Debra J.

Stewart
Madeira Beach FL 33708 (727) 501-6050

OBJECTIVE:

A management position where superior organization and customer service skills can be utilized, leading toward company growth and professional advancement.

SUMMARY OF QUALIFICATIONS: Oversee billing/collections/verification departments for multi-million dollar home health care agency. Experienced in all aspects of medical billing including cash posting, collections, denials and insurance verification. Extensive knowledge of Medicare, Medicare Advantage and commercial reimbursement. Accountable for reviewing and negotiating contracts with various Managed Care Networks. Strong oral and written communication skills. Responsible for coaching, mentoring and monitoring all staff including new hire training. Prepare and maintain yearly budget for Florida operations division.

EXPERIENCE: 2002 2011 Senior Home Care, Inc. Director of Reimbursement Responsible for managing all aspects of an industry leading Medicare Home Health Billing and Customer Service Department. Reconcile and monitor the accounts receivable for 48 district offices. Oversee and monitor all operational departments to include insurance verification, billing, accounts receivables, cash posting, claim denial and customer service areas. Increase operational efficiencies in order to assure maximum reimbursement. Successfully decreased office error rate from 36% to less than 4%. Oversee approve all refunds, adjustments and write offs. Work closely with other department to met and maintain the Corporate goals and objectives.

2000-2002

Corporate Benefit Services of America Claims Manager Responsible for ensuring quality processing and attainment of quotas for this Third Party Administration of group medical, dental and disability claims. Directed all operational aspects of the Florida office to include claims, Customer service, medical review and repricing departments. Oversaw a 70-person area. Active in client presentations with regards to new and existing clients. Assisted client in review of benefit Plan design for cost effectiveness and enrollment participation. Restructured various departments to streamline procedure and increase revenue. Responsible for all areas of managed care to include contracting and repricing. Worked directly with Corporate office to maintain corporate goals and objectives. Worked closely with Marketing and Finance Departments to assure overall client satisfaction.

1991-2000

CoreSource, Clearwater, Florida Claims Manager Responsible to direct all aspects of a 28-person Claims/Customer Service Department to include all client services functions. Oversaw Reinsurance area to include Specific and Aggregate claim filings. Assisted clients in review and changes in their benefit Plan to insure cost effectiveness. Worked with all areas in the company to assure client satisfaction and corporate goals. Implemented team processing, and auditing procedures. Initiated pilot program on how to successfully negotiate claims. Trained personnel at 26 branch offices for this procedure. Under my direction, maintained a top producing office. Managed over 80% of office staff.

EDUCATION:

Certified in both LOMA and HIAA Medical Claims Studies Numerous professional seminars and training programs.