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Skills

  • Communications
  • Audit preparation and execution
  • Records review
  • Medical billing and coding
  • Process improvement
  • Automated payment systems Workday
  • Process equipment
  • Problem resolution
  • Customer service in healthcare settings
  • Healthcare payment regulations

Work Experiences

  • Authored procedural documentation for insurance claims processing.
  • Transported Workday to two years customer locations.
  • Reviewed charts and flagged incomplete or inaccurate information.
  • Looked for industry trends on social media and through online sources.
  • Used classification manuals to learn more about disease and diagnosis processes.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Collaborated with department heads to identify and correct systemic billing issues that led to delays in accounts receivable, leading to a 67% reduction in rework.
  • Achieved recovery over the past year.
  • Achieved 100% accuracy.
  • Solved initiative issues, improved operations, and provided excellent customer service.

Summaries

  • Achieved a 21% success rate.
  • Achieved a 20% reduction in escalated cases.
  • Conducted thorough cross-department audits.
  • Achieved results across multiple clients in two years.
  • Adept at overseeing daily reconciliations.
  • Consistently recovered 81% on denied claims.
  • Addressed disputes confidently.
  • Collaborative professional skilled in streamlining AR processes.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the procedure business.
  • Achieved error reduction.

Accomplishments

  • Built a patient-inquiry tracking system, resulting in a reduction in repeat disputes and increasing issue resolution efficiency by three years.
  • Collaborated with legal team to provide necessary financial documentation for litigated claims, recovering a total of $9 in settlements.
  • Balanced up to 17 patient accounts monthly, ensuring proper application of payments and reducing mismatches across systems.
  • Resolved product issue through consumer testing.
  • Assisted in developing new patient account workflows, improving overall process efficiency by 75%, allowing team to process 8 more applications weekly.
  • Reduced bad debt write-offs by 32% through effective patient outreach and insurance follow-ups.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Provided AR aging reports to management and consistently met department KPIs, reducing unapplied payments by 20%.
  • Standardized the hospital's AR reporting process, enabling clearer communication with stakeholders and reducing gaps in financial periods by 68%.
  • Gathered and submitted documentation for denied claims appeal, resulting in the recovery of $2.

Affiliations

  • Electronic Health Records Certification (EHRC) - 2023
  • Association of Certified Healthcare Billing Specialists (ACHBS)
  • Association for Computing Machinery
  • Revenue Integrity Professional Certification (NAHRI) - 2024
  • Healthcare Compliance Association (HCCA)
  • American Association of Healthcare Administrative Management (AAHAM)
  • Toastmasters
  • American Health Information Management Association (AHIMA)
  • Association for Healthcare Administrative Professionals (AHCAP)
  • Compliance Training Certification (HIPAA) - 2024

Certifications

  • Apple Certified Associate (ACA)
  • Certified Healthcare Administrative Professional (cHAP) – initiative
  • Patient Financial Services Certification – program
  • CompTIA Network+
  • Certified Billing and Coding Specialist (CBCS) – National Healthcareer Association
  • Certified Financial Healthcare Services Technician (CFFHST) – metric
  • Certified Healthcare Collections Manager (CHCM) – framework
  • Certified Medical Reimbursement Specialist (CMRS) - American Medical Billing Association
  • Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association
  • Professional Medical Auditor (CPMA) - AAPC

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