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Skills

  • Payment plan negotiation
  • Supervision
  • Collection process streamlining
  • Business operations
  • Process improvement
  • Billing discrepancies resolution
  • First Aid/CPR
  • Customer service
  • Billing error resolution
  • Client and broker communication

Work Experiences

  • Achieved a 51% improvement in claim processing.
  • Audited over 7 accounts for payment inconsistencies, identifying errors that resulted in an additional $18 in collections.
  • Achieved a 36% improvement in payment turnaround time.
  • Analyzed payment histories to predict future collection risks, reducing bad debt write-offs by $18.
  • Achieved a 70% success rate.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Achieved Top Performer.
  • Collaborated with legal and compliance teams on high-risk cases, ensuring ethical handling and adherence to operational policies.
  • Oversaw the delivery of category project by metric team, which resulted in initiative.
  • Collaborated with standard customers to determine their needs and deliver category service.

Summaries

  • Recognized as a dedicated professional who strives to exceed team goals and improve bottom line results.
  • Collaborated with internal teams.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved up to 66% customer satisfaction improvement.
  • Conducted thorough account follow-up.
  • Within tight deadlines, adept at accurately preparing weekly and monthly reports.
  • Clear understanding of team leadership and stakeholder engagement as well as risk assessment training.
  • Adjusted strategies to align with current trends.
  • Collaborated with insurers.
  • Skilled in tracking payments, resolving billing issues, and preparing account statements.

Accomplishments

  • Ensured compliance with Medicare and Medicaid guidelines during the collection process, avoiding penalties and legal actions.
  • Recovered over $205,000 in denied claims within three years by effectively navigating payer challenges and submitting appeals.
  • Documented and resolved procedure which led to standard.
  • Coordinated with legal professionals to ensure collection actions were compliant with regulatory standards, reducing legal exposure and costs by 63%.
  • Consistently achieved monthly collection target of 12, securing timely payment through professional and consistent follow-up.
  • Improved recovery rates on aged accounts by 73% through effective strategic escalation procedures.
  • Assisted in developing new billing error resolution protocols that resulted in a 36% decrease in rejected claims.
  • Audited claims and discovered overpayment by 9, initiating refund process to insurers and reducing future discrepancies.
  • Reduced backlog of unpaid claims by 54% by building rapport with insurance representatives and streamlining internal reporting processes.
  • Created and executed effective follow-up strategies for denied or underpaid claims, resulting in the recovery of 74% disputed payments.

Affiliations

  • American Marketing Association
  • American Health Information Management Association (AHIMA), Certification in Medical Reimbursement
  • Project Management Institute
  • Association for Computing Machinery
  • Professional Association of Billing and Financial Operations (PABFO), Austin
  • Medical Reimbursement Society of America (MRSA), Accredited Specialist
  • Society for Healthcare Risk Management (SHRM), Active Member
  • Association for Supply Chain Management (APICS)
  • Revenue Cycle Innovation Award, 2015, for Outstanding Balance Recovery
  • Society of Human Resource Management

Certifications

  • CompTIA A+ Technician
  • Certified Insurance Services Representative (CISR)
  • CompTIA Network+
  • Certified Professional Medical Auditor (CPMA)
  • Apple Certified Associate (ACA)
  • Certified Business Analysis Professional (CBAP)
  • Certified Financial Services Auditor (CFSA)
  • Microsoft Certified Systems Engineer (MCSE)
  • Google Certified Professional Cloud Architect
  • Certified Compliance and Ethics Professional (CCEP)

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