JAMES A. MELILLO
70 Upper Rainbow Trail | Denville, NJ 07834 | 201-400-5070 |
Objective
With over 23 years work experience in home health care service; I seek a challenging position in a health care or business environment with an opportunity to utilize my skills and professional experience.
Employment History
Visiting Nurse Association of Northern New Jersey / 1989 — 2013
Senior Patient Care Specialist, 2011-2013
-  Managed department of 8 clinicians who provided care for 60+ patients on a revolving basis
-  Acted as a liaison between patient and care providers to ensure quality services
-  On call patient advisor for coordination of crisis intervention services as needed
-  Coordinated nursing and HHA schedules on a daily basis
-  Managed order strings for VNA clinicians and licensed staff
-  Oversaw patient care for hospitalizations and home care support
-  Formulated comprehensive reporting data on homecare patients for senior staff on regular basis
-  Created and maintained active census of patients for clinical management
-  Provide process reporting and information verification to senior clinical management weekly
-  Managed and organized all administrative paperwork for clinicians and department heads
OASIS/Services Data Specialist, 2004-2011
-  Managed benefit verifications for eligibility, co-payments and deductibles on all private insurance and Managed Medicare plans
-  Oversaw processing of all OASIS and commercial insurance authorizations
-  Liaison between insurance providers and clinical staff/management
-  Batched OASIS contacts daily for transmission to CMS
-  Edited all non-clinical data from transmission reports to ensure accuracy
-  Produced and distributed monthly CMS reports to upper management
-  Managed compliance of all records for clinical review specialists to meet Medicare/Medicaid guidelines
-  Supported Manager of Finance
-  Conceptualized and developed comprehensive database of patient contacts and private insurance
Customer Service Coordinator, 2003-2004
-  Provided direct customer service to ensure high level patient satisfaction
Data Processing Specialist, 1996-2003
-  Provided administrative support for billing department
-  Coordinated data summaries and reviewed statistical reports
-  Offered technical support for troubleshooting software difficulties within homecare informational systems
Billing Coordinator, 1989-1996
-  Supported billing department through data processing, electronic claims submissions, insurance balance transfers, billing adjustments and auditing.
other professional work experience
Macy’s, Men’s Fragrance Consultant, Livingston, NJ / 1986 — 1994
Norda/PPF Int’l Assistant to Vice President & Chief Perfumer, NJ / 1977 — 1989
Education
-  Attended bi-annual Medicare and Medicaid Regulation Seminars
-  Hoffman Institute, New York, New York – attended advanced perfumery classes
-  High School Diploma, Dover High School, Dover, New Jersey
Computer Skills/Experience
-  Microsoft Word, Microsoft Excel,Officewyse, Cerner, JeffNet, HomeWorks,Delta, Road Notes, Lotus Notes, Internet Explorer, Mozilla, Firefox, IBM AS400/System 36, HCIS
References Available upon request