SKILLS SET

¶ Admin. Experience working in an office setting

I have a diverse background and experience in office environments; both in small and large settings. My

interaction with the public and professionals is a major component of my job. My first corporate job was

with Highmark Blue Cross Blue Shield (Pittsburgh, PA). There I was enrolled in a 3 month intensive

training program to become a dedicated Insurance Representative. I was responsible for dealing with

HR/Benefits Departments from clients in our dedicated unit, e.g. Alcoa, Heinz, and Waste Management.

I worked closely with clients as a point of contact and mediator. I reviewed binding contracts,

deciphering/conveying legal text and judiciously ruled on disputes regarding Highmark's liability towards

its client's health care products. I have interfaced with the public during my 18 years of working in the

private and corporate sector in various capacities as clerk to manager. In this instance, the term public

refers to consumers, vendors, patients, and fellow colleagues.

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¶ Experience working with legal property-related documents

To summarize my experience working with legal documents, Ill refer to Highmark Blue Cross Blue Shield

once again and my last contract job at NorCal Skin Disease and Surgery. I was first exposed to reviewing

legal binding contracts while at Highmark. I quickly learned how to read passages from

contracts/documents and comprehend, interpret and accurately convey information therein. Also as

Billing Manager/Office Administrator for NorCal Skin Disease and Surgery I re-credentialed the

physician's professional licensures. I read and familiarized myself with the HIPAA Compliance Laws

updated by the United States Dept of Health and Human Service. After which I rewrote the existing

corporate manual to reflect the federal guidelines. I over saw and implemented a new electronic billing

system, web based phone system and time card system; extensive attention to detail, reading contracts

and negotiating with vendors was required.

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¶ Experience: Verifying the accuracy of assessment data entered into computerized files.

Comparing and Proofing information for completeness, accuracy, and conformance with standards.

While I was with NorCal Skin Disease and Surgery I was proactive in creating a new "super bill" for the

medical corporation. The "super bill" insured that we were compliant with both state and federal bi-

laws. The Excel document; listed the most commonly performed services within the specialty practice. It

detailed the required researching of current Federal CPT and ICD9 codes, using the Medicare UCR

pricing list and applying the appropriate mark ups to the physician fee driven services. In addition, I

implementation a new billing system. This required the careful review of 17 binding legal documents

through the contracted clearinghouse Gateway. The insurance carriers relayed processing information

to Gateway on how to adjudicate funds for negotiated services.

Accuracy and filing deadlines were crucial to ensuring the company received the highest financial

reimbursement.

SKILLS SET

¶ Experience learning and working with laws, regulations, policies and procedures.

In my previous positions of supervisor and manager I was responsible for following policies and

procedures in every aspect of my job. Much like the answer for question 3, I had to research all current

office policies and look for any inconsistencies with state/federal laws. If I was doing supervisory work

such as when I worked for Atlanta Woman's Health Group or UPS, I read and understood the current

policies and procedures of the company. I may, at the appropriate time, suggest alternatives to the

policies and procedures if it wasn't functional to the mission statement of the department. If I was in a

managerial position such as Physician Family Practice or NorCal Skin Disease and Surgery; I would read

and understand the current policies. I would suggest alternative options and change the policies or even

write new policies and procedures. I did this by reading the policies presented to me by the company

and then researched state/federal mandates on the perspective websites. If my comprehension of the

said company policy didn't parse with those of the state/federal I would get confirmation from the

director as to the nature, reasoning, and ramifications of the disputing policies and procedures.

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¶ Computer software programs with which you have experience.

I have used various computer applications/software in my career. The majority have been Microsoft

based medical proprietary software. The Windows software was specific and tailor-made to each of the

employer’s needs. I have used Medix software as well as Oracle and Excel

Microsoft office –Advanced (Used in every job I worked in)

Excel--Intermediate (UPS, NorCal Dermatology) Multiple proprietary medical billing systems; Oracle,

Medix, EClinical Works--Advanced (Medical private practices, UPS)

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¶ Experience providing clerical support; such tasks as filing, data entry, and scheduling.

My first “hands on” experience with clerical/ administrative duties was at Physician Family Practice

(11/03-02/05) as Business Manager. I had to create an AR/Billing system for patients. I also had to create

a rolodex system in Microsoft to track vendors, contacts for fire, building inspector, insurance

representatives, employees, etc. I created entries into a calendar system to remind me of doctor re-

credentialing, employee evaluations, staff/doctor meetings, etc

UPS (06/07-08/08) I used Microsoft to remind me of upcoming meetings, evaluations. I created a filing

system for my 11 direct reports to track attendance; HR issues i.e. Performance evaluations,

promotions, disciplines, etc

NorCal Dermatology and Cosmetic (02/12-05/28/12) Hire, termination, and disciplinary activity, staff

scheduling and resource management, equipment contract and supply orders, and general facility

management. Implemented a new billing system for the entire corporation, set up a new phone system,

and a new web based time card system. These tasks required detailed filing systems, (both standard and

electronic) as well as scheduling appointments for the various vendors throughout the different phases

of implementation.

SKILLS SET