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Skills

  • Problem resolution
  • Claims quality control measures
  • Certification in medical billing and coding compliance
  • Documentation and control
  • Database administration
  • Claims data analysis and reporting
  • Data Management
  • Relationship development
  • Payroll and budgeting
  • Project organization

Work Experiences

  • Achieved a reduction of uncollected amounts.
  • Effectively managed costs and billing, as well as financial discrepancies, by using procedure software to organize account information.
  • Aimed at reducing manual claim processing.
  • Achieved Top Performer for improving operational efficiency.
  • Provided expert clerical support by handling a wide range of routine and special requests efficiently.
  • Achieved a 23% reduction in claim denials.
  • By automating client correspondence, record tracking, and data communications, I was able to improve office operations.
  • Organized physical files and digitized records so that authorized team members could update and retrieve them quickly.
  • Achieved recovery in under 2024.
  • Achieved results within 9 months.

Summaries

  • Insurance Billing Manager with 18 years of successful risk assessment and performance reporting experience.
  • Achieved 62% improvement in operational accuracy.
  • Clear understanding of risk assessment and budget management as well as risk assessment training.
  • Achieved a 25% increase in collected revenue.
  • Recruiting established talent in stakeholder engagement and workflow optimization for Insurance Billing Manager.
  • Accomplished this within 8 months.
  • Adaptable person with strategic planning and client relations abilities.
  • Achieved a 55% improvement in accuracy.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Excellent communicator and project manager with expertise in day-to-day operations, workflow improvements, and customer service.

Accomplishments

  • Oversaw the shift to electronic billing and payments, leading to a 55% year-over-year decrease in manual processing time.
  • Streamlined invoice auditing process, cutting down review time by 50% and increasing focus on high-risk accounts.
  • Exceeded department performance targets by achieving a collection rate of 22% on outstanding medical claims within three years.
  • Managed partnerships with third-party agencies to improve account reconciliations, reducing outstanding A/R by 40%.
  • Directed a successful billing team through multi-payor environments, increasing net payments by 59% across 9 insurance types.
  • Facilitated cross-department collaboration on billing and compliance workflows, ensuring adherence to both state and federal insurance regulations.
  • Led transformation initiative that resulted in a 65% reduction in claim rejections for both private and public payors.
  • Introduced an automated denial tracking method, resulting in a 63% increase in timely appeal submissions.
  • Devised strategies to work with insurance companies that resulted in faster claim approvals, reducing outstanding claim days by 3 days.
  • Monitored and reduced patient credit balances, driving down the error rate by 34% over three years.

Affiliations

  • International Association of Administrative Professionals
  • Engaged in Continuing Education Units (CEUs) with AAPC to maintain up-to-date knowledge on healthcare billing codes and industry trends.
  • Member of the American Medical Billing Association (AMBA), staying updated on regulatory changes in the medical billing field.
  • Served as a mentor in AAHAM’s program, educating others on revenue cycle management and insurance billing protocols.
  • American Marketing Association
  • Freemason
  • Lions Club
  • Participated in an AMBA Leadership course, developing the skills to lead high-performance billing teams and improve department goals.
  • Member of the Medical Group Management Association (MGMA), focusing on efficient healthcare operations and revenue cycle optimization.
  • Completed the Certified Revenue Cycle Specialist (CRCS) designation from AAHAM, increasing efficiency in managing multi-payor insurance environments.

Certifications

  • SHRM Certified Professional (SHRM-CP)
  • Certified Medical Insurance Billing Specialist (CMIBS)
  • Certified Revenue Integrity Professional (CRIP) by NAHRI
  • ICD-10 Certification by AAPC
  • Certified Medical Insurance Specialist (CMIS)
  • Certified Public Accountant
  • Health Information Technology Certification (HIT) by CompTIA
  • Certified Public Accountant (CPA)
  • Certified Business Analysis Professional (CBAP)
  • Project Management Professional (PMP)

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