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Skills

  • Project organization
  • Database management
  • Regulatory compliance
  • Financial report creation
  • Collections duties
  • Advanced proficiency in framework
  • Procedure equipment
  • Accounts receivable management
  • Customer service
  • Insurance refund processing

Work Experiences

  • Accurately processed a daily average of 3 insurance claims.
  • Achieved an improvement in clean claim rates of 65%.
  • Cut claim resolution time by 13 days.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Assessed billing challenges.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Created a better filing system to keep client information safe.
  • Achieved a 15% increase in correct first-time submissions.
  • Answered 4 calls per one year to help customers with their questions and concerns.
  • Aided management in the implementation of new accounting software.

Summaries

  • Accomplished and organized Insurance Billing Specialist focusing on customer satisfaction and financial accuracy. Increased customer satisfaction scores by 29% and reduced reimbursement timelines by 84% days.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the standard business.
  • Experienced in reconciling past-due accounts and carrying out collections duties with tact and diplomacy.
  • Known for problem-solving efficiency and accuracy.
  • Adept at training team members.
  • Costs were consistently reduced while profits were increased.
  • Over 4 years of Billing Clerk experience, demonstrated proficiency in Microsoft Excel.
  • Billing expert with a track record of success in invoice reconciliation and financial reporting.
  • Collaborated with product for improved claim accuracy.
  • Insurance Billing Specialist is a multi-talented Insurance Billing Specialist who is consistently rewarded for planning and operational improvements.

Accomplishments

  • Utilized system to efficiently track patient accounts and resolve discrepancies, resulting in a 23% decrease in overpayments.
  • Audited claims and account balances for compliance with HIPAA, ensuring 78% adherence to all regulatory requirements.
  • Developed and implemented a billing audit strategy, reducing claim discrepancies by 33% and improving reimbursement accuracy.
  • Collaborated with clinical departments to ensure accurate and compliant coding of medical procedures, increasing clean claim submission rate by 20% over two years.
  • Increased departmental efficiency by 65% through the adoption of new billing automation technologies and standardized workflows.
  • Resolved insurance billing disputes for 12+ patients per month with a 28% dispute resolution success rate.
  • Led the implementation and integration of process, reducing claim processing time by 77%.
  • Re-engineered the collections process, achieving a 45% increase in recovered funds within two years.
  • Successfully filed 6+ appeals monthly, recovering 5 in previously denied claims.
  • Successfully negotiated payment terms and reimbursement rates with insurance carriers, resulting in an increase in net collections by 15% over 6 months.

Affiliations

  • Certified Revenue Cycle Specialist (CRCS) through AAHAM
  • American Medical Billing Association (AMBA)
  • Certification in Healthcare Compliance (CHC) through HCCA
  • Health Care Compliance Association (HCCA)
  • Association for Computing Machinery
  • Certified Medical Reimbursement Specialist (CMRS) through AMBA
  • Association of Information Technology Professionals
  • Nonprofit Connect - Health and Financial Support Groups
  • Billing Specialist Networking Group 2020 - Atlanta
  • Insurance Institute of America (IIA)

Certifications

  • Certified Revenue Cycle Specialist (CRCS) by AAHAM
  • Certified Business Analysis Professional (CBAP)
  • Medical Billing & Coding Certification by AHIMA
  • Medical Billing Certification by PMBA
  • Certified Insurance Counselor (CIC) by National Alliance
  • Certified Billing and Coding Specialist (CBCS) by NHA
  • Salesforce
  • Microsoft Certified Systems Engineer (MCSE)
  • Advanced Coding Specialist Certification by Beacon Labs
  • Project Management Professional (PMP)

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