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Skills

  • Team building
  • Communications
  • 3M Encoder
  • Process improvement
  • First Aid/CPR
  • Aging report generation
  • Regulatory compliance
  • Billing software integration
  • Discrepancy resolution for invoices
  • Insurance claim processing

Work Experiences

  • Used email and the phone to communicate effectively with staff, patients, and insurance companies.
  • Authored procedural documentation for insurance claims processing.
  • Saved $6 by putting in place cost-cutting measures that addressed long-standing issues.
  • Reviewed charts and flagged incomplete or inaccurate information.
  • Conducted research and compiled statistical data in order to support cost-cutting and quality-of-care initiatives.
  • Assisted in training new team members.
  • Looked for industry trends on social media and through online sources.
  • Addressed patient billing inquiries.
  • Collaborated with process customers to determine their needs and deliver initiative service.
  • Collaborated with the insurance verification team.

Summaries

  • Bilingual achiever with experience scanning and indexing medical records to the correct chart.
  • Achieved consistent recovery of 65% of disputed claims.
  • Medical Records Specialist with 13 years of experience in document evaluation and quality control.
  • Adept at resolving EOB discrepancies, resulting in a 26% decrease in refund requests within 2022, through consistent auditing and problem-solving.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved seamless transaction integration.
  • Cut invoice processing time by 9 days.
  • Achieved a 20% reduction in escalated cases.
  • Achieved 100% compliance with hospital standards.
  • Conducted regular audits.

Accomplishments

  • Resolved product issue through consumer testing.
  • Balanced up to 17 patient accounts monthly, ensuring proper application of payments and reducing mismatches across systems.
  • Provided AR aging reports to management and consistently met department KPIs, reducing unapplied payments by 20%.
  • Created custom reports on AR trends to assist hospital's senior management with decision-making, increasing transparency in the collection process.
  • Collaborated with legal team to provide necessary financial documentation for litigated claims, recovering a total of $9 in settlements.
  • Recovered $14 in denied claims by accurately resubmitting insurance documents and working closely with payers.
  • Successfully resolved aged patient accounts spanning over 3 days, decreasing AR backlog by 26%.
  • Led cross-functional collaboration with the billing and coding departments, reducing claim errors and improving first-pass acceptance rates by 76%.
  • Resolved insurance underpayments and patient billing disputes within two years, resulting in over $17 in recovered revenue.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Healthcare Compliance Association (HCCA)
  • American Society of Safety Professionals
  • Association for Computing Machinery
  • Association for Financial Professionals (AFP)
  • Healthcare Leadership Academy (HLA) Graduate - 2017
  • Jaycees
  • Association for Healthcare Administrative Professionals (AHCAP)
  • Revenue Cycle Certification Program (HFMA) - 2024
  • Toastmasters
  • Compliance Training Certification (HIPAA) - 2024

Certifications

  • Certified Medical Office Manager (CMOM) - Practice Management Institute
  • Certified Professional Biller (CPB) - AAPC
  • First Aid/CPR Certified
  • Cash Flow Optimization Specialist (CFOS) – standard
  • Certified Revenue Integrity Professional (CRIP) – process
  • Certified Revenue Cycle Specialist (CRCS-I) – method
  • Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Business Analysis Professional (CBAP)
  • CPAR (Certified Patient Account Representative) – procedure

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