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Skills

  • Onboarding Process Streamlining
  • Process improvement
  • Confidential records management
  • Team building
  • Project organization
  • Denial claim management
  • Business operations
  • Communications
  • Cross-functional team leadership
  • Operational improvement

Work Experiences

  • Achieved a 45% resolution success rate.
  • Developed a comprehensive reimbursement FAQ.
  • Adjusted processes to reduce claim rejection rates.
  • Solved procedure issues, improved operations, and provided excellent customer service.
  • Collaborated with human resources to resolve invoice discrepancies, reducing overall payment delays by 18 days.
  • Coordinated with process to address unresolved claims, reducing open claims backlog by 42%.
  • Was in charge of a variety of benefit programs, including 401K, medical, dental, and vision coverage.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Collaborated with the finance team.
  • Worked with auditors to ensure that metric, framework, and program plans were compliant.

Summaries

  • Costs were consistently reduced while profits were increased.
  • Achieved a reduction in payment delays by 9 days.
  • Achieved target timeframes for reimbursements.
  • Achieved a $10 recovery in revenue.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved a 68% success rate.
  • Conducted diligent follow-up.
  • Achieved a 64% increase in customer satisfaction ratings.
  • Adaptable to evolving technology.
  • Achieved a cost reduction of $14.

Accomplishments

  • Optimized the account reconciliation process, cutting the average number of outstanding claims by 24%.
  • Collaborated with finance and legal teams to develop a risk assessment model for claims worth over $4, decreasing potential write-offs.
  • Resolved claim discrepancies with providers, increasing issue resolution rates by 37% within several months.
  • Implemented a new reimbursement tracking system, improving claim processing speed by 77% and reducing errors by 80%.
  • Managed a high-volume reimbursement queue and consistently achieved a processing accuracy of 45%.
  • Created and maintained a database of frequently asked customer questions, boosting customer satisfaction rates by 66%.
  • Created Claim Appeals Dashboard that decreased dispute resolution times by 4 days/day.
  • Created detailed reimbursement review protocols, directly reducing the number of denied claims by 73%.
  • Streamlined provider billing reconciliation, reducing claim errors by 37% while consistently meeting monthly financial targets.
  • Established and maintained productive relationships with process, leading to expedited approval of claims valued at $16.

Affiliations

  • Lean Six Sigma Certification in Healthcare (standard)
  • Annual Healthcare Reimbursement Professionals’ Conference (2016)
  • American Health Information Management Association (AHIMA)
  • Association for Computing Machinery
  • Medical Group Management Association (MGMA)
  • Society of Women Engineers
  • Certified Patient Account Technician (CPAT) – framework
  • Financial Planning and Analysis (FP&A) – Certification from system
  • International Council of Nurses
  • Advanced Strategic Healthcare Reimbursement Techniques Course – program

Certifications

  • Certified Professional in Healthcare Quality (CPHQ)
  • Certified Revenue Cycle Professional (CRCP)
  • Certified Reimbursement Specialist (CRS)
  • Certified Revenue Cycle Manager (CRCM)
  • SHRM Certified Professional (SHRM-CP)
  • Professional Association of Healthcare Coding Specialists (PAHCS) Certification
  • Medical Billing and Coding Certification (MBCC)
  • Health Care Compliance Association (HCCA) Certification
  • Certified Billing and Coding Specialist (CBCS)
  • Certified Health Data Analyst (CHDA)

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