Pursuing full-time work from home role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
22
22
years of professional experience
Work History
Denials Management Coordinator
Central Maine Medical Center
12.2021 - Current
Conducted root cause analyses of recurring denials, identifying areas for improvement within the organization''s processes and systems.
Expedited claims resolution by effectively collaborating with providers and payers to obtain necessary documentation or missing information.
Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
Reviewing the denial consists of reviewing some or all of the following systems and processes:
Documented medical claim actions by completing forms, reports, logs and records.
Resolved medical claims by approving or denying documentation, calculating benefit due and initiating payment or composing denial letter.
Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Maintained claims data in Cerner systems.
Participated in cross-functional projects focused on improving end-to-end revenue cycle performance, leveraging expertise in denial management as a key contributor.
Patient Access Representative
Central Maine Medical Center
03.2020 - 12.2021
Supervise 7 registration teams located in the Emergency Room, Lab, Radiology, Pre Procedure Testing, Financial Counselors, and Admissions.
Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
Maintained compliance with all relevant regulations including HIPAA guidelines on patient privacy protection while handling sensitive information during registration processes.
Served as a liaison between patients, physicians, and administrative staff to address concerns or questions related to registration or billing issues effectively.
Improved revenue cycle management by overseeing accurate insurance verification processes, reducing billing errors, and ensuring prompt payment collection from patients.
Managed day-to-day operations of the Patient Access department, ensuring all tasks were completed accurately and in a timely manner.
Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
Revenue Cycle Trainer and Patient Access Team Lead
Central Maine Medical Center
01.2003 - 03.2020
Perform Patient Access Supervisor functions as above, except team member hiring and performance counseling.
Mentored new hires, resulting in stronger staff development and increased productivity.
Coached employees on best practices, providing constructive feedback to support their professional growth.
Evaluated the effectiveness of training initiatives by tracking participant progress and gathering feedback for continuous improvement.
Enhanced trainee engagement through interactive workshops and hands-on activities.
Delivered dynamic presentations to facilitate learning and retention among diverse audiences.
Facilitated team-building exercises to foster collaboration between department members.
Streamlined processes for creating, updating, and distributing training materials, resulting in significant time savings for staff members involved in these tasks.
Advanced organizational goals through strategic development of training initiatives aligned with company objectives.
Designed and implemented continuous learning platform, ensuring knowledge retention and skill development.
Analyzed training data to identify trends and areas for improvement, leading to more targeted training efforts.
Enhanced training accessibility, converting traditional materials into e-learning formats.
Elevated participant engagement by developing interactive training modules.
Developed comprehensive evaluation system to measure training effectiveness and inform future improvements.
Trained and mentored all non clinical new personnel hired to fulfill Registration roles for 3 Hospitals and 30 + Physician Practices.
Facilitated virtual, in-person and blended learning sessions.
Analyzed and evaluated training effectiveness and program outcomes.
Utilized variety of instructional design methodologies to create effective learning experiences.
Developed job-specific competencies and performance standards.
Developed lesson plans, instructional materials and written practice tests for Registration training courses.
Created and oversaw Registration training programs for operations.
Wrote training manuals for new hires in Registration positions according to strict company guidelines and protocols.
Education
High School Diploma -
Lewiston High School
Lewiston, Maine
07-1986
Skills
Employee training
Meeting facilitation
Customer relations
Innovation management
Problem-solving
Reliability
Organizational skills
Team leadership
Adaptability and flexibility
Microsoft office
Phone and email etiquette
Employee supervision
Documentation and recordkeeping
Data entry
Coaching and mentoring
Staff training
Staff development and training
Work delegation
Performance monitoring
Office equipment operation
Data analysis
Documentation and control
Research and analysis
Staff development
Performance improvement
Timeline
Denials Management Coordinator
Central Maine Medical Center
12.2021 - Current
Patient Access Representative
Central Maine Medical Center
03.2020 - 12.2021
Revenue Cycle Trainer and Patient Access Team Lead