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Skills

  • Insurance billing
  • Onboarding and mentorship of new staff
  • Continuous improvement methodologies (Six Sigma, Lean)
  • Process improvement
  • Call center operations management
  • Error reduction initiatives
  • Supervision
  • Appeals processing and reduction strategies
  • Operational improvement
  • Client-centric case management approaches

Work Experiences

  • Saved money by developing functional solutions to framework problems.
  • Examined applicants' credit histories and determined whether or not the requested loans could be granted.
  • Authored over 15 policy updates.
  • More than 15 client relationships were effectively managed by me.
  • Discovered valuable solutions for credit-challenged customers.
  • Worked with others to brainstorm new program possibilities.
  • Conducted client eligibility appeals, reducing overturned decisions by 36% and improving customer trust in the process.
  • Achieved Top Performer for process improvement.
  • Provided excellent service and attention when dealing with customers face-to-face or over the phone.
  • Achieved no discrepancies.

Summaries

  • Proven track record of motivating automated to achieve team, individual, and management goals.
  • Accomplished Financial Eligibility Team Lead.
  • Achieved a 61% decrease in processing errors.
  • Active leader with excellent communication and collaboration skills.
  • Knowledge of ServiceNow in depth, as well as project management and performance reporting abilities.
  • Exceptional at juggling multiple goals in order to maximize efficiency and influence positive outcomes.
  • Strategic thinker with expertise in project management.
  • Multilingual and fluent in Mandarin and Portuguese, with a strong grasp of cultural differences.
  • Achieved a 27% improvement in transitions.
  • Accuracy-focused Financial Eligibility Team Lead with 7 years of experience managing complex case reviews, consistently achieving 24% compliance with evolving federal and state regulations.

Accomplishments

  • Directed an error reduction initiative for eligibility coding, lowering error incidence to less than 82% per submitted case.
  • Served as the primary contact for escalated client eligibility cases, achieving 52% conflict resolution on first interaction.
  • Evaluated client disputes and implemented enhanced communication protocols that decreased dispute resolution time by 6 days on average.
  • Trained and supervised remote teams in Atlanta, achieving a 18% increase in on-time case completion within three years.
  • Identified gaps in eligibility procedures leading to a 51% reduction in inaccuracies and improved audit outcomes.
  • Introduced a client engagement model that reduced customer complaints by 44% and maintains proactive communication throughout the eligibility review process.
  • Partnered with HR to roll out a new financial eligibility training program, reducing employee turnover by 15% within 2022.
  • Optimized financial eligibility criteria, resulting in 57% fewer rejected applications and enhanced clarity for applicants.
  • Guided a successful nationwide implementation of new eligibility procedures, reducing overall turnaround time by initiative and increasing accuracy rates to 64%
  • Reduced eligibility determination time from 2 days to 3 days while sustaining a 50% customer satisfaction rating.

Affiliations

  • Volunteer with the Financial Management Association International (FMA) contributing to financial technology best practices for automating workflows.
  • Member of the National Association of Healthcare Access Management (NAHAM) since 2015, gaining insights into financial eligibility standards within healthcare organizations.
  • Member of the International Association of Financial Executives, connecting with industry peers to develop skills in risk mitigation and financial compliance.
  • Completed a Professional Certificate in Eligibility Determination and Appeals Training through the framework in 2023.
  • Member of the Risk Management Association (RMA), utilizing group discussions to strengthen skills in identifying and mitigating financial risks.
  • Certified Financial Eligibility Professional (CFEP) affiliation in 2017 through the Institute of Financial Services Association.
  • Active member of the American Association of Healthcare Administrative Management (AAHAM) participating in professional development events focused on eligibility processes.
  • Held a leadership role within the National Society of Accountants (NSA)'s subcommittee on eligibility documentation and claim reviews.
  • Attended workshops hosted by the Society for Financial Services Professionals to expand industry knowledge on eligibility assessment workflows.
  • Attended the Automated Financial Systems Annual Conference to learn best practices around technological innovation in financial eligibility.

Certifications

  • Certified Compliance Officer (CCO)
  • Lean Six Sigma Black Belt
  • Certified Professional in Supply Management (CPSM)
  • Financial Data Professional (FDP)
  • Salesforce
  • Certified Professional in Healthcare Quality (CPHQ)
  • Financial Risk Manager (FRM)
  • Certified Government Financial Manager (CGFM)
  • Six Sigma Green Belt Certification
  • Certified Compliance and Ethics Professional (CCEP)

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