Vania James CPC
Vanna0092@aol.com
OBJECTIVE; I would like to obtain employment with a company that will utilize my skills and degree to the organization and my progression.
EDUCATION
Certificate, Medical Coder,
Associate Degree, Human Services, 6/1998
Certificate, Healthcare Coordinator, 9/1995
Bachelor Degree, Arts Psychology, 12/2009
EMPLOYMENT
2/2008 – Present, Mental Health Center Trainer/Technical Assistance, South Carolina DMH Columbia, South Carolina
Serve as trainer and facilitator to seventeen mental health centers. Provides technical assistance to agencies and helps agencies to resolve billing issues. Ensure that reports are accurate and completed within the required time period. Compiles data related to special research studies and surveys regarding agency programs. Gathers all financial data needed to complete the agency's activity based inventory, accountability and annual reports. Consults with and advises the agency in the development, maintenance, and utilization of program evaluation indicators to decrease program and administrative costs and improve overall program and Agency effectiveness. Collect historical and current program data for the purpose of program evaluation, eligibility monitoring and assisting in forecasting the Agency's annual budget request.
4/2007-02/2008, Collection Specialist, Kershaw Medical Center, Camden SC
Responsible for coordinating collections of bad debts for all patient types and any activities associated with collection of Self Pay accounts. Establish payment arrangements within guidelines established by departmental policy for self pay accounts. Review all accounts to insure insurance has paid on all accounts. Maintain all LTC and private pay billing is current. Assist and educate all nursing home patients and family member on insurance and facility protocols.
9/2005-9/2006, Billing Manager, Ridgeview Manor Nursing Home & Assisted Living, Hopkins, SC
Manage business office staff with daily operations, medical billing and all revenue cycle. Ensure planning, staffing, directing and controlling the activities and operations of the business office. Educate and train providers and clinical staff on new and revised insurance protocol. Perform accurate reports for Medicare such as Balance Credit reports, Bad Debt reports and other report. Maintain accounts payable and subsidiary documentation, maintain staffing schedules, overseeing daily balancing and deposits, and acting as liaison between staff, administration and physician.
1/2003-5/2005, Insurance Analyst/Admission Specialist, Columbia Psychiatric Associate, Columbia SC
Perform daily medical billing via Internet and electronically, conduct appeals and denials in a timely manner as well as post daily charges and payments. Prepares and participates in project planning, analysis, specification development, and implementation, of billing and insurance system. Obtain and conduct per-certification and utilization review. Interface with HMO, Medicare, Medicaid, worker's compensation and managed care companies. Ensure that all providers are credentialed with appropriate insurance companies and facilities. Medical terminology, ICD-9 and CPT-4 coding was vital to my job performance in keeping the patients informed about their accounts. Assist patients and family in admissions and placement of hospitals and other facilities.
6/2000-8/2002, Managed Care Specialist, South Carolina Heart Center, Columbia SC
Ensure that all insurance benefit is pre-certified prior to all procedures being performed by any of the thirty-nine cardiologists. Obtain all information for admissions and pre-cert. for hospital and other facilities. Educate and train providers and clinical staff on new and revised insurance protocol. Counsel patients appropriately in situations where insurance companies deny benefits by explaining waiver to patient and answering questions. Manage and conduct utilization review and case management with HMO, managed care companies, and worker's compensation. Perform liaison functions with hospitals and outreach offices.
SALARY; Negotiable
Vanna0092@aol.com
OBJECTIVE; I would like to obtain employment with a company that will utilize my skills and degree to the organization and my progression.
EDUCATION
Certificate, Medical Coder,
Associate Degree, Human Services, 6/1998
Certificate, Healthcare Coordinator, 9/1995
Bachelor Degree, Arts Psychology, 12/2009
EMPLOYMENT
2/2008 – Present, Mental Health Center Trainer/Technical Assistance, South Carolina DMH Columbia, South Carolina
Serve as trainer and facilitator to seventeen mental health centers. Provides technical assistance to agencies and helps agencies to resolve billing issues. Ensure that reports are accurate and completed within the required time period. Compiles data related to special research studies and surveys regarding agency programs. Gathers all financial data needed to complete the agency's activity based inventory, accountability and annual reports. Consults with and advises the agency in the development, maintenance, and utilization of program evaluation indicators to decrease program and administrative costs and improve overall program and Agency effectiveness. Collect historical and current program data for the purpose of program evaluation, eligibility monitoring and assisting in forecasting the Agency's annual budget request.
4/2007-02/2008, Collection Specialist, Kershaw Medical Center, Camden SC
Responsible for coordinating collections of bad debts for all patient types and any activities associated with collection of Self Pay accounts. Establish payment arrangements within guidelines established by departmental policy for self pay accounts. Review all accounts to insure insurance has paid on all accounts. Maintain all LTC and private pay billing is current. Assist and educate all nursing home patients and family member on insurance and facility protocols.
9/2005-9/2006, Billing Manager, Ridgeview Manor Nursing Home & Assisted Living, Hopkins, SC
Manage business office staff with daily operations, medical billing and all revenue cycle. Ensure planning, staffing, directing and controlling the activities and operations of the business office. Educate and train providers and clinical staff on new and revised insurance protocol. Perform accurate reports for Medicare such as Balance Credit reports, Bad Debt reports and other report. Maintain accounts payable and subsidiary documentation, maintain staffing schedules, overseeing daily balancing and deposits, and acting as liaison between staff, administration and physician.
1/2003-5/2005, Insurance Analyst/Admission Specialist, Columbia Psychiatric Associate, Columbia SC
Perform daily medical billing via Internet and electronically, conduct appeals and denials in a timely manner as well as post daily charges and payments. Prepares and participates in project planning, analysis, specification development, and implementation, of billing and insurance system. Obtain and conduct per-certification and utilization review. Interface with HMO, Medicare, Medicaid, worker's compensation and managed care companies. Ensure that all providers are credentialed with appropriate insurance companies and facilities. Medical terminology, ICD-9 and CPT-4 coding was vital to my job performance in keeping the patients informed about their accounts. Assist patients and family in admissions and placement of hospitals and other facilities.
6/2000-8/2002, Managed Care Specialist, South Carolina Heart Center, Columbia SC
Ensure that all insurance benefit is pre-certified prior to all procedures being performed by any of the thirty-nine cardiologists. Obtain all information for admissions and pre-cert. for hospital and other facilities. Educate and train providers and clinical staff on new and revised insurance protocol. Counsel patients appropriately in situations where insurance companies deny benefits by explaining waiver to patient and answering questions. Manage and conduct utilization review and case management with HMO, managed care companies, and worker's compensation. Perform liaison functions with hospitals and outreach offices.
SALARY; Negotiable
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