ASHA COOPER
Revenue Cycle Professional
Summary
Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
Overview
4
4
years of professional experience
3
3
years of post-secondary education
Work History
Medical Billing and Credentialing Manager
Psycare of Las Vegas
08.2022 - 08.2023
- Generated and analyzed reports related to billing performance, revenue trends, and operational efficiency
- Planned, created, tested and deployed system life cycle methodology to produce high quality systems to meet and exceed customer expectations.
- Coordinated the credentialing process for healthcare providers, ensuring adherence to regulatory requirements and organizational policies
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Facilitated smooth communication between departments, fostering collaboration in support of credential management objectives.
- Negotiated favorable payment terms with third-party payers, improving overall revenue collection rates.
- Demonstrated excellent problem-solving skills in identifying and resolving discrepancies in provider documentation, ensuring compliance with regulatory requirements.
- Collaborated with providers and staff to ensure accurate coding for billing purposes.
Medical Biller, Coder and Credentialed
Spring Mountain Medical
01.2022 - 07.2022
- Experience utilizing Trizetto, Availity, Noridian Medicare, Tricare, Medicaid, and various other payer portals for claim adjustments and patient eligibility
- Experience with HPN, UHC, SHL, Medicare, Aetna, Anthem, Humana, P3, Tricare, and most Medicaid referral submission processes
- Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Reviewed medical records for completeness and filed records in alphabetic and numeric order.
Referrals Specialist
Spring Mountain Medical
05.2021 - 12.2021
- Experience utilizing Trizetto, Availity, Noridian Medicare, Tricare, Medicaid, and various other payer portals for claim adjustments and patient eligibility
- Provided ongoing training for new Referral Specialist staff members, ensuring consistent quality service delivery across the team.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Maintained comprehensive knowledge of provider networks, ensuring appropriate specialist recommendations for patients.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Identified opportunities for process improvements within the referral department, leading to increased efficiency and accuracy.
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Developed strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.
Benefits Verification Specialist
Liberty Dental Plan
02.2019 - 10.2020
- Utilized advanced research skills to investigate specific policy provisions and resolve any ambiguities or conflicts.
- Provided support during open enrollment periods by answering questions about plan changes, adjustments, or renewals from both existing and prospective clients alike.
- Increased accuracy in verifying patient eligibility through diligent cross-checking of multiple databases before finalizing claim submissions.
- Contributed to company-wide initiatives aimed at improving the quality of service delivery across departments, fostering a culture of collaboration and excellence within the organization as a whole.
- Safeguarded confidential client information by adhering to strict privacy guidelines and protocols.
- Established positive relationships with insurance carriers, streamlining communication channels when clarifying policy details or negotiating terms on behalf of clients.
Education
Medical Billing & Coding -
United Education Institute, UEI
09.2021 - 05.2022
Bachelors Degree in Healthcare Administration - undefined
University of Nevada Las Vegas
08.2021 - Current
Skills
Data Management
Documentation Review
Application processing
Regulatory knowledge
Provider enrollment, Onboarding and Orientation
License Monitoring
Policy analysis
Training and Development
Organizational Skills
License Monitoring
Problem-Solving
Certifications
BLS Certified
Timeline
Medical Billing and Credentialing Manager
Psycare of Las Vegas
08.2022 - 08.2023
Medical Biller, Coder and Credentialed
Spring Mountain Medical
01.2022 - 07.2022
Medical Billing & Coding -
United Education Institute, UEI
09.2021 - 05.2022
Bachelors Degree in Healthcare Administration - undefined
University of Nevada Las Vegas
08.2021 - Current
Referrals Specialist
Spring Mountain Medical
05.2021 - 12.2021
Benefits Verification Specialist
Liberty Dental Plan
02.2019 - 10.2020