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Valerie Bullard

Germantown, MD

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Work Experience

Medicaid Specialist

Genesis Healthcare / Crescent Cities Center
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Riverdale, MD
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February 2011 to Present

Primary responsible for conducting eligibility screenings, assessment of patient financial requirements, and counseling patients on insurance benefits and co-payments. Serves as a liaison between the patient, hospital, and governmental agencies; and is actively involved in all areas of case management process. 
 
(Same as the duties list below)

Medicaid Specialist

Collingswood Nursing & Rehabilitation Center
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Rockville, MD
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March 2008 to February 2011

Primary responsible for conducting eligibility screenings, assessment of patient financial requirements, and counseling patients on insurance benefits and co-payments. Serves as a liaison between the patient, hospital, and governmental agencies; and is actively involved in all areas of case management process. 
1. Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity application. 
2. Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment. Ensures appropriate signatures are obtained on all necessary forms. 
3. Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination. 
4. Complete and file applications. 
5. Initiate and maintain proper follow-up with the patient and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation. 
6. Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately. Document progress notes to the patient's file and the hospital computer system. 
7. Participates in ongoing, comprehensive training programs as required. 
8. Follows policies and procedures to contribute to the efficiency of the office. Covers and assists with other office functions as requested. 
9. Maintain Petty Cash Advances for Residents. 
10. Prepare monthly care cost payments for bank deposit and process resident's monthly insurance premium payments. 
11. Interact with the Central Accounting Office to aid in Medicaid billing as needed. 
12. Coordinate Resident Fund Management Service (RFMS), and respond to residents'' financial request. 
13. Work with the Admissions to screen potential new admissions for meeting 
The criteria for Medical Assistance. Assist Admission Department when needed (Back - Up) 
14. Work with the local Department of Human Health Services (Medicaid) and surrounding Agencies & Family members in the screening process & 
application process for the residents who are to be placed on Medicaid 
Assistance. 
15. Assist residents / families on the yearly Medicaid Re-certification 
Process. (Recon) 
16. Assist residents and families in setting up Resident Funds Direct Deposit 
Accounts and the setting up for the facility to become the Representative 
Payee. 
17. Make Deposits and Withdraw transaction via computer. (RFMS) 
18. Process the monthly bank reconciliations for Petty Cash Account and Care 
Cost Accounts. 
19. Make monthly review of all Medicaid residents' accounts to ensure accurate and timely payment of income received. 
20. A/R follow up on passed due balances and provide assistance in setting up payment arrangements. 
21. Work Medicaid denials to ensure payment coverage. 
22. Provide Assistance for setting up residents families with the Register of 
Wills Department in the processing of deceased closed accounts. 
23. Ensure that resident's financial files are complete and meet legal, egulatory and audit compliance requirements on a monthly basis.

Billing Specialist

Center for Cancer and Blood Disorder
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Bethesda, MD
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May 2007 to March 2008

1. Follow up on status on accounts and document all work performed in the company and client computer systems. 
2. Assess accounts to determine the next appropriate course of action in line with company policies and procedures. 
3. Place outbound calls to insurance companies, guarantors, patients, doctors' offices and/or facilities and handle incoming calls as necessary utilizing proper customer service protocol. 
4. Process related correspondence from insurance companies. 
5. Reconcile balances and payment as necessary. 
7. Process denial to ensure payment of submitted claims 
8. Process claims with the knowledge of using - procedure codes, diagnoses, and patient liability and understanding of hospital/physician /skilled nursing facility billing. 
9. Conducting insurance verifications interacting with patients to answer 
financial questions and set financial arrangements as needed. 
10. Posting write-offs and closing cases 
11. Monitoring and processing of daily charge posting and insurance and patient payments 
12. Prepare checks and reports for bank deposits 
13. Prepare daily transactions and reports for bookkeeper 
14. Process insurance refunds 
15. Process register of wills (Estate Accounts) for deceased patients 
16. Process payments via telephone

Intake Coordinator

Total Care of Genitive - Home Health-Care
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Rock Hill, SC
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April 2006 to May 2007

1. Receive/respond to incoming calls from referral sources or potential patients, exchange information to identify patient needs, and determine the Company's ability to meet them. Record the outcome of calls either manually or in an automated manner, make follow-up calls as necessary, and identify alternative community service resources when company's solutions are not available. 
2. Perform initial telephone screening to determine patients' appropriateness for home care services with referral sources. Advise branch staff of patient acceptance and provide all relevant information to ensure patients' smooth transition to home care. 
3. Contact referral sources to advise of referral status, and provide to the clinical team who will deliver the services requested. 
4. Identify potential payer sources, verify benefits with payer sources (as required by department organizational structure), negotiate rates and obtain initial authorizations and frequency of visits from case managers. Establish primary payers and document conversations with payer sources. 
5. Access national or regional account information, including the names of accounts and terms of the contracts as appropriate and communicate these conversations to branch and intake department staff as needed. Work with Intake team, branch staff, and patients to identify potential solutions as problems are identified with payer sources. 
6. Monitor and track referral sources' satisfaction levels. Communicate customer service issues to up-line Intake and branch staff as appropriate 
7. Orders and maintains an adequate supply of departmental office supplies 
8. Processed start of care oasis/re-cert oasis/transfers/discharges/485's/medication profile 
9. Collaborated with the care team members and administrative employees to ensure adherence to company policies associated with record establishment, retention, maintenance, and confidentiality 
10. Received and entered data for new/current patients and employee records and/or documentation, managed confidential data on employees-(current driver's license, current nurse license, current tb-skin test results) 
11. Maintain a availability list and a complete/accurate schedule, including frequency and duration of services as identified in the plan of care 
12. Processed weekly payroll hours and mileage 
13. Received doctor's orders for service via fax-set up schedule according to the order

Education

Some Collage Courses - Business Skills

East High School

January 1972

Skills

Business Skills, Office Management, Medical Billing on the job training courses

Awards

Received the Core Values Awards

August 2011

for - my ongoing sprit and commitment. For Respect & Appreciation

Certifications

Fred Pryor Seminars

August 2009 to Present

Finance and Accounting for Non-Financial People 
Management Skills for Secretaries, Administrative Assistants, and Support Staff 
How to Collect Accounts Receivable 
How to Deliver Exceptional Customer Service

Publications

The Collingswood Post

September 1, 2009

Employee Spotlight- "When You Need a Friend"  
 
A friend can be described as someone who is trustworthy, always willing to lend a hand and almost always available to help. Valerie Bullard makes a great friend to our residents, families and staff.

Additional Information

I am seeking a job in order to relocate to be closer to my family