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Skills

  • Proficient in SAP
  • Project organization
  • Budgets
  • Customer service excellence in healthcare
  • MS Office
  • Insurance reimbursement recovery
  • Relationship development
  • Supervision
  • Adherence to category insurance standards
  • Insurance coverage verification

Work Experiences

  • Achieved 19% compliance rate in 2021.
  • Achieved results within several months.
  • Followed strict procedures to safeguard sensitive patient data, such as medical records and payment information.
  • Analyzed insurance discrepancies and resolved them in collaboration with claims and billing departments, decreasing errors by 63%.
  • Assessed the appropriateness of payers in order to protect the organization and reduce risk.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Transported Tableau to three years customer locations.
  • Solved system issues, improved operations, and provided excellent customer service.
  • Conducted root-cause analysis on denied claims.
  • Boosted claim acceptance.

Summaries

  • Working with stressed, confused, and upset people who need benefits information and supportive guidance to navigate metric systems is one of my specialties.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the system business.
  • An experienced Insurance Verification Specialist with a proven track record of handling a wide range of office tasks with ease.
  • Exceptional organizational skills and meticulous attention to detail.
  • Insurance Verification Representative is a multi-talented Insurance Verification Representative who is consistently rewarded for planning and operational improvements.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Recognized on a regular basis for outstanding performance and contributions to the Insurance industry's success.
  • Dedicated to learning, growing, and succeeding in Insurance.
  • Conducted thorough verification.
  • Conducted thorough benefit explanation.

Accomplishments

  • Utilized system to track and process insurance verifications, improving overall daily processing efficiency by 61%.
  • Facilitated education on benefit options to patients, ensuring coverage understanding and reducing post-treatment disputes by 83%.
  • Applied strong knowledge of method insurance products to effectively verify complex benefits, leading to a 78% increase in successful claims.
  • Reduced insurance verification turnaround times by 56% using Microsoft Excel to enhance processing efficiency.
  • Verified insurance eligibility and benefits for over 8 patients daily, reducing claim denials by 69% through prompt and accurate verification.
  • Assisted in the resolution of high-level billing disputes by providing accurate insurance verification data, reducing rejections by 42%.
  • Specialized in securing prior authorizations with a 81% success rate, accelerating patient scheduling for critical surgeries.
  • Trained and mentored a team of 7 junior staff, enhancing their understanding of insurance verification procedures and strategies.
  • Processed prior authorizations within the past year, securing insurance approval for surgeries and procedures critical to patient recovery timelines.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Certified Healthcare Financial Professional (CHFP) - 2020 Raleigh
  • Healthcare Revenue Cycle Auditor Certification - OSHA
  • Healthcare Compliance Association (HCCA)
  • Association of Credit and Collection Professionals (ACA International)
  • National Healthcareer Association (NHA) – Certified Billing and Coding Specialist (CBCS)
  • American Health Information Management Association (AHIMA)
  • Revenue Cycle Coordinator Certification - OSHA
  • National Council for Prescription Drug Programs (NCPDP)
  • Member, Professional Association of Health Care Office Management (PAHCOM)
  • Medical Group Management Association (MGMA)

Certifications

  • Certified in Healthcare Compliance (CHC) by HCCA
  • ServSafe
  • Certified Business Analysis Professional (CBAP)
  • HIPAA Professional Certification (HIPAA-P) by HIPAA Academy
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Healthcare Financial Professional (CHFP) by method
  • Certified Revenue Cycle Specialist (CRCS) by AAHAM
  • CompTIA Security+
  • Certified Health Data Analyst (CHDA) by AHIMA
  • Microsoft Certified Systems Engineer (MCSE)

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