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Skills

  • Investigative research
  • Payment plan negotiation
  • Operational improvement
  • Denial management strategies
  • Relationship development
  • Bill processing
  • Eligibility document verification
  • Statement issuing
  • Client relationship management
  • Administrative support

Work Experiences

  • Analyzed loss reports and discussed them with senior management to assess overall portfolio performance.
  • Developed a reputation for punctuality and hard work.
  • Collaborated with the cash application team and the credit manager to ensure that remittances were posted on time and accurately.
  • Achieved a recovery of $12 over two years.
  • Assisted in building new claim handling workflows that reduced Medicaid claim processing times by 5 days on average.
  • Tableau was delivered to customer locations by me.
  • Assisted in the creation of metric procedures.
  • Audited and analyzed 7 Medicaid claims monthly.
  • Achieved President's Club.
  • Analyzed Medicaid eligibility documents for 18 patients per week to ensure accurate billing procedures and compliance.

Summaries

  • Medicaid Collector and team leader with 12 years of experience in framework settings.
  • Accomplished in building strong relationships with Medicaid clients, resulting in more efficient collections, fewer disputes, and improved recovery timelines by 62%.
  • Proven track record of motivating improved to achieve team, individual, and management goals.
  • Miscellaneous student seeking hands-on experience through an internship in process improvement.
  • Skilled Accounts Receivable Specialist with 16 years of experience in high-volume accounts receivable departments' daily collections.
  • SAP and Power BI experts with exceptional interpersonal skills.
  • Motivating leader who has built and managed system teams in the past.
  • Knowledgeable, analytical, and personable with strong problem-solving abilities and credit and collections expertise.
  • Accomplished Medicaid Collector.
  • With a team-oriented mentality, highly organized, proactive, and punctual.

Accomplishments

  • Improved claim approval rates by proactively following up with Medicaid representatives and patients, enhancing communication effectiveness.
  • Utilized HubSpot billing software to manage Medicaid claim submissions, reducing human error and increasing payout accuracy by 65%.
  • Minimized payment delays by resolving 90% of Medicaid claim disputes in under two years, expediting cash flow for the organization.
  • Identified and modified outdated billing practices, resulting in improved accuracy and a reduction of $15 in write-offs annually.
  • Successfully handled a high-volume workload of Medicaid claims, averaging 9 accounts per day with an accuracy rate of 18%.
  • Trained junior staff on Medicaid claim submission best practices, reducing claim denials by 62% within their first 18 months.
  • Reduced the number of aged Medicaid receivables by 29% through efficient claims follow-up procedures.
  • Mentored a team of 15 collectors on Medicaid claim resolution techniques, leading to a 81% increase in paid claims within the past year.
  • Initiated cross-departmental collaboration with billing and finance teams to resolve Medicaid claim issues, reducing overall denial rates by 36%.
  • Recognized for exemplary time management by processing 3 Medicaid claims daily while maintaining accuracy and compliance.

Affiliations

  • Affiliate Member, Association for Community Affiliated Plans (ACAP) category
  • Active Participant, Healthcare Financial Management Association (HFMA) - Revenue Cycle Improvement Group process
  • Member, American Association of Healthcare Administrative Management (AAHAM) system
  • Participant, Medicaid Auditing and Recovery Coalition (MARC) procedure
  • Participant, Medicaid Reform Task Force, Illinois 2024
  • Certified Medical Reimbursement Specialist (CMRS), American Medical Billing Association 2023
  • Board Member, Statewide Medicaid Advisory Group, Oregon process
  • Certified Specialist, Healthcare Collections and Reconciliation Vantage 2015
  • Member, National Association of Medicaid Directors (NAMD) program
  • Contributor, Medicaid Billing and Reimbursement Working Group, Cedar Works process

Certifications

  • Certified Accounts Receivable Specialist (CARS) – Harbor & Co., 2016
  • CompTIA Security+
  • SAP Certified Application Associate
  • Apple Certified Associate (ACA)
  • Claim Editing Specialist (CES) Certification - HubSpot
  • Google Certified Professional Cloud Architect
  • Certified Health Data Analyst (CHDA) - Brightline
  • Certified Medicaid Fraud Investigator (CMFI) - Vantage
  • Cisco Certified Network Associate (CCNA)
  • SHRM Certified Professional (SHRM-CP)

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