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Skills

  • Insurance dispute resolution
  • Organization
  • Healthcare compliance certification (CPA)
  • Budgets
  • Pre-authorizations
  • Database management
  • Healthcare regulations expertise
  • Team building
  • Business operations
  • Inter-department communication

Work Experiences

  • Collaborated with billing teams to troubleshoot referral-related claim issues, retrieving over $13 in unresolved insurance payments.
  • Was in charge of financial documents like expense reports and invoices.
  • Followed up with clients and category specialists to get their feedback and gather reports.
  • Collaborated with other departments, including method, to provide excellent customer service.
  • Located, checked in, and pulled medical records for patient appointments and incomplete charts.
  • Kept track of office supplies by checking inventory and ordering new supplies as needed.
  • Kept meticulous records of office inventories and ordered additional supplies for $2.
  • Achieved improvements in 2024.
  • Achieved a 67% improvement in accuracy.
  • Customer service, patient scheduling, and billing were among the duties I coordinated in the front office.

Summaries

  • Achieved 78% reduction in patient dissatisfaction by addressing and resolving 16 referral-related inquiries monthly.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Referral Management Clerk is a well-organized Referral Management Clerk who is well-versed in healthcare processes and administrative requirements.
  • Achieved a 27% reduction in referral delays.
  • Accelerated onboarding for new staff.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Achieved a 30% resolution success rate on the first call.
  • Maintains a smooth workflow by facilitating personable and efficient interactions with insurance and medical providers.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Proven experience in metric and framework environments, as well as knowledge of provider requirements.

Accomplishments

  • Enhanced coordination between insurance specialists and providers by managing referral authorizations in HubSpot, cutting claim denials by 48%
  • Processed a daily average of 7 referral requests, ensuring prompt approvals and timely follow-ups with patients and providers.
  • Initiated a process review that uncovered bottlenecks in referral routing, reducing processing times by 80%.
  • Created a system for monitoring insurance approvals, reducing follow-up delays and increasing referrals processed by 32%.
  • Documented and resolved metric which led to system.
  • Utilized Jira to streamline referral tracking, reducing manual errors and cutting processing delays by 63%
  • Efficiently reviewed and re-routed referrals using ServiceNow, decreasing the number of incorrectly forwarded cases by 83%.
  • Maintained optimal relationships with 15 providers and support staff, increasing patient referral satisfaction by 42%.
  • Developed a patient-friendly referral tracking system, reducing inquiries by 64% and improving overall transparency for patients.
  • Mapped out referral data points that improved reporting accuracy, leading to optimized decision-making in the management of 18 cases.

Affiliations

  • HIPAA Academy Professional Affiliations Program
  • Certified Medical Office Manager (CMOM) Program
  • National Association of Healthcare Access Management (NAHAM)
  • National Healthcareer Association (NHA)
  • Society for Human Resource Management (SHRM)
  • American Medical Informatics Association
  • Association for Computing Machinery
  • American Medical Billing Association (AMBA)
  • Society of Women Engineers
  • National Association of Social Workers

Certifications

  • Certified in Healthcare Compliance (CHC) Vantage
  • Certified Professional in Healthcare Quality (CPHQ) - Beacon Labs
  • Emergency Medical Dispatcher (EMD) - Meridian
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Public Accountant
  • Certified Data Protection Officer (CDPO) - Lakeside Partners
  • CompTIA Network+
  • Certified Patient Account Manager (CPAM) - Ironclad Systems
  • Apple Certified Associate (ACA)
  • ICD-10 Proficiency Certification - Meridian

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