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Skills

  • Accounting remittances
  • Electronic Health Records (EHR) management
  • Automated billing tools implementation
  • Management accounting
  • Sheet balancing
  • KPI monitoring and performance reporting
  • Healthcare compliance
  • Accounting systems and controls
  • Audit preparation and execution
  • Billing system upgrades implementation

Work Experiences

  • Administered the submission process for 7 claims monthly.
  • Decreased claim rejection rates by 27%.
  • Added $17 to the company’s bottom-line.
  • Created training programs that improved the billing team's knowledge of insurance regulations, decreasing claim rejections by 31%.
  • Contributed to a recovery of $10.
  • Coordinated with physicians and practitioners to verify service codes and avoid coding discrepancies, cutting down claim rejections by 60%.
  • Saved $18 by putting in place cost-cutting measures that addressed long-standing issues.
  • Applied my skills and knowledge to complete monthly closing processes, journal entries, and accruals on time and accurately.
  • Avoided coding discrepancies.
  • Collaborated with healthcare providers.

Summaries

  • To ensure payment accuracy, be familiar with verifying information in the accounting ledger against vendor information.
  • Clinical Billing Specialist with 13 years of successful vendor management and project management experience.
  • Costs were consistently reduced while profits were increased.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Focused, committed, and adept at quickly identifying errors and mitigating losses.
  • Achieved improved reimbursement efficiency by adjusting coding standards, reducing processing time from 9 days to 5 days, and increasing provider satisfaction.
  • Committed to processing invoices with 100 percent accuracy.
  • Clinical Billing Specialist is a detail-oriented Clinical Billing Specialist with 17 years of finance and accounting experience.
  • Offering 5 years of functional experience in the framework industry providing clerical, financial, and administrative services.
  • Achieved a 25% increase in billing accuracy.

Accomplishments

  • Collaborated with team of 5 in the development of program.
  • Worked closely with external auditors during payer audits, ensuring full documentation and reducing potential liabilities by $18.
  • Documented and resolved process which led to procedure.
  • Negotiated improved compensation rates with 13 third-party payers, directly enhancing cash flow by $13 annually.
  • Assisted the IT team in transitioning to a new EHR system, ensuring seamless integration with the billing software and improving overall efficiency.
  • Worked with clinical teams to ensure accurate and timely submission of medical records, reducing denials and rejections by 3%.
  • Developed a training module that onboarded 4 new billing specialists, reducing onboarding time by 30%.
  • Utilized Excel pivot tables and VLOOKUP to reconcile account discrepancies, contributing to a 53% improvement in payment application.
  • Conducted billing audits and communicated results with clinical leadership, reducing post-payment audit recoveries by 63%.
  • Implemented regular cross-training initiatives that increased team versatility and reduced operations downtime by 5%.

Affiliations

  • Certified Medical Reimbursement Specialist (CMRS) - American Medical Billing Association
  • Certified Healthcare Billing & Coding Association (CHBCA)
  • American Marketing Association
  • Certified Healthcare Financial Professional (CHFP)
  • Council for Affordable Quality Healthcare (CAQH)
  • Revenue Cycle Academy
  • Association for Supply Chain Management (APICS)
  • Radiology Business Management Association (RBMA)
  • Association for Computing Machinery
  • Society of Human Resource Management

Certifications

  • SHRM Certified Professional (SHRM-CP)
  • Insurer Provider Relations Certificate Program - Summit Group
  • Salesforce
  • Compliance Certification Board’s Healthcare Compliance Certification (CHC) - CCB
  • Credentialed Compliance and Coding Professional (CCCP) - CCO
  • Certified Medical Billing Specialist (CMBS) - AMBA
  • Certified Clinical Documentation Specialist (CCDS) - standard
  • Certified Healthcare Financial Professional (CHFP) - HFMA
  • CompTIA Network+
  • Certified Medical Insurance Specialist (CMIS) - PMI

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