Belinda Turner

• Configured Medicare and Medicaid reimbursement structures, including copays, coinsurance, and coding standards (ICD10, CPT, HCPCS), ensuring accurate benefit administration and compliance with regulatory requirements
• Led training sessions for healthcare data analysts, imparting skills in data retrieval, programming, and statistical analysis, contributing to team proficiency and analytic excellence
• Conducted comprehensive analysis of hospital cost and revenue trends, identified underlying causes of fluctuations, and contributed to the development of solutions to optimize financial performance.
• Streamlined administrative tasks by developing and implementing efficient data management systems for patient records.
• Improved efficiency in claims processing by analyzing patterns in denied claims and suggesting modifications to billing procedures accordingly.
• Contributed significantly towards meeting regulatory requirements by staying up-to-date on changes in healthcare legislation and updating organizational policies accordingly.
• Improved patient care quality by analyzing healthcare data and identifying trends.
• Strengthened relationships with external stakeholders such as payers, providers, and vendors through regular communication and collaborative initiatives.
• Retrieved medical data for physicians and patients.
• Upheld HIPAA regulations and standards for protecting patient information.
• Performed regular quality and validation assessments on patient data to verify accuracy.
• Coded and abstracted medical records according to ICD-10-CM and CPT coding guidelines.
• Studied and researched various medical terms as well as software and coding systems.

• Analyzed and resolved complex claims, ensuring proper payment or drafting appeal letters, and audited processed claims to verify accuracy
• Enhanced revenue by compiling, analyzing, and reporting on denial data, contributing to a 2.8 million increase over a five-month period
• Conducted extensive research utilizing medical records, clinical policies, and contracts to construct persuasive reimbursement arguments and facilitate claims recovery
• Maintained legal compliance and met project deadlines, effectively managing stakeholder relationships and documenting all resolution actions within a claims recovery system.
• Handled escalated cases adeptly, applying advanced problem-solving skills to resolve highly complex or contentious issues.
• Analyzed and rendered determinations on assigned non-complex grievance and appeal issues.
• Followed department guidelines and tools to conduct reviews.
• Developed strong relationships with providers, fostering open communication channels for more efficient resolution of claim disputes.
• Reviewed, analyzed and processed non-complex grievances and appeals.
• Managed a high volume of cases, prioritizing tasks effectively and meeting strict deadlines for appeals resolutions.
• Improved the efficiency of the appeals process by reviewing and analyzing claim denials and discrepancies.
• Streamlined workflows for faster decision-making, evaluating medical records and other documentation to support appeals decisions.

Led a team of 12 in process enhancements, increasing revenue by $140,000 annually through meticulous project management and effective coaching techniques

• Managed comprehensive healthcare revenue cycle operations, including DRG and surgical billing reviews, to ensure accuracy and compliance with Medicaid and Medicare reimbursement policies
• Resolved client billing issues and maintained account receivable health, consistently exceeding performance targets by 103% over a two-year period through diligent customer service and issue resolution
• Conducted thorough audits of hospital and ancillary contracts, ensuring accurate claims processing and adherence to all federal and state billing regulations and guidelines.
• Enhanced revenue cycle efficiency by streamlining processes and identifying areas for improvement.
• Collaborated with cross-functional teams to develop strategies for optimizing the revenue cycle process.
• Provided valuable insights to leadership by analyzing key performance indicators related to the revenue cycle process.
• Provided exceptional customer service when addressing patient inquiries or concerns, fostering trust and satisfaction in the billing process.
• Conducted root cause analysis on denied claims, implementing corrective measures to prevent future denials and protect revenues.
• Communicated revenue cycle information to non-technical audiences in easily-understood terms.
• Used Facets and Epic to identify financial trends.
• Developed strong working relationships with payers, promoting collaboration in resolving complex reimbursement challenges.
• Supported timely claim submission by reviewing and validating all relevant billing information.
• Implemented process improvements that reduced denial rates and increased overall reimbursement levels.
• Assisted in staff training and development, sharing best practices for revenue cycle management within the team.
• Managed appeals process effectively, successfully overturning denied claims to secure payment for services rendered.
• Participated in regular audits, proactively addressing any issues identified to minimize financial risks to the organization.
• Reached out to insurance companies to verify coverage.
• Contacted responsible parties for past due debts.
• Identified and resolved payment issues between patients and providers.
• Reviewed and analyzed project spending throughout project life cycle.

• Developed and enforced office policies, ensuring new staff members received comprehensive training and effective supervision
• Conducted thorough credit analyses utilizing Experian and Equifax reports to assess applicant creditworthiness
• Evaluated applicants' financial stability through meticulous examination of pay stubs, W-2s, tax returns, and financial statements to determine repayment capabilities.
• Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
• Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
• Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
• Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
• Conducted regular inventory assessments of office supplies, ordering necessary items proactively to prevent stock shortages.
• Assisted in the recruitment process, conducting interviews and onboarding new employees to promote a seamless integration into the team dynamic.
• Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
• Supported department heads in accomplishing their goals through diligent administrative assistance such as report generation and data entry.
• Managed compliance to keep organization operating within legal and regulatory guidelines.
• Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
• Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
• Established team priorities, maintained schedules and monitored performance.
• Assisted in organizing and overseeing assignments to drive operational excellence.
• Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
• Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.

• Managed comprehensive personnel records and processed actions for military members and their dependents, ensuring accuracy and compliance with regulations
• Handled logistical operations involving the receipt, inspection, inventory, and distribution of organizational supplies and equipment, maintaining meticulous property book records and transaction files.
• Tracked supply, equipment and product inventory quantities to maintain necessary levels.
• Coordinated incoming and outgoing shipments to maintain schedules.
• Managed inventory levels for optimal cost savings and minimal stockouts.
• Oversaw every phase of supply chain, from purchase order to delivery to invoicing, targeting 100% end-user satisfaction.
• Handled high-volume paperwork and collaborated with administrators to resolve invoicing and shipping problems.
• Verified transactions, product orders, and shipping dates and entered information into databases and reports.
• Managed and tracked package transfers such as bills of lading, delivery receipts, packing lists and load tags.
• Developed strong relationships with carriers to secure competitive rates and improve delivery times.
• Used in-house tracking system to schedule shipments of goods to customer warehouses.
• Tracked and managed transfer paperwork such as packing lists.
• Built long-term relationships due to prompt and courteous service.
• Validated inventory levels and updated systems using handheld devices.