View Cart

Certified Resume Writers | Professional Resume Writing Service ~ Starting at Only $99!

The sample below is for a Practice Management and Medical Administration Resume. This resume was written by a ResumeMyCareer professional resume writer, and demonstrates how a resume for a Practice Management and Medical Administration Candidate should be properly created. Our Certified Professional Resume Writers can assist you in creating a professional document for the job or industry of your choice.

Get Started Now!

Professional Profile
Self-motivated practice management and medical administration executive with significant years of relevant staff management, financial analysis, and process implementation experience. Detail–oriented individual who exemplifies professionalism, and an ability to manage multiple projects and tasks at any given moment. Demonstrated history of successful financial optimization and collections management, while providing ahigh-quality strategic vision, efficient capital utilization, and timely issue resolution. Highlighted leadership qualities and the ability to work with and manage individuals from varying backgrounds, while promoting team values. Driven partner eager for professional growth, responsibility, and the opportunity to leverage practice efficiency and revenue control expertise.

Professional Experience
St. Christopher’s Hospital for Children (Philadelphia, PA) 2007 – Present
Revenue Cycle Management Decision Support Data Analyst
• Perform data collection, tracking and analytical duties in support of revenue cycle operations and third-party contracting compliance supporting the decision making process of leadership
• Serve as a key resource in the design, deployment and utilization of the analyzer and other systems for data management
• Responsible for development, maintenance and reporting of executive summary reporting as well as detailed key revenue cycle indicators, MIQ Reports and contract performance metrics, as well as various ad hoc data requests
• Provide assistance and support to the management team in addressing any identified special project within Revenue Services including troubleshooting reporting issues, evaluating receivables performance, and coordinating special analyses, in order to optimize receivables performance and support appropriate action plans
• Perform audits and assured contractual compliance of vendors working accounts receivables

Rockland Orthopedics and Sports Medicine (Airmont, NY) 2007
Revenue Cycle Manager (Relocated to Wilmington, DE)
• Provided direction to billing staff to ensure adjudication, admissions, and billing functions are being performed accurately and in compliance with established policies and procedures to achieve the goals as defined by the practice administrator
• Responsible for receivables, coding, collections, insurance company relations, and EOB postings oversight
• Worked with practice administrator to identify, interview, hire and train new associates, monitoring quality of work and productivity against internal goals/benchmarks while providing performance feedback and ensuring policy adherence
• Acted as management liaison to resolve escalated service issues from patients, payors, and staff to ensure timely resolution.
• Managed all aspects of the revenue cycle and prepared various reimbursement and AR Analysis, significantly reducing practice accounts receivable size and age
• Reviewed all open accounts receivable on a regular basis, isolating payor issues and developing workable solutions
• Negotiated payor agreements and insurance contracts, ensuring reimbursement and coordinating grievances/appeals

The Whole Heart Center Cardiology (New York, NY) 2005 – 2007
Revenue Cycle Consultant (Contract/Freelance)
• Provided relevant strategic and tactical direction for all operational structures related to specific healthcare service categories, such as mental health services, OB/GYN, internal medicine, ENT, and other practice types
• Held responsibility for supervision of operations, billing, and collections staff and coordination of personnel training, policy and procedural reviews, staff meetings, annual staff appraisals, and adherence to medical center policies and regulations
• Assisted in all risk management and workflow optimization processes for use by internal staff and other relevant parties to facilitate efficient, safe, and legal operation
• Analyzed encounter processes, identified inefficiencies and discrepancies, and recommended necessary changes, communicating updates and findings regularly to all levels of management
• Performed cost/benefit analyses to determine areas for improvement while directing reimbursement and negotiation strategies
• Managed daily operations of the Billing Department for outpatient receivables, responsible for all activities involving the review and posting of electronic remittance.
• Responsible for collection and review of specific financial reports to perform account adjudication and deny claims as needed
• Oversaw various processes and projects, including medical and business information systems, grants administration, business development, and all regulatory and institutional compliance procedures
• Developed and implemented new policies for the improvement of patient service and optimization of practice finance administration, including billing, collections management, coding updates, and vendor relationships
• Worked with providers and health plans to promote new health service delivery models for high-cost Medicaid cases
• Promoted dissemination of project activities through correspondence updates and presentations at conferences and meetings, evaluating all project success points while documenting areas of improvement for future utilization
• Directed reimbursement and negotiation strategies while ensuring compliance to JCAHO & NYS DOH standards
• Screened and interviewed all prospective candidates for established positions and made recommendations for employment
• Managed consortium activities to promote information sharing and problem solving

H&D Physical Therapy (New York, NY) 2004 – 2005
Revenue Cycle Director
• Managed all operations, billing/collections and staff for multi-site physical therapy practices, coordinating and prioritizing staff responsibilities and applicable schedules as well as assessing quality assurance to maximize reimbursement
• Prepared for client audits, ensuring all letters, case files, policies and procedures were available for the auditor, developing any and all necessary responses and corrective actions based on audit results
• Implemented training procedures for new and established staff, coordinating staff seminars and continuing education,
• Monitored and reported revenue received vs. revenue expected, analyzing statistical reports to maximize financial efficiency, conducting cost-benefit analyses for practice, and implementing a new authorization procedure
• Served on the Board of Directors as well as the IT Board and conducted on-site visits to enhance staff communication
• Obtained authorization as necessary for in-network treatment for patients with no out-of-network benefits
• Increase accounts receivables to a 90% intake, while minimizing billing losses to 10% adjustments
• Monitored and ensured compliance with all applicable government and funding agencies, including compliance standards and HIPPA regulations

Worthington Consulting Group (Norwalk, CT) 1994 – 2004
Revenue Cycle Analyst
• Performed practice manager and billing manager positions for hospitals, multi-specialty practices, private practices and groups, traveling to practices and hospitals and analyzing financial productivity, procedure, and staff
• Managed all key account reporting projects, including project plans, documentation, training, and troubleshooting, providing relevant guidance and feedback to management regarding project status, issue resolution, and completion expectations
• Conducted formal training sessions with key national and local accounts to ensure a clear understanding of the terminology used in reporting as well as the various methods used to analyze utilization and cost trends
• Made key account recommendations regarding benefit plan design and purchase of medical management and disease management programs through comprehensive analysis of quarterly reports
• Managed office staff and assignments to ensure proper execution of reception, phones, scheduling, coding and correspondence, participating as needed to facilitate effective operations
• Successfully increased and maintained patient volume, while monitoring quality to meet care and efficiency standards
• Supervised all billing representatives in interaction with all parties including third-party billing, workers compensation, no-fault, liability, and commercial insurance companies
• Managed physician participation in insurance plans, HMO’s, etc. including applications for participation, renewals, physician credentialing, maintaining fee schedules, and assistance in negotiation and renegotiation of contracts
• Monitored compliance with all applicable government and funding agencies
• Supervised maintenance of all internal PC networks
• Guaranteed major projects do not exceed budgetary limits and deadlines by effective tracking of costs and schedules

Education
[Insert School or Institution] ([Insert City, State]) [Insert Dates Attended]
[Insert Degree Earned or Courses Studied]

Proficiencies
GE Centricity Enterprise Systems • SQL Databases • Cognos Impromptu Reporting • Powerplay Reporting • Business Objects • MIQ Reporting • Clinstar • Medical Manager • Last Word • Info Point • Docuscan • Climacs • Lytec • IDX • Raintree • Milbrooks • ADS • Electronic Filing Programs

Order From Us Securely at ResumeMyCareer.com