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Skills

  • Budgets
  • Data-driven decision making
  • Compliance in healthcare
  • Medical terminology expert
  • Client advocacy in claims processing
  • Revenue cycle management
  • Data analysis
  • Client communication and engagement
  • Business operations
  • HMFA credited

Work Experiences

  • Closed over $2 in outstanding claims annually.
  • Looked for industry trends on social media and through online sources.
  • Avoided fines and penalties.
  • Collaborated with the accounting team.
  • Assisted Medicare Collectors in properly applying customer remittances while working with Medicare Collector.
  • Achieved a 47% compliance rate.
  • Balanced collections duties with patient-centric financial education.
  • Assisted in transitioning the organization’s Medicare billing system to a digital platform, which increased collection efficiency by 32%.
  • Oversaw the delivery of process project by system team, which resulted in process.
  • Achieved a 23% resolution success rate on aged accounts.

Summaries

  • Dedicated to learning, growing, and succeeding in Healthcare.
  • Exceptional at posting and collecting payments in a timely manner.
  • Achieved collection within 14 weeks of submission.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the standard business.
  • Closed $18 annually.
  • Collections are efficient, and communication with coworkers is effective.
  • Achieved notable success in reducing outstanding balances by negotiating with insurance representatives and Medicare patients to recover 6.
  • Achieved monthly collection improvement by 67%.
  • Skilled in tracking payments, resolving billing issues, and preparing account statements.
  • Costs were consistently reduced while profits were increased.

Accomplishments

  • Created patient payment strategies that enhanced understanding of co-payment responsibilities, driving a 30% reduction in account delinquency.
  • Reviewed aging reports and developed new tactics for contacting Medicare insurance representatives, achieving a 62% increase in overdue claim collections.
  • Successfully reconciled 4 bulk adjustments from Medicare payers, recapturing revenue of $9 within three years.
  • Identified key payment trends and made recommendations that decreased claim underpayments by 77% over two years.
  • Led a process improvement initiative within the Medicare team that increased the overall claim acceptance rate by 71%, improving overall cash inflows.
  • Conducted root-cause analysis on frequently rejected claims, revising submission processes to lower claim rejections by 56%.
  • Collaborated with team of 2 in the development of process.
  • Coordinated with Medicare and third-party payers to resolve disputes, contributing to a 26% upward trend in account resolution.
  • Analyzed complex billing data using advanced MS Excel functionalities, identifying trends that led to an increase in Medicare payment recovery by $11.
  • Partnered with accounting and compliance departments to ensure adherence to all Medicare and federal regulations, reducing audit findings by 21%.

Affiliations

  • American Hospital Association (AHA)
  • American Marketing Association
  • Certified Revenue Cycle Representative (CRCR)
  • Healthcare Compliance Association (HCCA)
  • Certified in Healthcare Compliance (CHC)
  • Association for Supply Chain Management (APICS)
  • American Medical Billing Association (AMBA)
  • Lions Club
  • Toastmasters
  • National Healthcare Collectors Association (NHCA)

Certifications

  • Certified Business Analysis Professional (CBAP)
  • Certified Compliance & Ethics Professional (CCEP) with a focus on healthcare and Medicare policies
  • Specialized Medicare Collections Professional (SMCP) by Cedar Works
  • Healthcare Auditor Certification (CHCA) by Health Ethics Trust, specialized in Medicare audit compliance
  • Certified Patient Financial Services Professional (CPFS) by Summit Group with Medicare focus
  • Credentialed Denials Specialist (CDS) focusing on overturned Medicare denials, through Brightline
  • Salesforce
  • Revenue Cycle Representative Certification (RCR) through Healthcare Financial Management Association (HFMA)
  • Certified Compliance Technician (CCT) focusing on Medicare guidelines, offered by HCCA
  • Health Insurance Portability and Accountability Act (HIPAA) Compliance Certification, via Brightline

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