Business office Manager/supervisor Resume

Desired Industry: Management	SpiderID: 21984
Desired Job Location: The Woodlands, Texas	Date Posted: 8/5/2008
Type of Position: Full-Time Permanent	Availability Date: 08/05/2008
Desired Wage: 40000
	U.S. Work Authorization: Yes
Job Level: Management (Manager, Director)	Willing to Travel: Yes, Less Than 25%
Highest Degree Attained: Bachelors	Willing to Relocate: No

Objective:
Looking for a results-oriented company that seeks a dedicated person where acquired skills and education will be utilized toward advancement. Seeking positions in the Houston Metro Area.

Experience:
2004-July 2008 Business Office Liaison - Regency Hospital
Covington, LA
• Manage patient charges.
• Review and verify health insurance/authorizations.
• Supervise admitting process for accuracy.
• Interface with various hospital departments to ensure charges and reports are correct.
• Assist patients/families/ 3rd parties with insurance coverage, deductibles and co-pay information.
• Manage claim denials/rejections research
• Maintain item charge master on all prices and coordinate bills from other facilities for interrupted stays.
• Audit outside vendor bills for accuracy and timeliness.
• Administrator of all facility cash.
• Process payroll (ADP/Stromberg) including human resources general duties.

2000-2004 Manager Internal Operations - Touro Infirmary
New Orleans, LA
• Managed 10 employees in acute care hospital business office.
• Supervised staff for customer/patient inquiries.
• Administrator for all group/institutional accounts.
• Monitored financial charity programs for appropriateness and compliance.
• Directed cash posters for timeliness and accuracy.
• Interfaced with ED/Admitting department for more efficient and effective process.
• Managed all financial reports.
• Monitored agency placement of accounts for timeliness and accuracy.
• Performed internal audits of business office.
• Instrumental in a system conversion (OAS Gold/Siemens).
• Reported to the Director of Patient Business Services.

2000-2000 Customer Service Rep - North Texas Healthcare
Dallas, TX
• Quoted healthcare benefits for providers and insured.
• Helped providers with check reconciliation’s.
• Communicated contract language and payments.
• Performed check traces.
• Managed claims resolutions.

1999-1999 Appeal and Grievances - United Healthcare Inc.
Covington, LA
• Investigated appeals and grievances from members/providers.
• Ensured contract compliance and claim resolutions.
• Researched Department of Insurance inquiries across multiple computer platforms.
• Researched claim issues for provider relations department.
• Resolved claim disputes for the company internal legal department.

1997-1999 Medical Auditor - Gilsbar, Inc.
Covington, LA
• Audited medical and dental claims quarterly on a prepaid basis for contract compliance.
• Created reports based on the results for management.
• Trained new and experienced health and dental processors.
• Communicated the policy on claim issues as a result of completed audits.

1995-1996 Communications Supervisor - Hilton of New Orleans
New Orleans, LA
• Ensured guest satisfaction during their stay;
• Service recovery of dissatisfied guests.
• Maintained quality departmental standards.
• Created and disseminated various reports.
• Supervised 10 operators.
• Monitored the switchboard for call volume and response time.
• Trainer for the corporate in - house customer service classes.

1990-1995 Group Health Claims Supervisor - Pan American Life
New Orleans, LA
• Managed all group claims.
• Supervised 4 file clerks, 2 lead clerks and 11 health claims processors.
• Ensured quality/quantity guidelines were met office wide.
• Created and managed the communication and report documents
• Managed large claim dollar amounts.
• Assisted the claims manager.
• Worked with internal/external auditors
• Worked with outside independent review organizations
• Managed policy resolutions for providers and insured individuals.
• Developed and taught training for current and new processors.

Education:
Education University of New Orleans, New Orleans, LA
Bachelors of Science – Business Administration

Reference:
References
Leigh Gutierrez 504-864-7768
Barbara Seronne 504-897-8560
Peter Lloyd 504-566-4585
Mark Thompson 985-867-3964

Candidate Contact Information:

Name: Yvonne Winters
Street:	Phone: 9859660420
City: The Woodlands	Fax: -
State: Texas
Zip: 77382
Web Site: