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Skills

  • Healthcare claims submission
  • Financial Management
  • Cash Flow analysis
  • Medical billing and coding
  • Management accounting
  • Regulatory filings
  • Medical terminology proficiency
  • Budgeting
  • ACH and EFT payment processing
  • Data entry

Work Experiences

  • Assisted patients in understanding insurance policies and facilitated payment plans, improving collections by $4 annually.
  • Addressed recurring issues.
  • Conducted thorough reviews of aged claims.
  • Collaborated with initiative customers to determine their needs and deliver standard service.
  • Achieved 45% fewer billing rejections.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Achieved a 64% reduction of outstanding account balances.
  • Collaborated cross-functionally with the clinic's finance team, resulting in a 64% reduction of outstanding account balances.
  • Created and sent invoices in accordance with established accounts receivable schedules and terms.
  • Achieved a 43% reduction in team-wide errors.

Summaries

  • Accomplished Commercial Insurance Biller focused on patient financial advocacy, resulting in collections improvements of over $13 annually through clear communication and payment plan facilitation.
  • Committed to processing invoices with 100 percent accuracy.
  • 77% success rate in claims resolution.
  • Dedicated to increasing profits, lowering accounting errors, and streamlining accounting processes.
  • Accomplished in revenue cycle management with a dedication to improving claim validation processes, reducing resubmissions by 63% and expediting reimbursements.
  • Achieved a 36% increase in correct claim submissions.
  • Expert in payment processing to reduce outstanding debt, fees, and interest.
  • Accomplished in revenue cycle management.
  • Commercial Insurance Biller with 6 years of successful stakeholder engagement and workflow optimization experience.
  • Hardworking and effervescent, with a strong desire for precision and efficiency.

Accomplishments

  • Reduced claim denial rates by 36% through the consistent application of denial appeal strategies for performance reporting.
  • Identified and corrected repeated errors in diagnoses or service codes for system, resulting in an increase in first-pass claims approval by 43%.
  • Monitored claim submission deadlines for 6 providers, reducing late filings by implementing automated reminders within Power BI.
  • Reduced workload for the billing team by 84% by implementing a document scanning automation process that streamlined insurance submissions.
  • Successfully processed over 5 claims monthly with an approval rate of 60% by ensuring accurate coding and timely submission.
  • Provided clear and comprehensive training on payer requirements and billing compliance to 11 staff members, resulting in a 62% reduction in claim denials.
  • Facilitated cash flow improvement by ensuring claims were submitted within payer filing limits, reducing delays by 81%.
  • Collaborated closely with insurance payers to facilitate the adjustment and approval of disputed claims, recovering $9 in underpaid reimbursements.
  • Documented and resolved process which led to procedure.
  • Reviewed insurance Explanation of Benefits (EOBs) for discrepancies, leading to successful reprocesses and recoupment of $7 in underpaid or misallocated funds.

Affiliations

  • Accredited Claims Adjuster Six Sigma from Lakeside Partners
  • Jaycees
  • Insurance Billing and Coding Association (IBC Association)
  • Freemason
  • Healthcare Administrative Technology Association (HATA) Member
  • Association for Computing Machinery
  • Clinical Documentation Improvement Network (CDI Network)
  • Healthcare Businesswomen's Association (HBA) (for leadership opportunities)
  • American Medical Billing Association (AMBA)
  • Healthcare Insurance Transparency and Billing Compliance Board

Certifications

  • Certified Compliance Professional (CCP) by metric
  • Project Management Professional (PMP)
  • Healthcare Billing and Coding Certification by standard
  • Certified Healthcare Business Consultant (CMAA) by metric
  • SHRM Certified Professional (SHRM-CP)
  • Certified Public Accountant (CPA)
  • Certified Healthcare Revenue Manager (CHRM) by framework
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Healthcare Financial Professional (CHFP) by Healthcare Financial Management Association (HFMA)
  • Medical Billing and Coding Certification by program

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