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Skills

  • Vendor invoice processing
  • Medical billing accuracy
  • Audit Risk Mitigation
  • Audit coordination
  • Accounts receivable coordination
  • Regulatory filings
  • Cash Flow analysis
  • Accounting remittances
  • Compliance with CMS guidelines
  • Healthcare payment compliance

Work Experiences

  • Clarified documentation.
  • Achieved a 55% success rate on denied claims.
  • Billed and reimbursed claims at compliant levels.
  • Collaborated with clinical departments and coders to clarify documentation and maximize reimbursement potential, ensuring that coding met both payer and state regulations.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Looked for industry trends on social media and through online sources.
  • Achieved expert certification in ITIL.
  • Achieved a 23% clean claim rate.
  • Audited coding documentation regularly.
  • Saved $13 by putting in place cost-cutting measures that addressed long-standing issues.

Summaries

  • Committed to processing invoices with 100 percent accuracy.
  • Strengths in budget management and strategic planning backed up by Healthcare training.
  • Dedicated to learning, growing, and succeeding in Healthcare.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Proactive and self-motivated, with a high level of professionalism and excellent problem-solving skills.
  • Achieved a 75% success rate in correcting denied claims by collaborating with quality assurance and utilizing denial trend analysis across multiple healthcare departments.
  • Standard professional with a strong understanding of numbers who is capable of managing multiple projects with tight deadlines.
  • Achieved 8% accuracy across auditing procedures.
  • Accomplished Coding Reimbursement Specialist.
  • Clear understanding of risk assessment and stakeholder engagement as well as risk assessment training.

Accomplishments

  • Trained a team of 5, resulting in uniform adherence to the latest ICD-10, CPT, and HCPCS Level II guidelines with an accuracy improvement of 82%.
  • Monitored claim rejections and developed corrective action plans that reduced claim denials by 15%.
  • Monitored workflows for timely claim submission, reducing late claim submissions by 37% while improving payment turnaround time.
  • Integrated initiative into the billing system, reducing manual coding errors by 33% and increasing reimbursement accuracy.
  • Reviewed and updated company coding procedures in response to changes in regulatory standards, resulting in faster claim approvals by 48%.
  • Ensured the accuracy of CPT, ICD-10, and HCPCS Level II codes for inpatient and outpatient claims, achieving an 72% first-pass claim approval rate.
  • Reduced revenue loss due to coding errors by 53% by leading root cause analyses and implementing corrective actions across the coding department.
  • Implemented standardized procedures for coding inpatient and outpatient services, leading to a 78% improvement in correct payment reimbursements.
  • Spearheaded a project for the integration of new medical coding software, reducing coding time per chart by 38% and improving overall workflow efficiency.
  • Reviewed daily coding reports and acted as a subject matter expert for CPT and ICD-10 codes, ensuring alignment with payer guidelines across 16 facilities.

Affiliations

  • Lions Club
  • National Society of Certified Healthcare Business Consultants (NSCHBC)
  • Project Management Institute
  • International Association of Administrative Professionals
  • Society of Women Engineers
  • American Marketing Association
  • Society of Human Resource Management
  • Denial Management Professionals Collaborative (DMPC)
  • Certified Professional Medical Auditor (CPMA) Association
  • Health Care Compliance Association (HCCA)

Certifications

  • ServSafe
  • Salesforce
  • Certified Professional Coder (CPC) by AAPC
  • Project Management Professional (PMP)
  • Certified Professional Biller (CPB) by AAPC
  • Google Certified Professional Cloud Architect
  • Certified Healthcare Privacy and Security (CHPS) by AHIMA
  • Certified Professional in Healthcare Quality (CPHQ) by NAHQ
  • Certified Public Accountant
  • Medical Coding and Billing Specialist (MCBS) by Ultimate Medical Academy

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