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Skills

  • Case management and resolution
  • Benefits investigation and verification
  • Filing and data archiving
  • Customer education on benefits and coverage
  • Supervision
  • 17 WPM typing speed
  • Project organization
  • Compliance with state and federal regulations
  • Team management
  • MS Office

Work Experiences

  • Assessed the urgency and priorities before accepting or declining appointments and meetings with the CEO.
  • Achieved a 79% boost in patient satisfaction.
  • Assessed patient eligibility for HubSpot subsidies.
  • Conducted root cause analysis on delayed claim approvals.
  • Was responsible for a variety of administrative, financial, and service-related tasks, including performance reporting and workflow optimization.
  • Was the finance, IT, and marketing departments' corporate liaison.
  • Achieved a 39% increase in reimbursement approval rates.
  • Opened and properly distributed incoming mail in order to respond to client inquiries more quickly.
  • Consulted with legal teams regarding disputed claims, contributing to the resolution of over 6 cases in favor of the patient.
  • Achieved $9 reimbursement recoveries.

Summaries

  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Thorough and dependable Office Worker with excellent administrative skills and a strong Human Resources background.
  • With a background in accounting and finance, I am a talented administrative professional.
  • Adaptable Benefits Investigator with expertise in tracking insurance trends, ensuring teams avoid potential discrepancies and maximize claim approvals.
  • Dedicated to learning, growing, and succeeding in Human Resources.
  • With an organized approach and strong multitasking abilities, dedicated to maximizing customer satisfaction and exceeding business objectives.
  • Addressed gaps to improve efficiency.
  • Achieved 17% accuracy in prior authorizations.
  • Achieved a 66% increase in team performance.
  • Achieved resolution.

Accomplishments

  • Analyzed trends in insurance denials, implementing strategies that reduced denial rates by 69% over three years.
  • Resolved mismatches between competing insurance policies for specialty medications, recovering 17 in underpaid claims.
  • Trained new team members on updated insurance compliance guidelines, maintaining a 66% adherence rate post-training.
  • Achieved 80% reimbursement recovery for the organization by conducting thorough benefit investigations on denied claims.
  • Collaborated with team of 4 in the development of procedure.
  • Engaged directly with patients to navigate complex benefits issues, achieving 51% resolution satisfaction.
  • Implemented a comprehensive auditing system that identified and corrected processing errors, resulting in an 7 annual cost saving.
  • Optimized insurance verification procedures, resulting in a 50% reduction in claim rejections.
  • Mentored new hires on claims investigation techniques, supporting an increase in daily case resolutions by 81%.
  • Provided subject matter expertise on benefit verifications during cross-departmental reviews, contributing to a 27% operational improvement.

Affiliations

  • National Association of Specialty Pharmacy (NASP)
  • Healthcare Education Associates (HEA)
  • Association for Computing Machinery
  • National Committee for Quality Assurance (NCQA)
  • Jaycees
  • Alliance for Patient Access (AFPA)
  • International Foundation of Employee Benefit Plans (IFEBP)
  • Toastmasters
  • American Association of Healthcare Administrative Management (AAHAM)
  • Freemason

Certifications

  • Certified Public Accountant
  • Certified Healthcare Access Associate (CHAA)
  • Project Management Professional (PMP)
  • Cisco Certified Network Associate (CCNA)
  • Healthcare Quality Regulatory Specialist Certification (HQRS)
  • Certified Patient Account Representative (CPAR)
  • MEDICAL BENEFITS SPECIALIST CERTIFICATION (MBS)
  • Certified Medical Administrative Assistant (CMAA)
  • HIPAA Compliance Officer Certification (HCO)
  • Healthcare Financial Management Association (HFMA) Certification

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