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Skills

  • Proficiency in medical billing software (Workday)
  • Training and development
  • Claim approval rate improvement
  • Actionable insights generation
  • Team building
  • Cross-functional team leadership
  • Business operations
  • Insurance settlement negotiation
  • Compliance auditing
  • Project management in reimbursement

Work Experiences

  • Aligned operations with insurance contracts.
  • Transported QuickBooks to 18 months customer locations.
  • Achieved zero findings in 2024.
  • Achieved $14 in annual savings.
  • Acted as point of contact for Adobe Creative Suite reimbursement escalations, reducing unresolved claims over the past year by 74%.
  • Acted as point of contact for Tableau reimbursement escalations.
  • Achieved excellence in revenue cycle management.
  • Updated personnel handbooks and individual records to keep the files accurate and detailed.
  • Audited reimbursement claims for compliance with metric.
  • Analyzed SAP pricing structures.

Summaries

  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Achieved a 83% improvement in client satisfaction.
  • Collaborated on developing advanced reporting tools.
  • Achieved a 53% increase in approval rates.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Adept at training staff.
  • To categorize positions, successfully gather and evaluate information, interview employees, and assess occupational information.
  • Achieved a 20% increase in claim success rates.
  • Accomplished results in under 15 months.
  • Conducted industry-standard workshops.

Accomplishments

  • Collaborated with team of 3 in the development of procedure.
  • Implemented a workflow optimization system that reduced the backlog of reimbursement claims by 75% in one year.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Identified and rectified coding discrepancies, improving claim accuracy and reducing denials by 82%.
  • Managed relationships with 3 major insurance companies, leading to a 71% increase in streamlined reimbursements.
  • Revised and standardized the reimbursement appeals process, achieving a 81% success rate in overturned claims.
  • Coordinated follow-up on aged receivables and resolved complex claims, leading to the recovery of $12,000 in remittance.
  • Audited claims processing for adherence to compliance regulations, leading to zero discrepancies during the 2024 audit.
  • Collaborated with revenue cycle management teams to reduce claim denials by 33% through revamped validation strategies.
  • Trained 11 new hires in medical coding and reimbursement processes, reducing claim submission errors by 71%.

Affiliations

  • Association for Supply Chain Management (APICS)
  • International Association of Administrative Professionals
  • Lions Club
  • Certified Coding Specialist (CCS) Certification
  • American Society of Safety Professionals
  • Revenue Cycle Leadership Certification (RCLC)
  • Society of Human Resource Management
  • Association of Information Technology Professionals
  • Association for Computing Machinery
  • Freemason

Certifications

  • SHRM Certified Professional (SHRM-CP)
  • Certified Revenue Integrity Professional (CRIP)
  • Certified Compliance & Ethics Professional (CCEP) by Harbor & Co.
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Healthcare Financial Management Association (HFMA) Certified Revenue Cycle Representative (CRCR)
  • Certified Revenue Cycle Executive (CRCE)
  • Salesforce
  • Health Insurance Portability and Accountability Act (HIPAA) Advanced Cert via Lakeside Partners
  • Six Sigma Green Belt Certification (Healthcare Focus)
  • Lean Six Sigma Black Belt for Healthcare via initiative

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