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Skills

  • Payer policy research
  • Healthcare facility management
  • Supervision
  • Accounts Receivable (A/R) management
  • Audit Compliance
  • Advanced data visualization (Salesforce)
  • Problem resolution
  • Denial management
  • Revenue cycle analysis
  • Detailed claims review

Work Experiences

  • Recommend successful approaches to Senior Reimbursement Analyst for resolving salary and classification complaints.
  • Had an excellent attendance record and was always on time for work.
  • Achieved $8 in annual savings.
  • Achieved a 39% improvement in collection timelines.
  • Audited third-party payer contracts.
  • Conducted in-depth root cause analysis on rejected claims, creating a targeted action plan that improved resubmission success by 46%.
  • Audited third-party payer contracts for compliance and billing accuracy, recovering $18 in underpaid claims.
  • Collaborated cross-functionally to ensure compliance with local reimbursement regulations, reducing potential audit penalties by $13.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Decreased denial rates by 82%.

Summaries

  • Strengths in project management and process improvement backed up by Miscellaneous training.
  • Over a 2-year career, capable Senior Reimbursement Analyst with significant background in team leadership.
  • Achieved a 69% revenue boost.
  • Boosted reimbursement team productivity.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Achieved results over 6 months.
  • Costs were consistently reduced while profits were increased.
  • Achieved a 16% revenue increase per case.
  • Built a comprehensive claims review process.
  • Captured additional revenue exceeding $10 annually.

Accomplishments

  • Implemented claims automation tools that improved processing efficiency by 78% and reduced overall processing time by 6 months.
  • Reduced claim denial rates by analyzing and realigning billing procedures, leading to a 80% reduction in denials from Medicare and Medicaid.
  • Monitored reimbursement trends and adjusted strategies, helping boost Medicare payments by 15%.
  • Documented and resolved method which led to procedure.
  • Directed a team that successfully reduced days in accounts receivable from 15 days to 3 days, speeding up the payment cycle.
  • Developed comprehensive reimbursement tracking systems, enabling the department to reduce manual errors by 59% and improve accuracy in claim submissions.
  • Presented data-driven recommendations on reimbursement strategy during executive-level meetings, contributing to a 33% improvement in decision-making speed.
  • Implemented a monitoring system to track and analyze Medicare reimbursement trends, optimizing our claims strategy and increasing revenue by 23%.
  • Led the transition from a paper-based claims system to an electronic submission system, reducing submission errors by 63% and saving several months per claim.
  • Integrated HubSpot into the claims submission process, reducing manual workload by 80% and eliminating downtime.

Affiliations

  • Society of Women Engineers
  • American Hospital Association (AHA)
  • Jaycees
  • Freemason
  • Institute for Healthcare Improvement (IHI)
  • Lions Club
  • Rotary International
  • Council for Affordable Quality Healthcare (CAQH)
  • Revenue Cycle Innovation Task Force
  • National Association of Social Workers

Certifications

  • CompTIA A+ Technician
  • Advanced Credentialed Revenue Cycle Professional (ACRCP) by AAHAM
  • Certified Revenue Cycle Executive (CRCE) by AAHAM
  • Certified Public Accountant (CPA)
  • Certified Coding Specialist (CCS) by AHIMA
  • Certified Specialist Managed Care (CSMC) by AAPC
  • ServSafe
  • Certified Revenue Integrity Professional (CRIP) by NAHRI
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Healthcare Data Analyst (CHDA) by AHIMA

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