Healthcare Professional
Resume:
Anila Smith
***** ***** ******, ************, ** 19116
acfm6i@r.postjobfree.com
* Over five years of billing service experience.* Proven results-oriented
leader and creative problem-solver. * Extensive experience managing the day-
to-day operations of unit personnel. * Working Knowledge of community
resources and how to access services for families and children.
education
University of Phoenix, Levittown, PA Master of Health
Administration 2009
Geneva College, Beaver Falls. PA B.S., Human Resources 1997
Temple University, Philadelphia, PA A.A., Psychology
1991
Russ Financial Schools, Philadelphia, PA Certificate of Health
Insurance 2008
employment experience
NHS Eearly Intervention Langhorne PA
2014-Present
Services Coordinator
. Screening
. Developmental Assessment
. Home Visits
. Community Enrichment Groups
. Parent Groups
. Resources Refferals
. Consultation to Community Early Childhood Programs
. Transition
. Interagency Planning Meetings
. Referral to Behavioral Health
AmeriHealth, Philadelphia PA 2013-2013
Provider Claims Service Representative:
. Identifies problems and adjust work activities in accordance to
departmental process
. Follows internal process and procedures to ensure activities are
handled in accordance with departmental and company
policies/procedures
. Reviews Claims and applies processing rules to determine allowable
benefits for payments.
. Reviews services for appropriateness of charge and medical necessity
and ensures that prior authorizations and precertification
guidelines are implemented
. Determines file, as appropriate to support payments decisions.
PHMC, Philadelphia PA
2009-2010
Supports Coordinator:
. Reviewed all case managements plans with outside agencies
. Provided Grant information and resources to families of youths and
other care providers
. Assisted with placement options to children and youths (PUNS review
and Waivers')
. Manage and maintain the program database and ensure its accuracy
(HICS)
. Coordinated with clients and third party payer sources
. Collected, recorded, and handled status of payments
. Assists team in sourcing potential opportunities and outreach events
to clients
. Set up training workshops for staff
. Assist in overall mission and goals of the agency
Delta Community Support, Feasterville, PA 2006 -2008
Project Director:
. Supervised, trained, and provided administrative direction to 30-
staff team in residential setting
. Knowledgeable in assessment, intervention, policy, procedure,
compliance, and confidentiality of financial arrangements
. Negotiated residential service contracts with sponsors and group
home providers
. Perform compliance audits, checking accuracy of information and
eligibility
. Managed collecting and recording of payments in conjunction with
reviewing insurance claims and forms
. Plan and manage monthly committee meetings, including agenda, and
minutes
. Manage scheduling of client site visits and conducts site visits as
needed
. Prepare and submit reports to agency director
Little World Family Daycare, Philadelphia, PA 2003-
2006
Owner and Operator:
. Intake of client information for city records, such as health
information, emergency contacts information and other miscellaneous
forms for maintenance of license
. Manage all HR activities, provided personnel assistance in
identifying, evaluating, and resolving human relations and work
performance problems within the company
. Facilitate communication and improved employee-human relations
skills
. Participate in resolving labor relations issues and assisted in
screening applicants for training programs
Allegheny Valley School, Philadelphia, PA
Program Specialist: 1998-2002
. Evaluation of MR clients, writing and implementing goal plans based
on each client needs, charting any medical changes in client due to
meds or physical disabilities
. Supervised staff on all activities including daily living with
clients, training staff on all paper work pertaining to facility
requirements
. In charge of fundraising for the area, planning and implementing
trips for clients
. Lead the interdisciplinary process in assessing the desires,
strengths, and needs of the individuals in Residential service
. Developed goals and objectives, and evaluated progress toward
independence
. Oversee and work with the various department heads to ensure goals
are met and files are processed in accordance with agency and state
mandates
St John Neumann Nursing Homes, Philadelphia, PA
Geriatric Care Managers:
1994-1995
. Conduct care planning assessments to identify problems, eligibility
for assistance and need for services
. Screen, arrange and monitor in-home help and additional health and
mental health services
. Review financial, legal and medical issues and offer referrals to
other professionals for dealing with problems and conserving assets
. Provide crisis intervention
. Act as a liaison to families and long-distance care givers
. Offer guidance in identifying alternative housing options and
facilitating transitions
. Provide counseling, psychosocial support, education and advocacy for
elders and their families.
M.C.P. EPPI Hospital, Philadelphia, PA
Psychiatric Aide 1990-1992
. Plan, organize and lead structured programs of counseling, work,
study, recreation and social activities for clients
. Modify treatment activities and approaches as needed in order to
comply with changes in clients' status
. Learn about new developments in their field by reading professional
literature, attended courses and seminars, and established and
maintained contact with other social service agencies
Human Services Corporation, Philadelphia. PA
Residential Counselor 1988-1990
. Trained individuals in adaptive living skills and clearly expressed
ideas orally and in writing
. Documented client medicine administration, assisted with activities
of daily living
. Oversaw group trips, managed money and created progress reports for
the clients
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