens and those in custody of local/state police departments for Legal Blood Alcohol testing

Patient Financial Services

Memorial Regional Hospital/Joe DiMaggio Children’s Hospital

Hollywood, Florida

January 2005 – February 2007

• Registered patients, collected pertinent patient information and data for pre-registration or interviewed on the date of services through Emergency Services and/or Traumas; maintained records of patient's accounts; corrected, updated and consolidated records to include the application of proper discounts to patients
• Responsible for the medical coding and billing for third party payers. Knowledgeable of health insurance plans and reimbursement models.
• Provided financial counseling to patients and their families regarding charges for their health care services; determined fees for services provided and implemented appropriate collection and refund actions; assisted indigent patients in arranging payment schedules; collected deductibles, co-pays and flat rates; posted/coded accounts for correct billing; verified insurance coverage for admission, pre-admissions and/or transfers (Medicare/Medicaid and HMO/PPO)
• Determined necessity of third party sponsorship; processed and examined insurance policies accordingly to other third party sponsor materials for sources of payment; obtained patient financial information for pre-certification and authorizations for health care services and procedures for admissions
• Managed and performed general clerical and patient safety duties including patient ID bracelets and labels according to safety regulations (Joint Commission)

Accounting Staff/Administrative Assistant

Amerijet International

Fort Lauderdale, Florida

August 2001 – May 2005

• Reconciled 30 domestic and international accounts for organization
• Initiated, reviewed, obtained, and balanced incoming and outgoing wire transfers
• Managed cash positions for domestic and international accounts
• Executive to Chief Financial Officer and Controller

Asset Recovery Specialist

Bluegreen Corporation

Boca Raton, Florida

May 1999 – September 2001

• Processed, prepared, and maintained asset recovery files (foreclosures); monitored and prepared terminations, foreclosures, deed-in-lieu of foreclosure, bankruptcies, note litigations, and release of properties.
• Processed and impounded legal and tax vouchers; provided high level of customer service and conducted collection calls on foreclosures

Manager

The Check Cashing Store

Sunrise, Florida

February 1994 – April 1999

• Reconciled store, processed daily deposits, processed accounts payable/receivable, maintained financial records of clientele, obtained personal loans and monitored daily cash position for store
• Coordinated and processed timesheets, employee schedules and served as in-house human resources