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Skills

  • Problem resolution
  • Revenue cycle management
  • Effective communication with healthcare providers
  • Medical billing code accuracy
  • Project organization
  • Financial recovery audits
  • Records review
  • Insurance claims submission
  • Cash posting practices
  • NDCMedisoft

Work Experiences

  • Analyzed accounts receivable aging reports.
  • Discovered new ways to improve the management of medical records.
  • Ensured that medical records and health information were accurate, complete, and secure.
  • Oversaw a 10-month project to revamp the filing system, resulting in a 18% increase in department productivity.
  • Went over the charts and highlighted any information that was missing or incorrect.
  • Collaborated with administrative staff.
  • Achieved results in the first 18 months.
  • Achieved results across Chicago.
  • Challenged and overturned 32% of denied claims.
  • Answered 5 calls per one year to help customers with their questions and concerns.

Summaries

  • Achieved a denial reversal success rate of 81%.
  • Collaborative team player with experience working cross-functionally with medical professionals to ensure the accuracy of diagnosis and procedure coding, increasing claim approval rates by 18%.
  • Achieved a 76% reduction in coding-related rejections.
  • Consistently met or exceeded monthly collection targets by negotiating with insurance adjusters and providing timely communication to patients about outstanding claims.
  • Respected Medical Records Specialist with exceptional attention to detail and expertise in analyzing and correcting medical records.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Achieved a 72% success rate in overturning denied claims.
  • Within Healthcare, senior Medical Reimbursement Specialist and outstanding performer in performance reporting and workflow optimization.
  • With strong time management skills and a reliable, hardworking nature, highly accurate and efficient.
  • Achieved an accuracy rate of 98%.

Accomplishments

  • Improved billing workflow by streamlining interactions with insurance providers, decreasing claim rejection rates by 27% through enhanced coding and documentation.
  • Regularly communicated claim statuses and billing issues to patients, ensuring transparency and boosting patient satisfaction by 55%.
  • Collaborated with team of 10 in the development of method.
  • Audited and corrected outdated billing practices, which eliminated program inefficiencies and reduced rejected claims by 44%.
  • Researched and implemented Workday, which increased claims filed within the first submission window from 80% to 26%.
  • Reduced the practice's dependency on external consultants by developing internal expertise in payer requirements and revenue recovery strategies, saving the practice $9 annually.
  • Identified underpayments during account reconciliations, resulting in retroactive payments totaling $9 owed by multiple insurance providers.
  • Decreased the average days in accounts receivable from 5 to 10 days by implementing targeted follow-up strategies on aged claims.
  • Trained a team of 3 staff members on medical billing regulations and compliance standards, increasing department efficiency by 84% in 2020.
  • Raised collection rates by 21% through improved patient communication and timely follow-up on outstanding balances, resulting in greater patient satisfaction.

Affiliations

  • Participation in 2016 reimbursement training certification courses certified by Beacon Labs
  • Freemason
  • National Association of Healthcare Access Management (NAHAM)
  • Member of an interdisciplinary revenue cycle advisory team to standardize collections practices across multiple locations
  • American Academy of Professional Coders (AAPC)
  • Certified Professional Coder (CPC) through AAPC
  • American Marketing Association
  • Contributor to 2022 industry-wide survey on reimbursement trends hosted by Harbor & Co.
  • International Association of Administrative Professionals
  • Alumni network of Denver University’s Billing and Reimbursement Certification Program

Certifications

  • CompTIA Security+
  • Certified Professional Biller (CPB) – Cedar Works
  • Google Certified Professional Cloud Architect
  • SHRM Certified Professional (SHRM-CP)
  • Certified Compliance Technician (CCT) - Summit Group
  • Medical Office Administration Specialist Certification - Ironclad Systems
  • ServSafe
  • Certified Specialist Business Intelligence for Healthcare (CSBI) - Northwind
  • Root Cause Analysis for Medical Billing Professionals - 2017
  • Certified Healthcare Financial Professional (CHFP) - Brightline

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