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Skills

  • Audit preparation and support
  • Patient collection management
  • Electronic claims submission
  • Claims tracking system implementation
  • Insurance claim processing
  • Denial management
  • Insurance claim follow-up
  • General accounting
  • Cash Flow analysis
  • Accounts receivable aging reports

Work Experiences

  • Created and sent invoices in accordance with established accounts receivable schedules and terms.
  • Attained Excellence Award for excellence.
  • Achieved a 80% increase in reimbursement rates through persistent follow-up on underpaid or denied claims.
  • Communicated with healthcare providers.
  • Appealed denied claims within 6-day timeframe.
  • Communicated effectively with insurance representatives to clarify coverage details, resolving patient billing inquiries in a timely manner.
  • Communicated effectively with insurance representatives.
  • Achieved results within 6 months.
  • Achieved a 95% resolution rate.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.

Summaries

  • 10 years of experience in processing high volumes of claims.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Insurance Billing Clerk who is results-oriented and has a track record of keeping finances up-to-date and accurate.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved a 78% reduction in accounts receivable backlogs.
  • Skilled at establishing positive relationships with clients and vendors, as well as managing accounts to reduce outstanding balances.
  • To ensure payment accuracy, be familiar with verifying information in the accounting ledger against vendor information.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Insurance Billing Clerk with over 15 years of experience who is efficient and detail-oriented.
  • Insurance Billing Clerk is a well-organized Miscellaneous with 10 years of experience.

Accomplishments

  • Served as the liaison between providers and payers to resolve complex billing issues, resulting in retrieval of 6 from disputed claims.
  • Collaborated with cross-functional teams to expedite category authorizations, improving overall turnaround time by 77%.
  • Optimized electronic billing protocols using Workday, reducing claim resubmission rates by 37%.
  • Led review and reconciliation of 7 outstanding claims, recovering 15 in unbilled services within 4 months.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented outgoing insurance claims, ensuring compliance with procedure, which led to consistently passing audits with 32% accuracy.
  • Analyzed 15 insurance denials monthly, identifying trends and implementing training for staff that reduced errors by 50%.
  • Devised an ongoing training program focused on industry changes, improving compliance understanding by 61% among billing staff.
  • Streamlined patient account resolutions, reducing refund processing time by 12 days through proactive communication with insurers.
  • Developed a new log system that accurately tracked unpaid insurance claims, reducing collection efforts by 73%.

Affiliations

  • American Health Information Management Association (AHIMA)
  • Project Management Institute
  • Certified Professional Biller (CPB) – method
  • Managed Care & Insurance Special Interest Group (MCISIG)
  • Healthcare Financial Management Association (HFMA)
  • American Hospital Association (AHA)
  • American Medical Billing Association (AMBA)
  • Medical Auditing Certification – process
  • National Association of Insurance Commissioners (NAIC)
  • American Society of Safety Professionals

Certifications

  • Medical Billing and Claims Certification - Meridian
  • Registered Health Information Technician (RHIT) - method
  • Certified Healthcare Billing Technician (CHBT) - Beacon Labs
  • Salesforce
  • Revenue Cycle Analyst Certification - Meridian 2017
  • Certified Healthcare Access Associate (CHAA) - process - 2016
  • Denial Management Certification - Harbor & Co. 2020
  • Accounts Receivable Management Certification - Summit Group 2022
  • Certified Medical Reimbursement Specialist (CMRS) - Ironclad Systems
  • Medical Billing Specialist Certification - Beacon Labs

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