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Skills

  • Healthcare claims submission
  • New billing staff training and onboarding
  • Data entry
  • CPT, ICD-10, and HCPCS coding
  • Client-facing communication skills
  • Monthly billing KPI reporting
  • Denial appeal strategies
  • Medical terminology proficiency
  • ERP software
  • Budgeting proficiency

Work Experiences

  • Paid vendors and employees by receiving and verifying expense reports and monitoring discount opportunities.
  • Codified billing processes.
  • Assisted patients in understanding insurance policies.
  • Collaborated cross-functionally with the clinic's finance team, resulting in a 64% reduction of outstanding account balances.
  • Accelerated payment processing for Asana services.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Collaborated with the insurance payer.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Had an excellent attendance record and was always on time for work.
  • Achieved a 64% reduction of outstanding account balances.

Summaries

  • Accomplished Commercial Insurance Biller.
  • Achieved collections improvements of over $5 annually.
  • Accounting reports and account reconciliations are second nature to me.
  • Committed to processing invoices with 100 percent accuracy.
  • Expert in payment processing to reduce outstanding debt, fees, and interest.
  • Commercial Insurance Biller with over 4 years of experience who is efficient and detail-oriented.
  • Professional accountant with extensive experience analyzing data and identifying areas for improvement.
  • Within Healthcare, senior Commercial Insurance Biller and outstanding performer in vendor management and project management.
  • Offering 4 years of functional experience in the system industry providing clerical, financial, and administrative services.
  • Accomplished in revenue cycle management with a dedication to improving claim validation processes, reducing resubmissions by 63% and expediting reimbursements.

Accomplishments

  • Improved patient collections and payment processing by 22% through the implementation of structured payment plans.
  • Leveraged Tableau to analyze AR trends and successfully reduce aging claims over 12 months old by 81%. This bolstered end-of-quarter financial outcomes.
  • Oversaw a detailed review of denied claims, identifying trends and triggering corrective coding actions that led to a 51% improvement in cash collections.
  • Analyzed and corrected high-frequency claim denial issues, facilitating the recovery of $3 in previously rejected reimbursements.
  • Reduced claim denial rates by 36% through the consistent application of denial appeal strategies for performance reporting.
  • Developed a reporting dashboard that highlighted outstanding claims issues and enhanced visibility on AR trends, reducing overall unpaid claims by 54%.
  • Identified and corrected repeated errors in diagnoses or service codes for system, resulting in an increase in first-pass claims approval by 43%.
  • Increased reimbursements for risk assessment by 20% after proactively coordinating with payers to resolve coding issues.
  • Developed streamlined workflows for claims processing that reduced claim rejection rates by 63%.
  • Collaborated with team of 15 in the development of program.

Affiliations

  • American Medical Informatics Association
  • HMO and PPO Insurance Billing and Claims Advisory Committee
  • Healthcare Financial Management Association (HFMA)
  • Credentialed Medical Administrative Assistant (CMAA) from NHA 2020
  • Certified Healthcare Access Manager (CHAM) credentialing by NAHAM
  • Medical Group Management Association (MGMA)
  • Healthcare Information and Management Systems Society (HIMSS) process
  • National Healthcare Collectors Association (NHCA)
  • National Association of Healthcare Revenue Integrity (NAHRI)
  • American Marketing Association

Certifications

  • Certified Electronic Claims Professional (CECP) by framework
  • Certified Public Accountant (CPA)
  • AHIMA Certified Coding Specialist (CCS) Certification by category
  • Billing and Reimbursement Certificate by process
  • Certified Medical Billing Specialist (CMBS) by system
  • Healthcare Claims Professional (HCP) by system
  • First Aid/CPR Certified
  • Certified Professional Coder (CPC) by AAPC
  • Certified Professional Biller (CPB) by American Academy of Professional Coders (AAPC)
  • Certified Healthcare Revenue Manager (CHRM) by framework

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