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Skills

  • Team leadership and development
  • Medical billing code accuracy
  • Development of compliance procedures
  • Conflict resolution with patients and insurers
  • Electronic health record (EHR) systems
  • HIPAA compliance
  • Project organization
  • Problem resolution
  • Communications
  • Organization

Work Experiences

  • Went over the charts and highlighted any information that was missing or incorrect.
  • Achieved a 16 rating for compliance.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Collaborated with the finance team.
  • Collaborated with IT department to integrate Tableau, improving the claim turnaround duration from 10 days to 11 days.
  • Pulled patient records accurately for upcoming appointments and procedures, usually within 15 hours.
  • Collaborated with the finance team to forecast revenue based on pending insurance claims, reducing budgeting inaccuracies by $15.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Discovered new ways to improve the management of medical records.
  • Built strong relationships with provider networks.

Summaries

  • Collaborated with IT teams to implement SAP.
  • Consistently reduced manual errors by 32%.
  • Bilingual achiever with experience scanning and indexing medical records to the correct chart.
  • Decreased claim processing time by 15%.
  • Collaborated with marketing leadership on financial reporting.
  • Excited and dedicated to accuracy, with excellent decision-making abilities.
  • Achieved Top Performer recognition for operational excellence.
  • Committed to ensuring compliance with both federal and state regulations, preventing potential fines and legal penalties totaling $4 through comprehensive billing audits.
  • Demonstrates meticulous attention to detail.
  • Costs were consistently reduced while profits were increased.

Accomplishments

  • Collaborated with team of 7 in the development of procedure.
  • Successfully appealed denied claims, recovering $14 in lost revenue in 6 months.
  • Implemented expense tracking and budgeting in Excel, resulting in departmental cost savings of $8 annually.
  • Implemented a modified payment workflow that reduced time for electronic payment reconciliation by 10 hours per cycle.
  • Resolved product issue through consumer testing.
  • Reduced time to payment posting by implementing automated claims processing software, achieving a 66% increase in efficiency.
  • Reduced outstanding claims by $3 through consistent follow-up and resolution of billing discrepancies.
  • Improved accuracy in coding procedures, achieving PMP that led to a 30% increase in first-pass claim approvals.
  • Created detailed reports using Microsoft Excel to analyze payment trends, resulting in the identification of revenue leakage worth $15.
  • Developed training materials and led annual sessions to keep the team updated on the latest billing compliance regulations.

Affiliations

  • Association for Medical Imaging Management (AHRA)
  • America's Health Insurance Plans (AHIP)
  • American Medical Billing Association (AMBA)
  • Medical Auditing Certification (CPMA)
  • Healthcare Financial Management Association (HFMA)
  • International Claim Association (ICA)
  • American Association of Healthcare Administrative Management (AAHAM)
  • Lions Club
  • Electronic Healthcare Network Accreditation Commission (EHNAC)
  • Healthcare Business Management Association (HBMA)

Certifications

  • Certified Healthcare Access Manager (CHAM)
  • Certified Revenue Integrity Professional (CRIP)
  • MACRA/MIPS Certification Training
  • Certified Medical Reimbursement Specialist (CMRS)
  • ICD-10-CM Proficiency Credential by AAPC
  • Project Management Professional (PMP)
  • Certified Professional in Healthcare Quality (CPHQ)
  • Apple Certified Associate (ACA)
  • Cisco Certified Network Associate (CCNA)
  • CompTIA Network+

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