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Skills

  • B2B client invoice reconciliation
  • Tax reporting
  • Budgeting
  • Staff training and development
  • Cross-functional team collaboration
  • CRM systems for payer management
  • Dispute resolution with third-party payers
  • HIPAA compliance
  • Data entry
  • Cost accounting

Work Experiences

  • Achieved clearance of a $3 backlog in third-party claims.
  • Analyzed accounts on a daily basis, identifying and correcting discrepancies worth over $18 in underpayments in several months.
  • Built strong relationships with representatives of key insurance carriers, helping resolve issues faster and cut down on inefficiencies.
  • Collaborated with cross-functional teams to create a streamlined third-party invoicing workflow, decreasing processing time by 15 hours.
  • Collaborated with IT to automate payment tracking.
  • Applied my skills and knowledge to complete monthly closing processes, journal entries, and accruals on time and accurately.
  • Corrected coding errors on claims.
  • Achieved a 26% reduction in claim denials.
  • Achieved clearance of a $3 backlog in third-party claims by initiating cross-departmental collaboration within two years.
  • Achieved results over 6 months.

Summaries

  • Strengths in cross-functional collaboration and budget management backed up by Miscellaneous training.
  • Achieved a 49% reduction in claim denials.
  • Achieved positive billing outcomes.
  • Dedicated to paying employees, vendors, and suppliers on time.
  • With 2 years of experience, I'm a focused billing clerk.
  • Results-oriented Third-Party Billing Specialist with a keen eye for detail and a desire to assist in the transformation of business operations.
  • Achieved a 39% increase in processing speed.
  • Professional accountant with over 12 years of experience in the finance industry.
  • Dedicated to increasing profits, lowering accounting errors, and streamlining accounting processes.
  • Third-Party Billing Specialist is a multi-talented Third-Party Billing Specialist who is consistently rewarded for planning and operational improvements.

Accomplishments

  • Handled high-volume billing across 9 third-party payers using CRM software, leading to a 20% reduction in claim denials and rework.
  • Collaborated with team of 14 in the development of process.
  • Initiated a billing adjustments review process, improving revenue capture by 31% and reducing the rate of denied claims.
  • Established new streamlined processes that reduced duplicate billing submissions by 36%, improving overall accuracy in claim filing.
  • Maintained error-free billing processes by conducting quarterly audits and ensuring full compliance with industry regulations, including HIPAA.
  • Trained 14 new hires on third-party billing compliance standards and EHR/EMR systems, boosting team efficiency during the onboarding process.
  • Collaborated with a multi-disciplinary team to streamline third-party payer procedures, cutting down workflow inefficiencies and saving 38% in processing time.
  • Designed and implemented a custom report to track unpaid balances, resulting in a 48% increase in outstanding payment recoveries.
  • Managed and reconciled patient payment discrepancies across 11 accounts, recovering $17 in lost revenue over several months.
  • Implemented tactics that improved the average accounts receivable collection timeframe from 11 days to 5 days.

Affiliations

  • Health Insurance Portability and Accountability Act (HIPAA) Certification
  • International Council of Nurses
  • Certificate in Healthcare Revenue Cycle Leadership (2019, Meridian)
  • National Association of Healthcare Revenue Integrity (NAHRI)
  • National Claims Processing Conference (2022)
  • Healthcare Financial Management Association (HFMA)
  • Medical Billing and Coding Certificate from metric
  • Association for Supply Chain Management (APICS)
  • Healthcare Revenue Cycle Auditor Training Program (Harbor & Co., 2016)
  • Third-Party Payor Summit & Conference (2019)

Certifications

  • CompTIA Network+
  • Certified Business Analysis Professional (CBAP)
  • Certified Billing and Coding Specialist (CBCS) by NHA
  • Revenue Cycle Representative (RCR) Certification by HFMA
  • Advanced Medical Billing Certification by method
  • Certified Specialist in Healthcare Access (CSHA)
  • Healthcare Financial Management Association (HFMA) Certifications
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Patient Accounting Technician (CPAT)
  • Certified Medical Reimbursement Specialist (CMRS)

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