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Skills

  • High attention to detail in claims processing
  • Regulatory compliance
  • Audit coordination
  • Generating and analyzing billing reports
  • Accounting systems and controls
  • Facilitating accounts payable (AP) resolutions
  • Claims submission and follow-up
  • Management accounting
  • Budgeting proficiency
  • Denial management and root cause analysis

Work Experiences

  • Decreased accounts aging by 13 days.
  • Answered 2 calls per one year to help customers with their questions and concerns.
  • Achieved faster claim approvals.
  • Adapted to changes such as framework.
  • Collaborated with IT to streamline the process of electronic claim billing using category, reducing submission errors by 19%.
  • Collaborated with the finance department to reconcile end-of-month reporting, leading to reduced financial discrepancies with a margin of error below 24%.
  • Addressed conflicting insurance responses.
  • Assisted in audits that reviewed over 7 claims, identifying and correcting discrepancies to maintain compliance.
  • Awarded President's Club at Denver for consistently exceeding collection targets by 63% annually.
  • Oversaw the delivery of framework project by metric team, which resulted in initiative.

Summaries

  • Adept at bridging gaps between patients, providers, and payers.
  • Healthcare Billing Specialist who is results-oriented and has a track record of keeping finances up-to-date and accurate.
  • Healthcare Billing Specialist is a multi-talented Healthcare Billing Specialist who is consistently rewarded for planning and operational improvements.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Achieved a 13% reduction through systematic reconciliation methods.
  • Accomplished in negotiating payments and resolving billing disputes, recovering over $13 in underpaid claims within three years.
  • Expert in payment processing to reduce outstanding debt, fees, and interest.
  • Achieved 26% annual growth in collections.
  • Offering 12 years of functional experience in the standard industry providing clerical, financial, and administrative services.
  • Adept at analyzing claim rejections.

Accomplishments

  • Developed strategic relationships with third-party payers, resulting in a decrease of 22% in denied claims over one year.
  • Spearheaded the integration of a new billing platform, reducing processing time by 3 hours per week and improving overall efficiency.
  • Resolved product issue through consumer testing.
  • Collaborated with clinical, administrative, and compliance teams, contributing to a 20% reduction in delayed payments.
  • Reduced outdated and denied claims by 27% through focused training and procedural upgrades, increasing recovery by $8.
  • Reduced claim rejection rates by 29% through systematic evaluation and improvement of the denial management process.
  • Maintained compliance with HIPAA regulations, reducing risk of data breaches and ensuring patient confidentiality across all billing processes.
  • Negotiated complex payment structures with insurance payers, successfully recovering $5 in underpaid claims from category.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Prepared, submitted, and monitored an average of 16 claims per week, leading to increased cash flow and a recovery rate of $4 monthly.

Affiliations

  • International Association of Administrative Professionals
  • Advanced HubSpot Certification through AAPC 2019
  • Co-authored industry guidelines on healthcare revenue integrity for Ohio regulations
  • Project Management Institute
  • American Health Information Management Association (AHIMA)
  • Certification in ICD-10 Coding Standards 2023
  • Rotary International
  • Organizer of a healthcare billing workshop at Portland 2021
  • Membership in EHR User Group for ongoing industry updates and networking
  • Toastmasters

Certifications

  • CompTIA Security+
  • Managed Healthcare Professional Certification - initiative
  • ServSafe
  • Certified Medical Reimbursement Specialist (CMRS) - AMBA
  • First Aid/CPR Certified
  • Hospice Certification for Billing Professionals - process
  • Certified Electronic Health Records Specialist (CEHRS) procedure
  • Certified Clinical Services Auditor (CCSA) - procedure
  • CompTIA A+ Technician
  • Certified Professional Biller (CPB) - AAPC

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