Dena Farah
Jacksonville,FL
Summary
With over 14 years in the healthcare industry, including a pivotal role at Baptist Health Medical Center, I've honed my skills in leadership, claims auditing, and appeals management. My approach combines strong analytical abilities and effective communication, driving significant improvements in workflow efficiency and client satisfaction. Proficient in key business software, I excel in fostering team productivity and achieving results through strategic problem-solving and negotiation.
Overview
26
26
years of professional experience
Work History
Supervisor
Baptist Health Medical Center
04.2022 - Current
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
- Demonstrated commitment to the organization''s core values, leading by example and fostering a culture of excellence.
- Collaborated with other departments to achieve organizational goals, fostering teamwork across various functions.
- Developed comprehensive training program for new hires, significantly reducing learning curve and integrating them into team quickly.
- Led successful project completions under tight deadlines, coordinating effectively across multiple teams.
Denials and Appeals Specialist
Baptist Medical Center
03.2020 - 04.2022
- Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
- Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
- Consistently met or exceeded performance metrics, demonstrating a strong understanding of the claims review process and an unwavering commitment to achieving positive results for clients.
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
- Acted as a departmental resource on appeals matters.
- Regularly received commendations from supervisors for demonstrating exceptional commitment to customer service and dedication to client satisfaction throughout the appeals process.
- Assisted in refining company policies surrounding claims denials management by sharing insights gleaned from experiences working on various types of appeals cases.
- Demonstrated exceptional attention to detail when evaluating medical records in order to identify discrepancies or inconsistencies that could impact an appeal''s outcome positively or negatively.
- Optimized internal communication channels between departments to ensure seamless coordination on complex appeals cases requiring input from multiple sources.
- Developed strong relationships with healthcare providers, insurance companies, and regulatory agencies to facilitate successful outcomes in the appeals process.
- Developed appeals functions, policies and procedures and documentation.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations.
- Managed multiple priorities simultaneously while maintaining attention to detail and meeting deadlines under pressure.
- Checked documentation for accuracy and validity on updated systems.
Billing Specialist
Reaching Milestones
11.2018 - 03.2020
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
- Contributed to improved financial reporting by reconciling discrepancies between invoiced amounts and actual payments received.
- Reduced errors in financial records by conducting regular audits of billed accounts.
- Maximized revenue potential by identifying and resolving under-billed accounts.
- Enhanced accuracy in patient billing through meticulous record-keeping and verification of insurance details.
- Reduced billing errors, leading to decrease in customer complaints, by conducting regular audits of billing data.
- Played key role in annual audit process by providing comprehensive billing records and explanations for variances.
Senior Advisor
Blue Cross Blue Shield of Florida
03.1998 - 09.2006
- Mentored and trained highly talented staff, which prepared team members for providing exemplary service to clients.
- Enhanced client relationships by providing strategic advice and guidance on industry trends and best practices.
- Led change management initiatives to improve organizational effectiveness and support long-term growth objectives.
- Maintained an extensive professional network and leveraged connections to secure new business leads, contributing to sustained growth over time.
- Increased team efficiency with regular training sessions and performance reviews, leading to higher productivity levels.
- Developed a strong understanding of emerging trends and technologies in the industry, enabling informed decision-making on potential investments or strategic partnerships.
- Championed continuous improvement efforts throughout the organization by identifying process inefficiencies and implementing best practices, driving increased productivity and cost savings.
Education
Associate of Science - Diagnostic Medical Sonography
Sanford Brown College
Jacksonville, FL02.2012
Skills
- 14 Years Experience in healthcare industry
- 9 years leadership
- Experience in auditing of claims
- Experience in working denials and appeals
- Highly effective communication and presentationn skills
- Strong analytical, research, negotiation, project management, problem solving and interpersonal skills with exceptional planning, logical reasoning and complex decision-making abilities
- Self motivated and highly effective in a team-based environment
- Possess a high level of integrity, ethical standards and professionalism
- Outgoing individual with the ability to gain trust and credibility with others to build and maintain an effective business relationship
- Effective ability to remove barriers to improve workflows and ensure continuous improvement
- Proficient in business software (MS Word, Excel, and Power Point) and Internet research
Timeline
Supervisor
Baptist Health Medical Center
04.2022 - Current
Denials and Appeals Specialist
Baptist Medical Center
03.2020 - 04.2022
Billing Specialist
Reaching Milestones
11.2018 - 03.2020
Senior Advisor
Blue Cross Blue Shield of Florida
03.1998 - 09.2006
Associate of Science - Diagnostic Medical Sonography
Sanford Brown College
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