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Skills

  • Adherence to HIPAA guidelines
  • Budgets
  • First Aid/CPR
  • Process improvement
  • Human resources Collaboration
  • Regulatory compliance
  • Knowledge of CPT, ICD-10 coding
  • Multilingual communication (e.g. Portuguese)
  • Cross-functional stakeholder communication
  • Client and payor communication

Work Experiences

  • Achieved recovery over a 18 months.
  • Collaborated with clients and insurance providers.
  • Achieved Outstanding Service Award for outstanding performance in reimbursement recovery, retrieving over $13 of delayed payments.
  • Shared my knowledge to aid in the improvement of financial management, billing, and tracking systems.
  • Used computer-assisted guidance packages such as skills assessment tools, career planners, psychometric tests, and personal inventories to help clients determine their strengths and weaknesses.
  • Built proactive, client-specific edits into the system to avoid future denials.
  • Assisted in the setup of framework.
  • Conducted interviews with applicants and explained the scope of various benefits that were available.
  • Achieved a 83% increase in processing speed.
  • Documented accurate descriptions of required job duties, working hours, and wages by writing job orders for employers.

Summaries

  • Clear understanding of risk assessment and client relations as well as quality assurance training.
  • Strengths in stakeholder engagement and team leadership backed up by Healthcare training.
  • Reimbursement Specialist Assistant is a knowledgeable Reimbursement Specialist Assistant who is responsible for demanding and detail-oriented billing work.
  • Collaborative Reimbursement Specialist Assistant.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Costs were consistently reduced while profits were increased.
  • Employers and community organizations are contacted to identify job opportunities for clients.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the system business.
  • Recognized on a regular basis for outstanding performance and contributions to the Healthcare industry's success.
  • Motivated professional capable of managing and monitoring member and group eligibility information.

Accomplishments

  • Assisted in implementing an automatic claim submission system which reduced manual entry errors by 58% and expedited revenue cycles.
  • Analyzed and corrected inaccurate patient billing issues, recovering over $8 in misbilled claims.
  • Reviewed Explanation of Benefits (EOB) documents for accuracy, leading to an improvement in correct claims payout rate by 64%.
  • Communicated Medicaid and Medicare coverage details to eligible patients, ensuring a 38% increase in patient understanding and compliance.
  • Earned Lean to enhance understanding of medical coding standards and claims adjudication processes.
  • Produced weekly reimbursement and denial tracking reports, improving visibility and intervention in delayed claims by 34%.
  • Created and implemented detailed policies for following up on denied claims, reducing appeal times by 18%.
  • Guided patients in completing financial assistance applications, facilitating repayment compliance and reducing outstanding balances by 61%.
  • Assisted in collecting over $16 on previously stalled claims by identifying and correcting CPT code inaccuracies.
  • Resolved product issue through consumer testing.

Affiliations

  • National Certified Insurance and Coding Specialist (NCICS)
  • Certified Medical Reimbursement Specialist (CMRS)
  • Rotary International
  • Member of the National Alliance of Medical Auditing Specialists (NAMAS)
  • Medicare Advocacy Coalition Member
  • Healthcare Financial Management Association (HFMA)
  • National Healthcareer Association (NHA)
  • National Association of Medicaid Providers (NAMP)
  • Toastmasters
  • Association for Computing Machinery

Certifications

  • Certified Outpatient Coder (COC) metric
  • Certified Healthcare Financial Professional (CHFP) - HFMA
  • Fundamentals of Revenue Cycle Certificate - Healthcare Financial Management Association (HFMA)
  • Certified Public Accountant
  • CompTIA Security+
  • Exam for Certified Revenue Cycle Executive (CREC) - Brightline
  • Certified Revenue Cycle Specialist (CRCS-I/CRCS-P) - Lakeside Partners
  • Certified Insurance and Billing Specialist (CIBS) - Cedar Works
  • Revenue Cycle Representative (RCR) Training Certificate - Healthcare Financial Management Association (HFMA)
  • CompTIA Network+

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