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Skills

  • Project organization
  • Customer service in healthcare settings
  • Insurance dispute resolution
  • Invoice generation
  • Insurance Verification
  • Denial management
  • Communications
  • Claims workflow automation
  • Conflict resolution
  • MS Office

Work Experiences

  • Conducted interviews with patients in order to obtain medical information and insurance information.
  • Was in charge of the procedure medical practice's administrative needs.
  • Automated insurance verification workflows using new software tools, increasing successful LOP verifications by 26%.
  • Was in charge of creating and maintaining accurate and confidential patient records.
  • Achieved a 5% faster turnaround on LOP verifications.
  • Achieved a 41% reduction in billing errors.
  • Achieved a 80% increase in verified claims.
  • Called patients to schedule metric appointments, double-checking information and availability on a regular basis.
  • Organized, secured, and updated financial documentation for framework and process.
  • Was in charge of supervising and training the admissions, billing, and collection staff.

Summaries

  • Exceptional at juggling multiple goals in order to maximize efficiency and influence positive outcomes.
  • Insurance Verification Specialist (LOP) with experience in a busy medical office assisting 18 physicians.
  • With excellent judgment and multitasking abilities, highly organized and resourceful.
  • Communicative and team-oriented, with HubSpot expertise.
  • Medical standards, compliance requirements, and operational procedures are all well-understood by this skilled administrative team member.
  • Program and framework have a proven track record.
  • A seasoned problem-solver with a warm and caring demeanor and strong communication skills.
  • Experienced Insurance Verification Specialist (LOP) with a track record of managing a wide range of medical administrative needs in high-volume, patient-centered environments.
  • Excellent attention to detail and dedication to improving patient outcomes through individualized care.
  • Working in framework and metric settings to meet all provider and patient needs is part of my background.

Accomplishments

  • Dedicated to maintaining up-to-date knowledge of insurance verification protocols for LOPs, which helped avoid non-compliance issues in 15 cases.
  • Worked with healthcare providers to ensure accurate documentation for LOP cases, reducing late claims submissions by 30%.
  • Developed comprehensive training materials on LOP guidelines for new hires, enhancing team readiness and reducing verification errors.
  • Spearheaded restructuring of verification protocols for LOP cases, cutting review times by 64% and boosting team productivity.
  • Prepared detailed reports on LOP agreements for compliance audits, contributing to a 57% increase in audit pass rates.
  • Partnered with cross-functional teams including legal and compliance to implement new LOP guidelines, ensuring a 15% adherence to policy updates.
  • Decreased manual entry errors in LOP agreements by 56% through the introduction of ServiceNow for automatic data verification.
  • Streamlined LOP verification by integrating HubSpot, reducing manual processing time by 48% and improving verification accuracy.
  • Reduced patient claim processing times by 33% by standardizing procedures for LOP filings in collaboration with interdisciplinary teams.
  • Managed the integration of framework to streamline insurance verification tasks, resulting in a 38% boost in operational efficiency.

Affiliations

  • Subscribed contributor, Insurance Verification Forum
  • Member, National Association of Pre-certification Professionals (NAPP)
  • Completed Fundamentals of Insurance Denial Management Course, 2019
  • Participated in Medical Insurance Processing and Verification Webinars, 2018
  • Certified member, Certified Professional Coder (CPC) through AAPC
  • Member, Patient Advocate Program (PAP), focusing on LOP dispute resolution
  • Member, Claims Appeals Working Group, specializing in LOP approvals
  • Alumni of Insurance Billing and Coding Specialist training program, framework
  • Participant, National Alliance of Insurance Education and Research Conference, 2020
  • Active participant in monthly Revenue Cycle Management Roundtable hosted by Vantage, 2015

Certifications

  • Certified Negotiation Expert (CNE) - program in Legal and Claims Settlements
  • Certificate in Health Insurance Proficiency (CHIP) - NAHU
  • Certified Professional Biller (CPB) - AAPC
  • Google Certified Professional Cloud Architect
  • Certified Healthcare Insurance Specialist (CHIS) - AHIP
  • Association for Project Management (APM)
  • Microsoft Certified Systems Engineer (MCSE)
  • American Academy of Financial Management (AAFM)
  • Salesforce
  • Certified Professional Medical Auditor (CPMA) - AAPC

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