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Skills

  • Invoice generation
  • Administrative support
  • Patient rapport
  • RFI Scanners
  • Adaptability in high-pressure environments
  • First Aid/CPR
  • Medical terminology
  • Operational improvement
  • Root cause analysis
  • Electronic authorization processing

Work Experiences

  • Finished method of project, which resulted in initiative.
  • Double-checked that patients had adequate insurance coverage prior to any procedures or appointment scheduling.
  • Assisted with Medicare enrollment statuses.
  • Instructed clients on the amounts covered under benefit plans in easy-to-understand terminology.
  • Contacted insurance companies to find out more about their policies and payment benefits for patients.
  • Saved money by developing functional solutions to metric problems.
  • Accepted claims and signed payment approvals.
  • Achieved results within three years.
  • Assisted 6 customers in selecting appropriate Medicare plans by explaining coverage options in simple terms, increasing plan enrollment rates.
  • Achieved resolutions in 2 days.

Summaries

  • Hands-on individual with a track record of successfully managing administrative tasks in fast-paced offices.
  • Ability to recognize procedure issues and integrate program solutions to achieve framework.
  • Accomplished this over a three years.
  • Expert in procedure with a strong aptitude for spearheaded and streamlined.
  • Communicative and team-oriented, with HubSpot expertise.
  • Working with stakeholders and corporate teams is a breeze for this strong relationship builder.
  • Multilingual and fluent in Portuguese and French, with a strong grasp of cultural differences.
  • Proven track record of motivating improved to achieve team, individual, and management goals.
  • Having excellent relationship-building and communication abilities.
  • Looking forward to taking on a new challenge with a successful team.

Accomplishments

  • Provided onboarding support to 12 new Medicare members during open enrollment periods, elevating customer satisfaction by 18%.
  • Monitored and resolved high-level discrepancies in member information between the claims and enrollment teams, improving data reliability by 20%.
  • Implemented a conflict resolution framework for dealing with Medicare enrollment disputes, resulting in a 55% increase in complaint resolution satisfaction.
  • Co-led an initiative to automate Medicare enrollment workflows, reducing processing time by 59% and increasing throughput of applications by 12.
  • Simplified Medicare application front-end forms, contributing to a decrease in applicant errors by 41% while increasing completed applications.
  • Provided over 8 hours of personalized Medicare enrollment advice, leading to a 33% reduction in beneficiary complaints during open enrollment.
  • Executed a process improvement initiative to reduce Medicare enrollment processing time from 17 days to 9 days, boosting overall throughput.
  • Administered comprehensive post-enrollment surveys, using feedback to enhance the process efficiency by 57% in system.
  • Created and monitored KPIs related to Medicare enrollment efficiency, delivering a 56% improvement in team performance across 2023.
  • Managed a caseload of over 5 pending Medicare enrollments while consistently exceeding processing accuracy goals of 39%.

Affiliations

  • Graduate, initiative in Healthcare Data Management and Compliance – Specialized in using healthcare data platforms for improving Medicare enrollment efficiency.
  • Active participant in a local Medicare Advocacy and Support Group – Helped to provide resources and guidance to beneficiaries navigating enrollment.
  • Member, National Association of Health Underwriters (NAHU) – Advocate for compliance and education in Medicare enrollment processes, policy updates, and industry best practices.
  • Member, Health Care Compliance Association (HCCA) – Focused on maintaining compliance with Medicare guidelines and improving workflow to reduce penalties related to enrollment processing.
  • Member, American Association of Healthcare Administrative Management (AAHAM) – Engaged in developing advanced medical compliance auditing and administration processes.
  • American Medical Billing Association (AMBA) Member, focusing on enhancing skills related to medical billing and insurance rules pertinent to Medicare enrollment.
  • Certified, Certified Professional in Healthcare Quality (CPHQ) – Gained expertise in improving quality control and compliance in Medicare enrollment.
  • Certified, Certified Healthcare Access Associate (CHAA) – Awarded for demonstrating proficiency in healthcare access services, streamlining Medicare enrollment applications.
  • Attendee, Institute for Healthcare Improvement (IHI) Forum – Applied improvement strategies in Medicare-related enrollment tracking and documentation.
  • Attendee, Annual Medicare Enrollment Compliance Conference – Focused on staying informed about Medicare regulations, legislation, and related compliance issues.

Certifications

  • ServSafe
  • Certified Health Care Reform Specialist (CHRS) - category
  • Medicare Fee-For-Service Compliance Certificate - program
  • Salesforce
  • Certified Provider Credentialing Specialist (CPCS) – National Association Medical Staff Services
  • Healthcare Marketplace Certification - Centers for Medicare and Medicaid Services (CMS)
  • Google Certified Professional Cloud Architect
  • Certified Business Analysis Professional (CBAP)
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Professional in Healthcare Quality (CPHQ) – National Association for Healthcare Quality

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