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Skills

  • Budgeting
  • Cross-functional team collaboration
  • Automating and expediting collections workflows
  • Financial reporting
  • Effective customer service and relationship building
  • Medical coding knowledge (CPT, ICD-10)
  • Closing processes
  • Time management and prioritization
  • Sheet balancing
  • ERP software

Work Experiences

  • Built long-lasting relationships with 15 key insurance representatives, reducing settlement timelines by 15% across all payers.
  • Achieved recovery over 6 months.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Achieved a collections success rate of 15%.
  • Achieved results over 6 months.
  • Achieved improvement over 2020.
  • Collaborated with the IT department to design proprietary tracking tools that reduced manual error rates across the department by 28%.
  • Collaborated with cross-functional teams, including legal and compliance, to reduce aged receivables by 24% in 2022.
  • Paid vendors and employees by receiving and verifying expense reports and monitoring discount opportunities.
  • Achieved the department’s Excellence Award.

Summaries

  • Insurance Collection Specialist is a multi-talented Insurance Collection Specialist who is consistently rewarded for planning and operational improvements.
  • Insurance Collection Specialist is a detail-oriented Insurance Collection Specialist with 12 years of finance and accounting experience.
  • Achieved a 30% increase in claims approval rates.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Results-oriented Insurance Collection Specialist with a keen eye for detail and a desire to assist in the transformation of business operations.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Adept at collaborating with cross-functional teams.
  • Addressed payment discrepancies.
  • Dedicated to learning, growing, and succeeding in Accounting and Finance.
  • Insurance Collection Specialist with 16 years of successful budget management and team leadership experience.

Accomplishments

  • Successfully negotiated with insurance providers, recovering 16 in lost revenue across 3 complex cases in the past year.
  • Improved team billing accuracy by implementing audit processes during claims submission, which reduced errors by 23% over 18 months.
  • Worked with third-party vendors to implement a new automated billing system, cutting payment posting times by 83% across all accounts.
  • Developed and maintained an appeals tracking system, reducing submission time by 6 months and improving recovery rates for denied claims by 47%.
  • Facilitated monthly audits, ensuring 58% adherence to insurance policies and closing out 16 aging accounts.
  • Reduced denial overturn time by one year through consistent claims submission follow-up and strategic appeals.
  • Championed process improvements that accelerated insurance payment posting timelines, resulting in increased cash flow of $13 in two years.
  • Provided regular reporting to senior management on collection efforts, resulting in actionable insights that improved collection rate by 29%.
  • Coordinated with the accounts receivable department to reduce unresolved claim amounts by $14 within a one year period.
  • Streamlined reconciliation processes, resolving 6 outstanding insurance payments in two years and clearing $14 in receivables.

Affiliations

  • National Association of Healthcare Compliance Officers (NAHCO) - Member, engaging in best practices and workshops to ensure audits meet compliance and regulatory standards.
  • Association of Information Technology Professionals
  • Healthcare Business Management Association (HBMA) - Contributor to thought leadership on third-party payer requirements and insurance billing.
  • Association for Financial Professionals (AFP) - Member, applying financial analysis skills to revenue cycle management in healthcare settings.
  • American Health Information Management Association (AHIMA) - Participated in continuing education on medical coding, HIPAA, and health IT standards.
  • American Marketing Association
  • Institute of Finance & Management (IOFM) - Accounts Receivable expert, working on improving insurance payment patterns and reducing denial rates.
  • Lions Club
  • Insurance Regulatory Examiners Society (IRES) - Dedicated participant in enhancing knowledge of insurance regulations as they pertain to healthcare collections.
  • Association of Certified Fraud Examiners (ACFE) - Healthcare-oriented member, analyzing insurance fraud patterns within collections processes.

Certifications

  • Certified Compliance Technician (CCT)
  • Certified Healthcare Accounts Receivable Specialist (CHARS)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Healthcare Compliance (CHC)
  • Health Insurance Portability and Accountability Act (HIPAA) Compliance Certification
  • Certified Revenue Cycle Representative (CRCR)
  • Certified Medical Office Manager (CMOM)
  • International Classification of Diseases (ICD-10) Certification
  • Apple Certified Associate (ACA)
  • Certified Public Accountant (CPA)

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