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Skills

  • First Aid/CPR
  • Accounting systems and controls
  • Cost accounting
  • Accurate medical chart review
  • Records review
  • Cross-departmental collaboration
  • Regulatory filings
  • Sheet balancing
  • QMSoftware Receivables Management
  • Revenue cycle management

Work Experiences

  • Acted as the primary point of contact for patients.
  • Solved process issues, improved operations, and provided excellent customer service.
  • Achieved a 75% reduction in claims processing time.
  • Pulled patient records accurately for upcoming appointments and procedures, usually within 2 hours.
  • Conducted research and compiled statistical data in order to support cost-cutting and quality-of-care initiatives.
  • Answered an average of 18 calls, emails, and faxes per day, responding to customer inquiries, resolving problems, and informing customers about new products.
  • Went over the charts and highlighted any information that was missing or incorrect.
  • Analyzed financial impact reports for the billing department, identifying inefficiencies that resulted in a 83% overhead cost reduction.
  • Achieved timely reimbursement within framework.
  • Started two key partnerships that resulted in a 54% increase in revenue.

Summaries

  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Working with Agile and Scrum methodologies to meet project milestones within specified timeframes is a strong suit.
  • Professional with 6 years of progressive experience in the field who is highly organized and detail-oriented.
  • Excited and dedicated to accuracy, with excellent decision-making abilities.
  • Knowledgable in a variety of design and testing methodologies.
  • Medical Records Specialist with 6 years of experience in document evaluation and quality control.
  • Dedicated to paying employees, vendors, and suppliers on time.
  • Expert in payment processing to reduce outstanding debt, fees, and interest.
  • Focused, committed, and capable of quickly identifying mistakes and minimizing losses.
  • Offering 16 years of functional experience in the procedure industry providing clerical, financial, and administrative services.

Accomplishments

  • Documented and resolved process which led to category.
  • Achieved a billing accuracy rate of 51% through careful documentation and persistent follow-up processes.
  • Initiated electronic claim submission processes, reducing claim-to-cash time by 18 days.
  • Collaborated with managed care organizations to renegotiate payment terms, increasing reimbursement rates by 54%.
  • Resolved product issue through consumer testing.
  • Increased sales 4% over three years.
  • Improved first-pass claim acceptance by 46% through accurate coding and attention to payer guidelines.
  • Assigned appropriate ICD-10 and CPT codes to patient records, resulting in a 75% reduction in claim denials.
  • Recovered $10 in outstanding claims by identifying and escalating disputed claims with insurance providers.
  • Recovered $13 through rigorous insurance claim follow-up, contributing to a 77% increase in revenue.

Affiliations

  • Professional Development Program in CPT© Code Training – 2015
  • Rotary International
  • ICD-10-CM and ICD-10-PCS Taskforce
  • National Advisory Board for Medical Coding Standards
  • Denials Management & Appeals Discussion Group
  • National Association of Healthcare Revenue Integrity
  • Certified Coding Specialist (CCS) Credential Holder
  • International Association of Medical Coding and Billing Professionals
  • Certified Electronic Health Records Specialist (CEHRS) Affiliation
  • Medical Coders and Billers Leadership Forum

Certifications

  • Certified Professional Biller (CPB) - AAPC
  • Medical Coding and Billing Diploma - Lakeside Partners, 2022
  • Medicare Fraud Prevention Certification - Cedar Works
  • Medical Billing and Coding Certification - Texas, Brightline, 2021
  • Advanced Coding Specialist (ACS) - AAPC
  • Certified Business Analysis Professional (CBAP)
  • Certified Healthcare Access Manager (CHAM) framework
  • Project Management Professional (PMP)
  • Certified Professional Medical Auditor (CPMA) - AAPC
  • Certified Coding Specialist – Physician-Based (CCS-P) - AHIMA

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