healthcare administrative manager
TRANSCRIPT
KAUSHAL PARIKH email: [email protected]
43540 Hoptree Dr, Sterling Heights, MI 48314 (586)646-0328
EDUCATION: University of Phoenix Masters in Health Care Administration / Informatics (Mar 2015) GPA: 3.9 Lawrence Tech University Lean Six Sigma Black Belt Certification (Nov 2015) Achieved University of Michigan and Blue Cross Blue Shield Blue Care Network of Michigan Lean for Clinical Redesign (Mar 2015) 30 Hours Utica Community Schools Certification in Medical Billing & Coding (Dec 2010) GPA: 4.0
SUMMARY: Health Care Operation Manager specializing in transformational leadership with capacity to grow with the organizations mission, vision, and values. With several years of experience increasing operational effectiveness by conducting and managing coordinated team effort to accomplish set goals, while improving patient experience. Extensive knowledge in reading and interpreting medical terminology utilizing ICD 9, ICD 10, CPT 4 coding. Strong understanding of Medicaid, Medicare, commercial/ managed care, Blue Cross Blue Shield, payer billing and reimbursement processes.
TECHNICAL SKILLS:
Advanced Microsoft Excel, Word, Powerpoint, Outlook, ICD-9, CPT Coding, IDX billing system, EMR, LINKS, CIS, Outlook, Other Certification: Certified Application Counselor
PROFESSIONAL EXPERIENCE:
Healthcare Operation Manager, October 2014 – Present Wayne State University Physician Group
Analyze and identify improvement opportunities for management of day to day operations of multiple clinics within the organization to help improve patient experience.
o Manage provider education regarding billing and meeting the meaningful use criteria o Facilitate new processes and implementation of new technology by creating process workflow
and standardization within WSUPG
Fundamental knowledge of lean process improvement techniques which include value streaming, 5S, cause and effect diagram, 5 why diagram, SWOT analysis, and PDCA cycle
Direct and support the front desk operations to improve billing and revenue cycle o Manage front desk staff who's responsibilities include insurance verification, charge entry,
arriving, and checking out patients, and many of other functions that help improve revenue cycle
Financial Healthcare Counselor, April 2013 – October 2014 Wayne State University Physician Group
Brought resolution to and maintained an average of over 500 patients accounts per month o Managed, maintained, and resolved large balance accounts (balances range from $25,000+)
Analyzed, evaluated and presented financial findings on patient regarding charity care
Assist patients in establishing budgets to make monthly payments on their account
Coordinate Insurance verification and billing by verifying ICD-9 and CPT coding
Knowledge of billing cycle and electronic claims generation for different payers
Conduct PowerPoint presentation and communicate with the public regarding the Affordable Care Act and assist in applying for insurance through the marketplace or through the State website
Medical Office Associate, April 2012 – April 2013 Wayne State University Physicians Group
Billing and Charge entry of patients visits according to physicians level of service and diagnosis
Responsible for transfer of patients personally identifiable information and health care data for coordination of care
Generate invoices for a Multi Physician Office
Electronically communicate with the physicians regarding patients request
Assist patients in signing up for patient portals
Coding and Billing Specialist April 2011 - July 2011 S.A Patel MD, Internal Medicine
Provide and apply coding principles using ICD 9 CM and CPT
Knowledge of HIPPA compliance regarding patient privacy
Past and current Accounts Receivables, includes rebilling denials, and dealing directly with insurance companies for payments and posting electronic checks and patient payments
Acquiring prior authorization for procedures with insurance companies