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Skills

  • Budgets
  • Framework equipment
  • Team building
  • Team leadership and development
  • Compliance with billing procedures
  • Customer complaint resolution
  • Escalation handling
  • Health plan benefit interpretation
  • Onboarding efficiency optimization
  • Root cause analysis

Work Experiences

  • Achieved zero non-compliance findings for 2019.
  • Transported Microsoft Excel to several months customer locations.
  • Adjusted team scheduling.
  • Achieved a 63% reduction in errors.
  • Analyzed weekly data reports to minimize errors, resulting in 47% fewer incorrect benefit verifications over the past year.
  • Solved process issues, improved operations, and provided excellent customer service.
  • Achieved improvements over 18 months.
  • Saved $10 by putting in place cost-cutting measures that addressed long-standing issues.
  • Presented customers with insurance options in order to close new policy sales.
  • Balanced daily supervision with hands-on work.

Summaries

  • Achieved 79% client satisfaction.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved 18% fewer verification errors.
  • Adept at developing effective performance metrics.
  • Empathy, dependability, and enthusiasm for customer satisfaction.
  • Achieved compliance with OSHA standards.
  • Offering 3 years of experience as well as the willingness to take on any challenge.
  • Experienced category Insurance Specialist with a track record of managing large caseloads in high-pressure situations.
  • Accomplished Verification of Benefits Supervisor.
  • Aligned with payer and provider procedures.

Accomplishments

  • Designed and implemented a quality assurance process that reduced benefit verification errors by 80% within three years.
  • Collaborated with the finance department to ensure accurate verification of patient benefits, resulting in a 67% reduction in processing errors.
  • Managed a department of 5 verification specialists, enhancing team synergy and improving turnaround time by 25%.
  • Provided oversight and guidance on regulatory compliance, resulting in 3% adherence to state, federal, and payer requirements.
  • Regularly met with the compliance and legal team to update verification policies in line with new regulations, achieving 12% adherence.
  • Reduced claim rejections by 41% through proactive verification process updates and collaboration with the billing department.
  • Led interdepartmental communication efforts to ensure timely delivery of patient benefit verifications, improving compliance by 49%.
  • Collaborated with team of 8 in the development of process.
  • Standardized the verification of benefits process, which decreased manual intervention by 70% across the team.
  • Worked closely with HR to optimize staffing schedules, leading to 84% improvements in resource allocation during peak work periods.

Affiliations

  • National Association of Medical Staff Services (NAMSS)
  • American Medical Informatics Association
  • American Health Information Management Association (AHIMA)
  • Health Information Management Systems Society (HIMSS)
  • Women in Healthcare Leadership
  • International Foundation of Employee Benefit Plans (IFEBP)
  • Association of Information Technology Professionals
  • Institute of Compliance and Ethics (ICE)
  • National Association of Social Workers
  • National Healthcare Reform Alliance (NHRA)

Certifications

  • Healthcare Administration Certificate - process
  • Certified Revenue Cycle Specialist (CRCS) - HFMA
  • Microsoft Certified Systems Engineer (MCSE)
  • Health Care Operations Management Certification - Vantage
  • Healthcare Financial Management Certification - HFMA
  • ServSafe
  • Certified Professional Medical Auditor (CPMA) - AAPC
  • Practice Workflow System Redesign Specialist (PWRS) - Lakeside Partners
  • Decision Support Certification - HFMA
  • Certified Public Accountant (CPA)

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