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Skills

  • Health Information Systems (HIS) Management
  • Organization
  • Cross-functional team collaboration
  • Interpreting Medicaid guidelines
  • Health program compliance
  • Inventory management
  • Medicaid claim processing
  • Insurance claim adjudication
  • Medical billing software Asana proficiency
  • Transcribing

Work Experiences

  • Assisted in the transition to ICD-10 codes for Medicaid billing, achieving a 17% increase in coding accuracy across finance.
  • Audited Medicaid claims for discrepancies.
  • Achieved benchmarks within 8 weeks of hire.
  • Collaborated with cross-functional teams.
  • Site evaluations, customer surveys, and team audits were all things I did.
  • Relayed information to the appropriate department, individual, or external location.
  • Implementing category process improvements increased team efficiency.
  • Addressed payment misapplied to Medicaid.
  • Was in charge of all tasks delegated to me, including vendor management and cross-functional collaboration.
  • Management recognized me for providing outstanding customer service.

Summaries

  • Active leader with excellent communication and collaboration skills.
  • Knowledge of Salesforce in depth, as well as stakeholder engagement and team leadership abilities.
  • Accomplished in 2015.
  • Expert in procedure with a strong aptitude for improved and implemented.
  • Exceptional at juggling multiple goals in order to maximize efficiency and influence positive outcomes.
  • Achieved a 27% increase in Medicaid claim acceptance rates.
  • Risk assessment in category settings and workflow optimization in data analysis settings.
  • Accomplished Medicaid Biller.
  • Proficient in promoting program by leveraging vendor management and quality assurance knowledge.
  • Medical Records Specialist who is self-motivated and has experience scanning and indexing medical records to the correct chart.

Accomplishments

  • Managed the accurate and timely submission of 17 Medicaid claims per month, increasing overall department productivity.
  • Decreased aged Medicaid receivables by 54% by implementing an automated follow-up schedule for overdue payments.
  • Accurately reconciled Medicaid payments across multiple platforms, reducing payment discrepancies by $3 over the course of two years.
  • Ensured strict compliance with HIPAA regulations during patient data audits, maintaining ITIL compliance standards.
  • Reviewed and refined the Medicaid claims submission process, reducing submission errors and increasing monthly revenue by $14.
  • Developed a comprehensive Medicaid billing manual, ensuring consistency and compliance across 15 team members.
  • Participated in cross-functional team projects focused on updating Medicaid billing protocols to align with new federal regulations.
  • Directly communicated with Medicaid representatives, reducing denied claims by 81% through proactive issue resolution.
  • Successfully implemented a Medicaid billing quality assurance program, identifying billing errors earlier and reducing rework by 45%.
  • Collaborated with the finance department to provide timely monthly reports on Medicaid reimbursements, contributing to overall budget accuracy.

Affiliations

  • Attended Annual Medicaid & Medicare Summit, Denver, 2019
  • Participant, Association for Healthcare Administrative Professionals (AHCAP), 2023-2024
  • Participant, HFMA Revenue Cycle Optimization Workshop, Seattle, 2021
  • Attendee, APHA Policy Learning Institute on Medicaid & State Health Policy, 2019
  • Completed Certified Healthcare Financial Professional (CHFP), HFMA, 2021
  • Certified Medicaid Specialist (CMS), National Healthcareer Association (NHA), 2019-2022
  • Member, Healthcare Financial Management Association (HFMA) metric
  • Active Participant, Medical Billing and Coding Forum, 2015-Present
  • Certification in Compliance Auditing, AHIMA, 2020
  • Member, Medicaid Integrity Institute, 2021-Present

Certifications

  • AAPC Certified Outpatient Coder (COC) - Northwind - 2016
  • Certified Denials and Appeals Specialist (CDAS) - Harbor & Co. - 2024
  • Project Management Professional (PMP)
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Health Data Analyst (CHDA) - Meridian, 2019
  • Certified Medicaid Coder (CMC) - Meridian - 2015
  • Cisco Certified Internetwork Expert (CCIE)
  • CompTIA Security+
  • SAP Certified Application Associate
  • Certified Healthcare Financial Professional (CHFP) Lakeside Partners 2024

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