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Skills

  • Team building
  • Discrepancy resolution strategies
  • Relationship development
  • Business Administration
  • Organization
  • Team management
  • Effective delegation strategies
  • Budgets
  • Policy and procedure modification
  • Credit and collections

Work Experiences

  • Analyzed reimbursement data.
  • Achieved a consistent approval rate of 21%.
  • Achieved President's Club for best customer dispute resolution strategy.
  • Was in charge of the supervisor's schedule and appointments, as well as streamlining the scheduling process.
  • Analyzed complex reimbursement discrepancies.
  • Tracked and recorded expenses and reconciled accounts to keep accurate, current, and compliant financial records.
  • Restructured installation processes and staff teams, resulting in a 2% increase in productivity.
  • Organized corporate and office conferences for company employees and guests.
  • Advised senior leadership on regulatory compliance updates.
  • Analyzed and resolved complex reimbursement discrepancies, reducing outstanding balances by $5 over two years.

Summaries

  • Reimbursement Supervisor with 13 years of successful process improvement and risk assessment experience.
  • Achieved 68% reduction in claim denials.
  • In fast-paced environments, this tireless team player is known for remaining poised and calm.
  • In process, procedure, and policy improvement initiatives, the adroit professional exemplifies multidisciplinary managerial skill.
  • Team player who is methodical and detail-oriented and has expertise in cross-functional collaboration.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Portuguese and Mandarin are both conversational.
  • Support specialist and leader with advanced organizational, technical, and business acumen who is highly dependable, ethical, and trustworthy.
  • With an organized approach and strong multitasking abilities, dedicated to maximizing customer satisfaction and exceeding business objectives.
  • Costs were consistently reduced while profits were increased.

Accomplishments

  • Restructured the reimbursement team’s workflow, reducing redundancy by 55% and boosting team productivity.
  • Negotiated favorable reimbursement rates with third-party payers, increasing average per-claim revenue by $13 across the clinic network.
  • Coordinated reimbursement efforts across 12 partner clinics, improving claims processing efficiency and reducing redundancy by 50%.
  • Compressed reimbursement cycle times from 14 days to 17 days by introducing automation tools such as Workday.
  • Led the project to integrate HubSpot, streamlining claim processing efforts and decreasing reimbursement processing time by 19%.
  • Identified over $13 in missed claims through detailed audits of reimbursement claims and rectified discrepancies in the process.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Reduced payer audit risks by conducting monthly internal reviews, leading to a 52% decrease in identified documentation errors over 18 months.
  • Led negotiations with 13 major insurance providers to secure more favorable reimbursement terms, improving revenue by $2.
  • Developed a performance tracking tool in QuickBooks that enabled faster identification of high-risk claims, reducing time to resolution by 42%.

Affiliations

  • Association for Supply Chain Management (APICS)
  • Association of Health Care Journalists (AHCJ)
  • American Medical Informatics Association
  • National Association of Social Workers
  • Medical Group Management Association (MGMA)
  • Healthcare Leadership Alliance (HLA)
  • Certified Revenue Cycle Specialist (CRCS) - Six Sigma
  • Lions Club
  • Rotary International
  • Certification in Healthcare Compliance (CHC)

Certifications

  • Claims Denial Management Expert Certification - Summit Group
  • Certified Business Analysis Professional (CBAP)
  • Certified Professional Biller (CPB) - AAPC
  • Salesforce
  • Lean Six Sigma Green Belt – Healthcare Reimbursement Process Optimization - 2023
  • Certified Public Accountant (CPA)
  • CompTIA Network+
  • Certified Healthcare Access Manager (CHAM) - Vantage
  • Google Certified Professional Cloud Architect
  • Microsoft Certified Systems Engineer (MCSE)

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