Coordinator Resumes in US-Georgia-Atlanta: odell

Coordinator Resume

Contact Candidate

Name:

odell

Location:

US-Georgia-Atlanta

Experience:

Most Recent Job Title:

Coordinator

Objective:

Occupation Objectives:
To obtain an position responsible for leading and directing healthcare services, administative operations or ambulatory clinic operations.

Resume Text:

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The Curriculum Vitae

Of

O’Dell Covington

Home (770) - 413-0203, Cell (678) – 457-5519, Work 404-616-7167

Occupation Objectives:

To obtain an exempt, management position responsible for leading and directing hospital based ambulatory clinic operations or primary care operations.

Qualifications:

Extensive hospital based management experience, physician practice management, patient financial services, claims, revenue management and administrative experience at an executive level. Ten years of experience at the Director’s level with duties that include responsibility for ambulatory care operations, financial operations, human resource management, budget and fiscal management, hospital based primary care management, patient financial services, revenue cycle management, information systems, risk management, compliance management, corporate compliance and other functional areas. Executives with strong leadership experience, solid critical thinking and excellent strategic planning skills. Demonstrated track record of improving billing and collections, increasing patient volumes and successfully acquiring and integrating practices.

Knowledge Skills and Abilities

Knowledge of clinic management, healthcare finance, claims, billing, and revenue cycle management. Knowledge of medical practice development, group practice operations, physician joint venturing, managed care, insurance verification, admissions, pre-admissions, patient registration, point of services collections, patient customer services, account follow-up, self pay collections, payment posting, managed care contracting, data analysis, billing, claims management, patient scheduling, clinic financial operations and clinic management and network development.

Employment History:

March 1996 to Present: (prn)

Utilization Review Coordinator, Division of Medical Affairs -- Care Management Department, Grady Health System, Atlanta, Georgia 30310

Assisting in planning, organizing, directing, and controlling healthcare services, treatment, and products in a cost effective manner while maintaining quality of patient care. Responsible for participating in organizational committees related to JCHAO, Core Measures, Patient Safety Initiatives and Patient Flow Committees. Also responsible for researching data from medical records and physicians for audit review as requested for Medicaid and Medicare patients or commercial insurances. Also responsible for working with revenue cycle physician advisors to review denied claims and assist with appeals. Also serves as a resource person to physicians and other case managers, medical staff, and the Admitting Department in matters relating to reimbursement issues for Medicaid, Medicare, and commercial insurances

Performs utilization review at selected inpatient areas and in preparation for Appeals. Assesses and interprets customer needs and requirements. Identifies solutions to non-standard requests and problems. Solves moderately complex problems and/or conducts moderately complex analyses. Works with minimal guidance; seeks guidance on only the most complex tasks. Translates concepts into practice. Provides explanations and information to others on difficult issues. Coaches, provide feedback, and guide others.

July 2007 to February 2009,

Director, Data Analysis and Reporting Unit, DHR, Atlanta, Georgia 30031

Infrastructure Development

Build the infrastructure needed for data, analyses and measurement tracking necessary to assist senior leadership in system-wide strategic planning and transformational change. Develop a quality program for data and statistical support for system wide transformations. Direct the design and implementation of the infrastructure needed for data display, statistical analyses and outcomes tracking needed by the agency local and national collaborative efforts.

Coordinate and facilitate the relationships between the various Divisions/departments, committees, and taskforces necessary to implement the performance improvement tools. Design and implement system(s) to coordinate, manage, spread and improve the performance measurement efforts as they move forward. Work with senior leadership to identify and move toward a future state culture, which will support pursuing perfect care through, improved data collection and reporting. Develop and educate staff and faculty in the methodologies to create and utilize data for performance improvement.

Fiscal Management

Identify, evaluate and make fiscally responsible recommendations regarding resource and system needs for the department, to include finances, materials, human resources, capital and space. Prepare, coordinate, and manage annual fiscal operating and capital equipment budgets for the area, working with the business Directors of Budget Services and Financial Service internal controls to safeguard the financial, information and human resources.

Staff Management

Supervised a staff of 22 through four line mangers. Ensure that a sufficient number of qualified and competent persons are available to accomplish the goals of the department. Manage the selection, development, motivation, evaluation and discipline of reporting personnel. Ensure that job requirements and goals for each position are clear to employees. Determine and document the qualifications and competence on a continuing basis. Provide leadership, mentoring and coaching of reporting personnel with the goal of developing the skills needed to facilitate achievement of team goals and enterprise-wide strategic priority goals. Ensure that orientation, in-service training and continuing education are provided to division personnel to achieve satisfactory levels of competence.

August 2000 to July 2007

Director of Clinical Affairs, DHR- DCBOH, Decatur, Georgia 30031

Served as the Business Manager/Business Administrator of the primary care and public health organization by: setting goals and objectives for the primary care clinics, developing strategic/business plan to achieve those goals and objectives, driving implementation through disciplined project management, escalating key issues to the Executive Director, Physician Manager, Medical Director, and serving as point of communication between the health departments and hospital corporate offices. Ensure that all providers Licenses and Credentials are updated for the Managed Care Organizations.

.Planned, administered, and monitored the departments’ capital equipment, operations, personnel budgets, budget expenses, year to date expenses and investigating variances. Ensures the staffing needs of the departments were met by projecting needs, interviewing and hiring employees to fill positions, and resolving staffing issues to ensure that the department’s workload is handled effectively. Actively recruits and seeks strategies to retain employees. Workflow: Monitored and directed workflow by observing and reviewing work produced by staff to maintain efficiency and timely services and a high level of customer service. Supervision: Worked with department leadership to resolve human resource-related issues and is accountable for the hiring, disciplinary, termination, and salary.

Assist in the preparation of annual departmental budgets. Monitor budgets monthly, reconciliation of expenses to account balances and monthly reconciliation of deposits Prepare Business/Operational Reports such as Business Plan or annual Revenue Projection, Productivity measurements.

August 1998 to August 2000:

Director of Patient Financial Services, Administrative Manager for Managed Care, DHR - DCBOH- Decatur, Georgia 30031

Budget Management, Strategic Planning, Influence and Alignment

Analyze Clinical activities such as Charges, Net Pay, Collection rate, Benchmarking, Payor mix, and summarizing findings for decision-making, and in negotiating new and renewal contracts/awards. Ensure that awarded grants conform to defined budget parameters and allocations, monitor revenue and expenses, track budget changes against approved budget, and resolve variances.

Ensure the quality and efficiency of operational performance by providing day-to-day management, direction and oversight for a large-scale multi-functional/multi-system Claims Processing Department. Developed, implemented and monitored business processes that support the continuum of care between physician practices, 4 hospitals, 6 health departments, after hours call center, Ancillary and Specialty Services. Direct the development, analysis and reporting of workload reporting statistics to senior leadership regarding Medicaid, Medicare, Managed Care collection, billing, and claims management.

Continually evaluate and improve the delivery of service by initiating and promoting best practice models. Engaged clinicians (for example, RN, MD, CNS, or PT), managers and staff in problem solving coverage or financial sponsorship opportunities. Identifies opportunities and provides support to assist with the implementation of revenue cycle performance improvement actions. Identified cross-functional opportunities to ensure effectiveness of performance improvement initiatives. Built and managed relationships with customer and client organizations. Took a leadership role in identifying new ideas that improved service. Developed and managed constructive relationships with business partners, internal customers, clients and staff. Directed and lead cross-functional projects in support of divisional and company-wide initiatives as assigned by Senior Leadership.

Compliance, Quality Assurance and Quality Control

Facilitated compliance with administrative/legal requirements and governmental regulations. Monitored departmental compliance with internal controls and developed remediation plans to address identified control weaknesses. Supported Revenue Cycle policies and procedures. Accountable for registration data quality monitoring.

Ensured all practices relating to the acquisition and maintenance of information comply with federal, state and hospital regulations, policies, and procedures. Consistently supported compliance by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting noncompliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Hospitals and DCBOH’s policies and procedures.

January 1992 to March 1996

Clinical Data Management Specialist,

St. Joseph’s Hospital – Mercy Care Corporation, Atlanta, Georgia 30342

Developed reports and monitor the validity of the data being reported. Responded to questions of data integrity and providing explanations of all data elements and calculations presented in the reporting tools. Performed functional and technical QA for data conversion activities.

Lead a cross functional team in building data analytics capabilities, tools and processes, and transforming the rich data into reliable, timely information and business performance improvements. Lead data and reporting resources.

Was responsible for identifying, tracking and reporting operational and administrative information to senior leadership, as well as creates and/or deploys tools for needed for the dissemination of both detail- and summary-level performance tracking. Lead and execute research including statistical analysis, data mining, primary data collection and analysis from customers through surveys, interviews and focus groups.

April 1988 – January 1992

Health Advocate / Clinical Services Manager /, St. Joseph Hospital – Atlanta, Georgia 30342

Collaborated with the Senior Management Team to establish and maintain direction, operation practices, procedures, and standards for the organization, operation and performance pertinent to the delivery of patient/athlete care. Assists in developing overall work objectives, determining short- and long-range goals, and planning and implementing strategies to achieve goals. Consulted with and advises director, VP of public relations and VP of Operations strategic initiatives regarding needs goals, future plans and challenges. Assured staff complies with safety and health policies and procedures of the clinic and ensures patient/athlete care is delivered in a safe manner consistent with health promotion. Acted in the stead of the Director when the Director is not on site. Marketed programs to target audiences and develops contractual agreements for athletic health care services. Maintained staff productivity to budgeted standards. Recruited and supervised the orientation and training of clinical and administrative support personnel. Assured that professional and support staff properly implement clinical policies and procedures. Evaluated, counseled and promoted the growth and development of the clinical staff.

Evaluated the effectiveness of services provided, and in collaboration with staff, devises improved techniques and methods of implementation consistent with national trends in the delivery of patient care. Maintained awareness of long and short term goals of the health system and recognizes opportunities for potential involvement in new service areas. Planned, directed and/or participated in the development of new treatment services. Meet regularly with directors of strategic initiatives, medical and clinical services to develop goals, objectives and plans for rehabilitation and athletic healthcare services. Served on intra-department and special task forces as appropriate. Planned, organized and presented in-service program(s).

Education Summary:

Master’s of Science Degree in Administration

Health Services Administration concentration

Central Michigan University

Mt. Pleasant, Michigan, 48859

Graduate Level Certification in

Data Management, Public Health Informatics, and Project Management

University of North Carolina – Chapel Hill

Kenan- Flagler Business School

Bachelor’s of Science Degree

Lander College, Greenwood, SC

Associate of Applied Science Degree

Piedmont Technical College, Greenwood, SC

Post-Baccalaureate Continuing Education Courses:

Certificates of training in Health Care Statistics and Reports,

Continuous Quality Improvement and QI Methods,

Utilization Review and in Case Management,

ICD 9 CM Coding, Advance ICD 9 CM Coding,

CPT 4 Coding, and Advance CPT 4 Coding

.Managing Multiple Projects,

Project Management,

Fundamentals of Business Writing,

Microsoft Word, Excel, Access, and Power Point

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