1. OBJECTIVE
To administratively manage and direct a FEE BASIS Unit to achieve maximum
utilization of VA facilities and provide veterans with continuity of care, both with in VA
Facilities and the veteran’s local community when necessary.
WORK EXPERIENCE
VA Medical Center
5500 Armstrong Road
Battle Creek, MI 49015
Federal Civilian (Highest grade GS-0303-7/ 2years)
Program Support Assistant 07/15/2002-to Present
Salary $36,400.00 40 hours weekly
Fee Basis Unit (June 2003 to Present, 2.5 years)
• Attended three days of Fee Basis training in Indianapolis VA including, eligibility for
both outpatient and inpatient services, Fee Pharmacy, Fee Dental, Unauthorized Claims
Beneficiary Travel, and renal care benefits and appeals process.
• Developed knowledge of services provided within local or nation wide VA services, for
transplants and other extensive surgeries and long term care.
• Establish eligibility for and pay community nursing home payments.
• Attended electronic billing/claim payment training in Detroit VA. Maintain current
knowledge of up-to-date procedures.
• Control Point clerk, 045, 301 and 5601 special FEE. Administer appropriate
disbursement of obligated funds for payment of health care claims, using control points
and obligations numbers.
• Discuss benefits and or denials with veterans and providers.
• Compose written correspondence to veterans and providers.
• Create payment reports for Fiscal office: AMIS, AMIS Dialysis, Mill Bill, Incomplete
claims, and Healthnet.
• Audit and analyze claims for correct usage of current procedural terminology (CPT), and
insurance codes.
Medical Care Cost Recovery (VA Medical Center, July 15, 2002 to June 2003)
• Prepared insurance claims for reimbursement of health care cost.
• Researched Pharmacy National Drug Codes for MCCR.
• Created pharmacy billing reports using VISTA SYSTEM and MS excel.
Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Spec. GS-0301-9/10
E-mail: Clarie201@Hotmail.com

2. • Determined billing information using CPRS.
• Attended Fileman Classes.
• Successfully completed all VA Synquest Classes and training.
• Committed to group goals for JCAHO accreditation surveys.
Health Risk Management (HRM), Division of Carebid, TPA
5250 Lovers Lane
Kalamazoo, MI 49002
Supervisor-Julie Clark (269) 567-7000.
Claims Payment/Customer Service Representative.
Accounts Payable
Salary $24,500 Annual
40 hours weekly
11/1999 to 04/2002
• Ensured and establish eligibility of group members for claims payment under several
group plans and limitations.
• Examined claims for payment of health care services using obligated funds of several
groups, using correct control and group numbers
• Trained co-workers
• Created computer macros.
• Answered phone inquiries.
o Solved all problems and issues within average 24-hour period.
o Discussed insurance benefits, claims payments or denials with members and
providers.
o Received Award for extraordinary work efforts and quality assurance.
• Committed to group goals for JCAHO accreditation surveys.
Kalamazoo Center for Medical Studies/Michigan State University
1000 Oakland Drive
Kalamazoo MI 49008
Supervisor- Kay Kucinich (269) 337-4406)
Accounts Receivable/Patient Registration Technician/Billing
$20,600 yearly
40 hours per week
12/1996 to 11/1999
• Prepared daily schedules of clinic appointments.
• Set patient appointments.
• Collected insurance co-payments tallied daily funds for deposit.
• Created health care claims for insurance reimbursement.
o Medicare, Medicaid, BCBS and Commercial insurance companies.
o Used current CPT codes and ICD-9 coding.
• Verified patient insurance eligibility.
• Performed as liaison between patients, doctors and other departments
• Devise computer macros for laboratory reports.
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3. • Produced daily reports using MS Excel program.
Bronson Healthcare Group (BHG)
601 John Street
Kalamazoo MI 49001
(269) 341-6310
Account Receivable /Verifications and Admitting Registry Team Leader
Salary $12.84 hourly plus $2.50 per hour to carry pager off hours (30,000 yearly)
40+ hours weekly
01/1991 to 12/1996
Supervisor- Karen Garrison (269) 341-6310.
• Acted as liaison between administration, doctors, staff and patients.
• Resolved wide array of staffing and patient placement issues with nurses and admitting
staff.
• Assisted staff members with computer problems.
• Established new verification office.
• Reduced unverified accounts from $3.5 million to $5000.
• Lowered unverified days from average of 180 to average of three to five days.
• Designed new computer reports.
• Called insurance companies to establish patient’s benefits.
• Discussed benefits and/or denial of benefits with patients, or family members.
• Created bills for reimbursement of medical care.
• Committed to group goals of maintaining average in receivable days of 36 to 45 days.
• Trained new employees and co-workers.
• Collected, cataloged and returned patient valuables.
o Tallied and made bank deposits of cash.
o Wrote checks to patients to return deposited cash
• Quality Council Member 1994-1996
o Committed to group goals for JCAHO accreditation surveys.
o Facilitated solutions to issues arising from communications and computer
conflicts between departments.
o Tracked and reported changes in departmental services, for positive or adverse
reaction hospital wide.
• Quality Customer Service Council 1995
o Recommend and discussed seminar solutions to Customer services issues.
o Implemented Disneyland Customer Services Seminars.
Patient Financial Specialist/Accounts Receivables (BHG)
07/1987-01/1991
Supervisor-Linda Gould (269) 341-6310
• Composed correspondence and legal narratives for attorneys, doctors and administrators
Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Specialist GS-0301-09/10
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4. • Billed all liability accounts in access of $50,000.00.
• Compiled and cataloged average daily cost of closed head injury patients, as well as
average length of stay cost for Trauma Care unit, Pediatrics ICU and Burn Unit.
• Collected and posted payments for services from explanations of benefits and payment
vouchers.
Registration Techniciani
/Accounts Receivable
9/1986-07/1987
Supervisor-Several (269) 341-6310
• Originated new patient records for accounts receivable and medical records, working in
several registration points, and several different departments.
• Documented accurate demographic and insurance information for new and current
patients.
• Answered phone inquires.
• Reduced census reports, reorganized overall census department and staff.
• Collected payments for services, made bank deposits and check tallies.
EDUCATIONii
• Kalamazoo Valley Community College (KVCC), 6767 West “O” Avenue, Kalamazoo,
MI 49003-4070, (269) 372-5000. Credit hours earned 89.
 Associates Degree, Liberal Arts.
 Associates Degree, Science Engineering
• Western Michigan University (WMU), 1903 West Michigan Ave, Kalamazoo, MI 49008,
(269) 387-1000. Credit hours 34.
• Kellogg Community College (KCC) 1971, 450 North Avenues, Battle Creek, MI 49017,
(269) 965-3931.
• Credit hours earned 10.
• Total Earned College Credit Hours 134, Quality Points 379.5, Current GPA 3.75, and
current Honor Roll Student.
• *For listing of completed college classes, see attachments.
• Loy Norrix High School, 606 E. Kilgore Road, Kalamazoo, MI 49001, Graduated 1971.
Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Specialist GS-0301-09/10
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5. VOLUNTEER SERVICES
• Delivered Meals on Wheels, 1970-1971.
• Served as a member of the planning committee for Corporate Olympics BHG, 1991.
• Member and Secretary of WMU student chapter of Kalamazoo Home Builders
Association, 1986.
• Member and Secretary-Treasurer of Church Girls League, 1969-1971.
• Member, Secretary-Treasurer and President of Church Youth League, 1968-1971.
• Hospice caregiver, providing custodial care and companionship to cancer patients 1989,
1994 and 2000.
• Selected as project leader to WMU president’s house Christmas decorations. Selected
crew of ten other art and design students and worked as team creating hand made
decorations.
• Held seat on Kalamazoo County Town Hall Forums for six months, 1996. Project to
better use State funding for health and welfare funds. Coordinated current programs with
already in place volunteer services, to better use funds.
Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Specialist GS-0301-09/10
5

6. Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Specialist GS-0301-09/10
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7. Claire Batieste
SSN: XXX-XX-9086
KNOWLEDGE, SKILLS AND ABILITIES
1. Knowledge and skill in applying analytical and evaluative methods and techniques to issues or
studies concerning and efficiency and effectiveness of program operations
I have collected information from FEE BASIS data, and complied reports including total
amounts paid, lines paid, production per FEE clerk, and predicted funds required to pay
out end of year outstanding claims. In addition, I evaluated how many man hours or full
time employees it would take to produce (pay or deny) existing claims.
I have effectively gathered and analyzed the census taking task at Bronson Methodist
Hospital (BMH). The goal was to eliminate the census task without adding work to
entities other than business office admitting. Working with informational services,
nursing services and admitting personal, I eliminated the need for the census department
by reorganizing the processing order and delivery technique, and there by eliminated one
point five EFT.
I have effectively gathered and reorganized the order of the Official Admitting Office
Manual and training manuals used at BMH, combining both books and documents into a
concise easy to use five page flip chart. This ultimately also caused, the elimination of a
separate training coordinator’s position, again reducing one EFT. (This was an intern task
combined with a Third Year Technical Writing course at WMU)
2. Ability to plan and organize multiple tasks, set priorities, and initiate and carry out specific
assignments to successful completion independently.
I have successfully completed and paid over 9,000 line items, processed over 2800
denials, managed authorizations, and control point monies in the past twelve months.
While also providing claim’s status for providers, answering veteran and provider
questions on benefits. In addition, tracking pricing from Austin and Healthnet and claims
payment tracking information for various reports such as AMIS, AMIS Dialysis, and
completed those reports.
Researching the insurance verification process at BMH, I collected data and information
and reorganized this process. I eliminated the use of paper admitting files. I designed new
and combined existing reports, and created a paperless system. Clearing sorting and filing
times, I was then able to work solely from reports and lowered the average outstanding
unverified accounts after discharge from 180 days to 3 days, and from $3,200,000.00 to
$5000.00 in three months. This new process allowed the verification office to verify all
new accounts in a twenty four hour period after admission not discharge, and also
eliminated future back log. I worked solely alone on this project, and in addition to my
regular admitting duties.
Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Specialist GS-0301-09/10
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8. During my long employment at BMH several computer upgrades, software changes, and
moves to different offices occurred. In addition to my regular duties, I often served on
committees to organize implementations, or committees to eliminate back logs prior to
implementations. Just after my employment move to KCMS, KCMS administers
announced new billing software would be implemented in six months. Although I
expressed concern for the six month back logs, supervision did not seem concerned.
I worked out a plan of my own for the first floor, and started it four months prior to
implementation of the new system. One week prior to going live with the new system,
supervision was suddenly concerned about the back log, and called a meeting. When the
first floor unit was asked how many encounter slips we had in back log my team mates
looked to me. I said zero percent, and we were dismissed from the meeting and
mandatory overtime.
3. Ability to accurately communicate agency significant issues in writing and orally to persons
with diverse backgrounds and educational levels and/or groups within and outside the
organization. Just today, I received the following thank you note:
“We want to thank you for your help on my husband’s bills from the hospital and
others. There isn’t many people who would help like you have. So you went way
above your duties. Thank you.” (The VETERAN)
In efforts to receive such a wonderful letter I had to convey government
regulations in writing, and orally to persons including the veteran, healthcare
providers, doctors as well as supervisors of all educational levels both inside and
outside of our organization. I also had to have extensive knowledge FEE
Eligibility. When the case was initially turned down by medical review, I re-
presented the case on the side of our veteran to a supervisor, and won.
Claire Batieste SSN: XXX-XX-9086
201 Balch Naturalized U.S. Citizen
Kalamazoo, MI 49001 Vacancy Announcement #: 515-05-125
Phone: 269-352-8216 Supervisory Program Specialist GS-0301-09/10
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Claire BatiesteSSN: XXX-XX-9086201 BalchNaturalized U.S. CitizenKalamazoo, MI 49001Vacancy Announcement #: 515-05-125 Phone: 269-352-8216Supervisory Program Specialist GS-0301-09/10
Claire BatiesteSSN: XXX-XX-9086201 BalchNaturalized U.S. CitizenKalamazoo, MI 49001Vacancy Announcement #: 515-05-125Phone: 269-352-8216Supervisory Program Specialist GS-0301-09/10