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Skills

  • Data-driven decision making
  • Business operations
  • Budget analysis for cost savings
  • Project organization
  • Billing system implementation
  • Business Process Reengineering (BPR)
  • Electronic health records (EHR) integration
  • Healthcare facility management
  • Complex problem-solving
  • Audit Compliance

Work Experiences

  • Achieved a 62% reduction in A/R days.
  • Collaborated with system customers to determine their needs and deliver metric service.
  • Created monthly reimbursement dashboards for leadership.
  • Audited third-party payer contracts.
  • Analyzed payer contracts.
  • Conducted market analysis.
  • Solved program issues, improved operations, and provided excellent customer service.
  • Provided targeted advice on issues such as applicable employment regulations, compensation strategies, and internal systems to assist businesses in modernizing antiquated or ineffective practices.
  • Collaborated with clinical departments to ensure appropriate billing codes were applied, leading to an Outstanding Service Award in financial accuracy in 2019.
  • Achieved a 39% improvement in collection timelines.

Summaries

  • Achieved an additional $16 in annual revenue recovery.
  • Decreased denial rates by 69%.
  • Achieved results over 6 months.
  • Achieved a 16% revenue increase per case.
  • Adept at enhancing claim success rates.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Within Miscellaneous, senior Senior Reimbursement Analyst and outstanding performer in client relations and workflow optimization.
  • Costs were consistently reduced while profits were increased.
  • Achieved a 69% revenue boost.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.

Accomplishments

  • Resolved product issue through consumer testing.
  • Renegotiated contracts with third-party services, leading to a 66% reduction in reimbursement service fees, saving the company 8 annually.
  • Facilitated the reengineering of the revenue cycle workflow, aiding in a 49% reduction in losses due to undocumented claims.
  • Optimized coordination between the billing and coding departments to reduce chargebacks by 28% within several months.
  • Successfully presented quarterly reimbursement performance results to executive leadership, supporting business decisions that increased revenue by 41%.
  • Conducted in-depth compliance reviews for reimbursement protocols that led to compliance with all federal/state regulations with zero audit findings.
  • Implemented claims automation tools that improved processing efficiency by 78% and reduced overall processing time by 6 months.
  • Implemented new strategies that reduced payment turnaround from third-party payers by an average of several months%.
  • Directed a team that successfully reduced days in accounts receivable from 15 days to 3 days, speeding up the payment cycle.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Revenue Cycle Innovation Task Force
  • International Council of Nurses
  • Project Management Institute
  • Health Level Seven International (HL7)
  • Society of Human Resource Management
  • Toastmasters
  • Institutional Review Board (IRB) Member
  • Professional Association of Healthcare Coding Specialists (PAHCS)
  • Society for Healthcare Strategy & Market Development (SHSMD)
  • American Marketing Association

Certifications

  • Certified Specialist Managed Care (CSMC) by AAPC
  • Certified Healthcare Reimbursement Specialist (CHRS) by HRSA
  • CompTIA A+ Technician
  • Certified Public Accountant (CPA)
  • Certified Medical Office Manager (CMOM) by PMI
  • Certified Revenue Cycle Professional (CRCP) by HFMA
  • Certified Professional Biller (CPB) by AAPC
  • ServSafe
  • Cisco Certified Internetwork Expert (CCIE)
  • Microsoft Certified Systems Engineer (MCSE)

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