sithabiso chibanda

Responsible for the analysis of the data used in preparation of Medicare/Medicaid Cost Reports, UCC Reports, Medicaid Federal DSH Survey Reports and completion of tasks with associated audits

* Admission and registration of all Inpatient, Partial, and Ambulatory patients * Oversaw the daily activities of the Team members of effectively motivate and ensure that the quality and productivity standards set for the unit are being met * Applied knowledge of insurance payer rules and regulations related to registration * Responsible for verifying coverage, benefits and getting authorization from insurance companies * Responsible for identifying and collecting payments from all self-pay patients and posting to appropriate accounts * Used the charge master to distinguish the professional fee and the technical fee * Communicated with administration, physicians, and managers of different areas within the hospital * Monitored the Registration interface to ensure proper mapping of data fields and make recommendations to the supervisor to correct interface issues

* Patient Accounting and 3rd Party Billing: * Conducted activities in Account receivables Recovery Project that focused * on HMOs * Received and respond to calls from third party payers and other healthcare providers * Researched and followed-up on payment denials from third party payers on patient accounts * Performed primary and secondary billing * Performed all other duties and responsibilities as directed

* Assist in the preparation, analysis of cost report filings to governmental agencies (Medicare, Medicaid and Champus) * Assist in the preparation of monthly Net Revenue calculation for McLean Hospital * Participates in many aspects of government third party reimbursement * Establish a working knowledge of regulations and calculations impacting the cost reports including those related to to reimbursement for GME and IME * Gather, analyze and organize data related to overhead statistics, direct costs, volume and payor mix * Data collection and analysis, regulation research, and audit support * Cooperate with third party auditors. Support cost report filings with complete and appropriate work papers that demonstrate compliance * Enter data into specialized cost report software * Maintains communication and financial services regarding payment variances