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Skills

  • Claims data analysis and reporting
  • Insurance claims processing
  • Customer service
  • Conflict resolution with customers and payers
  • Policy and procedure modification
  • Database administration
  • Data-driven decision making
  • Credit and collections
  • Staff management
  • Continuous process improvement

Work Experiences

  • Aimed at reducing manual claim processing.
  • Provided expert clerical support by handling a wide range of routine and special requests efficiently.
  • By automating client correspondence, record tracking, and data communications, I was able to improve office operations.
  • Was in charge of the CRM database, which included troubleshooting, maintenance, updates, and the creation of reports.
  • Organized physical files and digitized records so that authorized team members could update and retrieve them quickly.
  • Assisted the legal department with patient billing-related litigations by providing accurate historical records, contributing to favorable resolutions.
  • Achieved a reduction of uncollected amounts.
  • Aligned billing practices with medical coding guidelines.
  • Achieved Top Performer for improving operational efficiency.
  • Achieved results within 9 months.

Summaries

  • Accomplished Insurance Billing Manager with a history of developing and implementing billing policies that led to a 53% improvement in accuracy and a 52% reduction in processing times.
  • Achieved a 61% improvement in net collection scores.
  • Achieved a 25% increase in collected revenue.
  • With 8 years of Healthcare experience, I am a well-organized Administrative professional with excellent multitasking abilities.
  • To meet project objectives, prioritize projects and multitask effectively.
  • Adaptable person with strategic planning and client relations abilities.
  • Accomplished in leveraging claims data analysis to recover over $3 in lost revenue and maintaining accurate billing records for SAP and QuickBooks insurance.
  • Healthcare administrative office management, related regulatory guidelines, and stakeholder engagement certified Scrum Master and Insurance Billing Manager.
  • With over 11 years of experience in the Healthcare field, I am a well-organized Office Manager.
  • Accomplished Insurance Billing Manager.

Accomplishments

  • Led the monthly review of denied claims, contributing to a 77% improvement in overturning insurance claim denials.
  • Documented and resolved system which led to metric.
  • Built and maintained key relationships with insurance payors leading to an increase in reimbursement rates by 82%.
  • Reduced claim-processing time by 30% by automating repetitive billing workflows using Power BI.
  • Developed and managed a billing accuracy training program that reduced claim submission errors by 41%.
  • Designed and rolled out an internal audit process that identified 3 non-compliant practices, fixing them before external review.
  • Implemented a real-time reporting system for daily billing operations that enhanced decision-making and improved cash flow by 39%.
  • Streamlined invoice auditing process, cutting down review time by 50% and increasing focus on high-risk accounts.
  • Analyzed monthly cash collection trends and implemented strategic changes that led to a 75% increase in overall revenue.
  • Monitored and reduced patient credit balances, driving down the error rate by 34% over three years.

Affiliations

  • Association for Computing Machinery
  • Volunteer at local HFMA events to enhance skills in financial management within a healthcare setting.
  • Association for Supply Chain Management (APICS)
  • Project Management Institute
  • Lions Club
  • Attendee at the 2023 AAHAM Annual Conference, integrating new trends and technology in insurance claim processing and revenue cycle improvement.
  • Member of the American Medical Billing Association (AMBA), staying updated on regulatory changes in the medical billing field.
  • Society of Human Resource Management
  • Member of the National Healthcare Cost and Quality Association (NHCQA), contributing to cost-effective healthcare solutions through administrative excellence.
  • International Association of Administrative Professionals

Certifications

  • CompTIA Network+
  • Registered Health Information Technician (RHIT) by AHIMA
  • Certified Healthcare Billing and Management Executive (CHBME)
  • Certified Professional Coder (CPC) by the AAPC
  • Epic Billing Certification for Healthcare Providers
  • Certified Compliance Technician (CCT) by AAHAM
  • Certified Public Accountant (CPA)
  • Healthcare Financial Management Certified Specialist in Business Intelligence (CSBI)
  • Certified Revenue Integrity Professional (CRIP) by NAHRI
  • Certified Medical Office Manager (CMOM) by PMI

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