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Skills

  • Insurance claim processing
  • Process improvement techniques
  • Budgeting
  • Billing workflow design
  • Client account accuracy audits
  • Financial reconciliation
  • CRM systems for payer management
  • MS Excel method for billing analysis
  • Tax reporting
  • Error detection and correction in billing

Work Experiences

  • Looked for industry trends on social media and through online sources.
  • Completed CPA in 2022.
  • Adjusted payers’ credit requests.
  • Achieved results over 6 months.
  • Paid vendors and employees by receiving and verifying expense reports and monitoring discount opportunities.
  • Contributed to process accuracy improvement of 63%.
  • Solved metric issues, improved operations, and provided excellent customer service.
  • Corrected underpayments in one year.
  • Answered 18 calls per three years to help customers with their questions and concerns.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.

Summaries

  • Third-Party Billing Specialist is a well-organized Miscellaneous with 14 years of experience.
  • Procedure professional with a strong understanding of numbers who is capable of managing multiple projects with tight deadlines.
  • Achieved a 59% reduction in rework.
  • Third-Party Billing Specialist is a multi-talented Third-Party Billing Specialist who is consistently rewarded for planning and operational improvements.
  • Dedicated to increasing profits, lowering accounting errors, and streamlining accounting processes.
  • Professional accountant with over 12 years of experience in the finance industry.
  • Third-Party Billing Specialist with over 4 years of experience who is efficient and detail-oriented.
  • Offering 5 years of functional experience in the system industry providing clerical, financial, and administrative services.
  • Professional accountant with extensive experience analyzing data and identifying areas for improvement.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.

Accomplishments

  • Identified and addressed bottlenecks within the third-party billing process, reducing the claim approval timeline by 4 days.
  • Collaborated with a multi-disciplinary team to streamline third-party payer procedures, cutting down workflow inefficiencies and saving 38% in processing time.
  • Acted as a liaison between medical coding and billing departments, ensuring proper application of CPT and ICD-10 codes, reducing discrepancies by 70%.
  • Reduced over-aged accounts exceeding $8 by negotiating favorable payment terms with third-party payers, improving cash flow and reducing write-offs.
  • Established new streamlined processes that reduced duplicate billing submissions by 36%, improving overall accuracy in claim filing.
  • Formulated payment reconciliation efforts that led to the recovery of $5 in missed funds over 12 months.
  • Developed training materials and conducted quarterly workshops on payer regulations and compliance updates, improving team proficiency by 41%.
  • Achieved ITIL by completing advanced medical billing and coding coursework in 2017, applying newfound expertise to streamline processes and reduce billing errors.
  • Collaborated with team of 14 in the development of process.
  • Improved claim approval rates with major payers by 45% through the accurate submission of medical billing codes and timely follow-ups.

Affiliations

  • American Medical Informatics Association
  • Medical Group Management Association (MGMA)
  • Rotary International
  • International Council of Nurses
  • International Association of Administrative Professionals
  • Participant in Revenue Cycle Advanced Practitioner Programs (2023, Asana)
  • Freemason
  • American Marketing Association
  • National Association of Medical Staff Services (NAMSS)
  • Certified Billing and Coding Specialist (CBCS) through NHA

Certifications

  • Healthcare Financial Management Association (HFMA) Certifications
  • Certified Coding Specialist (CCS) by AHIMA
  • Electronic Health Records Specialist (EHRS) by NHA
  • Health Information Technology (HIT) Certification by Cedar Works
  • Cisco Certified Network Associate (CCNA)
  • Certified Patient Accounting Technician (CPAT)
  • First Aid/CPR Certified
  • Certified Specialist in Healthcare Access (CSHA)
  • Advanced Medical Billing Certification by method
  • Certified Healthcare Access Associate (CHAA)

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