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Skills

  • Business operations
  • Team building
  • Project organization
  • Insurance claims auditing
  • Insurance billing
  • Invoice generation
  • MS Office
  • Claims workflow automation
  • Communications
  • Data entry accuracy

Work Experiences

  • Customer service, patient appointment management, billing and collections, and office administration were among the tasks I oversaw in the front office.
  • Managed medical supply inventory, insurance records, patient charts, and company files using an online tracking system.
  • Collaborated across departments on LOP claims.
  • Achieved results within 2018.
  • Achieved consistent error-free submissions.
  • Assisted in updating insurance policies.
  • Achieved a 5% faster turnaround on LOP verifications.
  • Called patients to schedule metric appointments, double-checking information and availability on a regular basis.
  • Collaborated with legal counsel and insurance representatives.
  • Conducted interviews with patients in order to obtain medical information and insurance information.

Summaries

  • Working in framework and metric settings to meet all provider and patient needs is part of my background.
  • Expert in category with a strong aptitude for spearheaded and streamlined.
  • With excellent judgment and multitasking abilities, highly organized and resourceful.
  • Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
  • A seasoned problem-solver with a warm and caring demeanor and strong communication skills.
  • With hands-on experience, eager to learn new skills and advance knowledge.
  • Lean certified
  • Organize files, schedule appointments, and assist patients to keep the medical office running smoothly and efficiently.
  • Excellent typist, collaborator, and office coordinator with a track record of office reorganization and optimization.
  • Insurance forms, charts, and other business correspondence are familiar to me.

Accomplishments

  • Increased departmental accuracy in insurance verification processes, earning the team a President's Club for excellence in operational effectiveness.
  • Dedicated to maintaining up-to-date knowledge of insurance verification protocols for LOPs, which helped avoid non-compliance issues in 15 cases.
  • Enhanced patient satisfaction by coordinating closely with customer service teams to resolve insurance and LOP disputes within the past year.
  • Implemented a system that tracked overdue LOP verifications, resulting in a 49% increase in on-time submissions within one year.
  • Partnered with cross-functional teams including legal and compliance to implement new LOP guidelines, ensuring a 15% adherence to policy updates.
  • Led system-wide deployment of QuickBooks for improved LOP tracking and real-time policy verification updates, reducing verification delays by 32%.
  • Established communication best practices between legal and medical departments to speed up LOP reviews and resolve conflicts, reducing claim re-work by 25%.
  • Utilized Tableau to track LOP and medical claims, resulting in a 59% rise in accuracy for tracking care coverage details.
  • Successfully resolved escalated insurance verification issues for 6 high-priority cases, restoring customer satisfaction by 15%.
  • Conducted thorough reviews of Letter of Protection (LOP) agreements to ensure they adhered to all compliance requirements, leading to a 84% reduction in audit discrepancies.

Affiliations

  • Member, Patient Advocate Program (PAP), focusing on LOP dispute resolution
  • Member, American Association of Healthcare Administrative Management (AAHAM) since 2019
  • Affiliation with the Insurance Information Institute (III) on revenue cycle improvement strategies
  • Active participant in monthly Revenue Cycle Management Roundtable hosted by Vantage, 2015
  • Participant, National Alliance of Insurance Education and Research Conference, 2020
  • Attended Insurance Compliance and Billing Audit Conference, Boston, 2021
  • Certified Medical Reimbursement Specialist (CMRS) through the American Medical Billing Association (AMBA).
  • Certification, Electronic Health Records Technology (EHR/EMR), 2018
  • Certified Insurance Services Representative (CISR), Designation acquired in 2015
  • Certified member, Certified Professional Coder (CPC) through AAPC

Certifications

  • CompTIA Security+
  • Certified Public Accountant (CPA)
  • Microsoft Office Specialist (MOS)
  • First Aid/CPR
  • Certified Healthcare Access Associate (CHAA) - process
  • Certified Specialist in Managed Care (CSMC) system
  • Certificate in Health Insurance Proficiency (CHIP) - NAHU
  • Salesforce
  • Certified Medical Office Manager (CMOM) - Practice Management Institute
  • Project Management Professional (PMP)

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