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Skills

  • NDCMedisoft
  • Insurance contract negotiation
  • CMS-1500 and UB-04 claim forms
  • Process improvement
  • Multitasking in fast-paced environments
  • Operational improvement
  • CPT coding proficiency
  • Communication with Insurance Companies
  • Siemens Soarian Financials
  • Team building

Work Experiences

  • Collaborated with standard customers to determine their needs and deliver framework service.
  • Conducted research and compiled statistical data in order to support cost-cutting and quality-of-care initiatives.
  • Achieved results within 2 months.
  • Contributed to a 16% increase in billing accuracy.
  • Achieved a 29% improvement in claims handling efficiency.
  • Achieved a 59% improvement in department productivity.
  • Collaborated with physicians and administrative staff.
  • Saved $8 by putting in place cost-cutting measures that addressed long-standing issues.
  • Achieved a 74% improvement in patient satisfaction scores.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.

Summaries

  • Certified Medical Biller adept at navigating complex insurance contracts and payer terms, leading to an increase of 60% in reimbursement for high-value procedures.
  • Completed within 15 months.
  • Audited billing procedures meticulously.
  • Medical Biller who is skilled at auditing patient charts and billing the appropriate parties.
  • Medical Billing with 14 years of successful team leadership and stakeholder engagement experience.
  • Advanced understanding of payer reimbursement structures.
  • Adept at navigating complex insurance contracts.
  • Excited and dedicated to accuracy, with excellent decision-making abilities.
  • Achieved 77% approval accuracy on first-pass claims submissions.
  • Comprehensive understanding of medical billing software QuickBooks.

Accomplishments

  • Negotiated successfully with major insurance companies to secure better reimbursement rates, increasing organization revenue by $7 annually.
  • Revised and updated payer contracts, resulting in an average increase of 61% in reimbursement rates and overall department revenue.
  • Created detailed claim rejection analysis reports that identified billing trends, reducing claim rejections by 27% within 18 months.
  • Analyzed and identified top claim rejection reasons and created an automated alert system, improving claim acceptance rates by 30% over 2019.
  • Gained proficiency in initiative, which contributed to reducing claim errors and denials by 54% while ensuring timely follow-ups.
  • Successfully resolved 16% of billed claim disputes within the first follow-up, improving the overall revenue cycle.
  • Utilized Tableau to identify aging accounts, reducing outstanding receivables by 84% within one year.
  • Facilitated a 21% reduction in turnaround time for claim processing by reorganizing workflow within the billing department.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Audited large accounts and identified account discrepancies, resulting in recovery of $9 in outstanding payments.

Affiliations

  • National Association for Health Care Quality (NAHQ)
  • Healthcare Information and Management Systems Society (HIMSS)
  • American Hospital Association (AHA) Affiliate Program
  • Project Management Institute
  • Certified Professional Medical Auditor (CPMA) by Vantage
  • Association for Healthcare Revenue Integrity (AHRI)
  • International Council of Nurses
  • American Medical Billing Association (AMBA)
  • American Society of Safety Professionals
  • Lions Club

Certifications

  • Certified Medical Administrative Assistant (CMAA) by NHA
  • Google Certified Professional Cloud Architect
  • CompTIA Security+
  • CompTIA A+ Technician
  • Healthcare Information Technology Certification (HITC)
  • Healthcare Data Analytics Certificate by Meridian
  • Certified Public Accountant
  • Certified Professional Biller (CPB) by AAPC
  • Cisco Certified Network Associate (CCNA)
  • Clinical Documentation Improvement Practitioner (CDIP) by program

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