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Skills

  • Customer service
  • Project organization
  • Advanced Excel proficiency
  • Supervision
  • Operational improvement
  • RFI Scanners
  • First Aid/CPR
  • Communications
  • Compliance audit coordination
  • Process automation

Work Experiences

  • Authored a comprehensive certification manual that reduced training time for new hires by method, standardizing compliance procedures.
  • Instructed clients on the amounts covered under benefit plans in easy-to-understand terminology.
  • Site evaluations, customer surveys, and team audits were all things I did.
  • Attained President's Club in 2024.
  • Made a master spreadsheet to keep track of procedures, rejections, and approvals.
  • Made certain that proper coding was followed in order to maximize efficiency.
  • Achieved $10 annual savings.
  • Workday was delivered to customer locations by me.
  • Made sure that all patient and insurance information was updated on a regular basis and entered into the company's computer system with care.
  • Boosted client retention by 51%.

Summaries

  • Strong technical skills and experience in budget management.
  • Effective at dealing with people in stressful and confusing situations in order to address benefits needs and navigate the structures of framework agencies.
  • Dental student seeking hands-on experience through an internship in performance reporting.
  • Expert in framework with a strong aptitude for spearheaded and streamlined.
  • Working with stakeholders and corporate teams is a breeze for this strong relationship builder.
  • Proven track record of motivating improved to achieve team, individual, and management goals.
  • Time management and interpersonal skills are available.
  • Analytical Insurance Certification Coordinator with strong data-gathering, report-writing, and data-compilation abilities.
  • A skilled Insurance Verification Specialist with experience contacting insurance companies for vital information and preparing patient documents for billing purposes.
  • With a team-oriented mentality, highly organized, proactive, and punctual.

Accomplishments

  • Facilitated an 14% improvement in the certification process, reducing the approval time from 3 days to 16 days across 7 insurance providers.
  • Developed comprehensive training materials on certification updates, which contributed to a 15% increase in team readiness during audits.
  • Enhanced communication with insurance providers by establishing a real-time certification status portal, improving request response time by 29%.
  • Successfully coordinated certification for 6 health plans, ensuring full compliance with both state and federal insurance regulations.
  • Orchestrated inter-departmental coordination on complex certification cases, leading to faster resolution and improved regulatory adherence.
  • Led certification compliance projects that resulted in 18% adherence to updated insurance guidelines across the Pacific Northwest/Texas.
  • Collaborated with the legal team to implement an insurance fraud detection protocol, preventing 5 fraudulent certification submissions.
  • Standardized the certification verification process for 14 insurance partners, achieving a 58% accuracy rate in 2017.
  • Mentored junior staff to improve accuracy in certification updates, contributing to a 58% reduction in compliance-related errors.
  • Spearheaded a cross-functional training program that decreased team errors in certification verification by 27%.

Affiliations

  • Chartered Property Casualty Underwriter (CPCU) – Joined after earning this advanced designation, using knowledge of CMS regulations to improve workflow efficiency.
  • American Conference Institute (ACI) – Participated in seminars covering insurance compliance frameworks and policy certification initiatives.
  • Certification of Insurance Service Representatives (CISR) – Completed 2021 training, applying principles to improving certification accuracy and compliance adherence.
  • National Healthcareer Association (NHA) – Attended forums addressing the integration of insurance certification timeliness with healthcare workflows.
  • Healthcare Financial Management Association (HFMA) – Engaged in discussions on the integration of certification processes with healthcare financial systems and insurance claims.
  • Society for Human Resource Management (SHRM) – Collaborated with HR specialists to improve onboarding and compliance training focused on insurance certification operations.
  • Council of Insurance Agents & Brokers (CIAB) – Participated in certification-focused initiatives aimed at minimizing certification processing errors while ensuring compliance.
  • American Insurance Association (AIA) – Attended training sessions on insurance administrative procedures, used to enhance the efficiency of certification policies.
  • Health Care Compliance Association (HCCA) – Participated in certification events, applying best practices to reduce compliance errors in insurance certification.
  • Associate in Insurance Services (AIS) – Achieved designation focusing on improving customer feedback utilization during certification renewals and audits.

Certifications

  • Cisco Certified Network Associate (CCNA)
  • Insurance Billing Coding Certification (IBCC) - 2019
  • Certified Healthcare Reform Specialist (CHRS) - 2021
  • Accredited Advisor in Insurance (AAI) - Austin
  • Fundamentals of Health Insurance, Part A & B (AHIP) - 2019
  • CompTIA Security+
  • Certified Risk Manager (CRM) - Cedar Works
  • ServSafe
  • Certified Business Analysis Professional (CBAP)
  • Microsoft Certified Systems Engineer (MCSE)

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