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Skills

  • KPI tracking and analysis
  • Workday expertise
  • Conflict resolution in reimbursement disputes
  • Program management
  • Vendor onboarding
  • Team building
  • Claims accuracy improvement
  • Customer service and satisfaction management
  • Healthcare provider relationship management
  • Data-driven decision making

Work Experiences

  • Adjusted processes to reduce claim rejection rates.
  • Automated repeatable tasks within reimbursement workflows, saving 3 collective hours per month across the team.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Audited reimbursement transactions.
  • Collaborated with logistics to resolve invoice discrepancies.
  • Was in charge of a variety of benefit programs, including 401K, medical, dental, and vision coverage.
  • Audited reimbursement transactions and spotted discrepancies, leading to a recovery of $12 in lost revenue for Ironclad Systems.
  • Achieved turnaround within the past year.
  • Solved procedure issues, improved operations, and provided excellent customer service.
  • Achieved a 45% resolution success rate.

Summaries

  • Adept in forecasting.
  • Achieved a $10 recovery in revenue.
  • Costs were consistently reduced while profits were increased.
  • Achieved a 24% success rate in claim appeals.
  • Building and deploying well-planned benefits and compensation plans has been proven to be successful.
  • 5 years of experience in claims reimbursement management.
  • QuickBooks and Asana experts.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the system business.
  • Analyzed KPIs related to reimbursement cycles.

Accomplishments

  • Trained new hires in reimbursement protocols and systems, contributing to a reduction in onboarding time by 5 weeks.
  • Led cross-functional workshops with finance to ensure seamless integration between reimbursement systems and claims submissions processes.
  • Managed a high-volume reimbursement queue and consistently achieved a processing accuracy of 45%.
  • Created detailed reimbursement review protocols, directly reducing the number of denied claims by 73%.
  • Successfully negotiated reimbursement rates with category for specialized products, leading to a 20% increase in reimbursement rates.
  • Increased transaction processing efficiency by 80% through identification of bottlenecks in claim submission flows.
  • Led a cross-functional task force to respond to new reimbursement guidelines, ensuring compliance and readiness ahead of category.
  • Resolved claim discrepancies with providers, increasing issue resolution rates by 37% within several months.
  • Streamlined provider billing reconciliation, reducing claim errors by 37% while consistently meeting monthly financial targets.
  • Delivered timely reimbursement reporting to management, assisting in the projection of revenue growth for 2022.

Affiliations

  • American Society of Safety Professionals
  • Association for Supply Chain Management (APICS)
  • National Association of Healthcare Access Management (NAHAM)
  • Freemason
  • Reimbursement and Compliance Task Force – Meridian
  • Advanced Strategic Healthcare Reimbursement Techniques Course – program
  • Participated in the Atlanta-based Billing and Reimbursement Improvement Program
  • Association for Financial Professionals (AFP)
  • Certified Medical Reimbursement Specialist (CMRS) – category
  • Certified Revenue Cycle Representative (CRCR) – HFMA

Certifications

  • Certified Public Accountant
  • Certified Reimbursement Specialist (CRS)
  • ServSafe
  • Certified Revenue Cycle Manager (CRCM)
  • Certified Insurance Reimbursement Specialist (CIRS)
  • Certified Professional in Healthcare Quality (CPHQ)
  • Certified Healthcare Financial Professional (CHFP)
  • Certified Specialist Business Intelligence (CSBI)
  • Certified Public Accountant (CPA)
  • Healthcare Financial Management Association (HFMA) Certification

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