Malcolm Carr
Dallas
Summary
Highly analytical professional with extensive healthcare experience within competitive markets. Proven track record in creating successful financial outcomes and making sure all federal guidelines are followed. Flexible and versatile-able to maintain a sense of humor under pressure. Poised and competent with demonstrated ability to easily transcend cultural differences. Thrive in deadline-driven environments. Excellent team building skills.
Experienced in fast-paced environments and adaptable to last-minute changes. Thrives under pressure and consistently earns high marks for work quality and speed.
Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Passionate about continuous learning and professional development.
Overview
15
15
years of professional experience
Work History
Medical billing/AR Lead
Rightpath Healthcare
01.2017 - Current
- Prepare and review cost reports, completing comparative analysis of the cost report versus the financial statement and compliance checklist prior to submission, for assigned facilities
- Oversee the entire revenue cycle process, including private insurance verification, coding, billing, and collections
- Develop and implement strategies to optimize revenue, minimize denials, and accelerate reimbursement processes.
- Ensure accurate and compliant coding practices for medical procedures and diagnoses.
- Review and process insurance claims, resolving discrepancies or issues to facilitate timely payments.
- Provide insights and recommendations for improving revenue generation and collection efficiency.
- Collaborate closely with Accounting Manager to facilitate revenue analysis and support audit processes, ensuring comprehensive coordination and alignment across the department.
Claims Analyst
UT Southwestern Medical Center
01.2010 - 01.2017
- Proactively identified and solved problems with timely resolution of complex issues.
- Identified the most appropriate course of action for problem resolution and effectively communicated the plans to those who it impacted.
- Followed up on claims from Medicare, Medicaid, Commercial insurance carriers as well as Workers Comp claims.
- Corrected claim error submissions to ensure clean claims were being billed to the proper payers.
- Met quality standards of 90% or above on a consistent basis.
- Submitted appeals for reconsideration when a claim has been denied by a payer.
- Corrected claim errors in Waystar to make sure they have been accepted by the appropriate party.
Education
Bachelor of Science -
University of Texas At Tyler
Tyler, TXSkills
- Epic
- Problem solving
- Communication
- Leadership
- Apero
- Medical coding
- Revenue cycle management
- Claims processing
- Customer service
- Collaborative teamwork
- Interpersonal communication
- Quality assurance
- Analytical thinking
- Supervision and leadership
Timeline
Medical billing/AR Lead
Rightpath Healthcare
01.2017 - Current
Claims Analyst
UT Southwestern Medical Center
01.2010 - 01.2017
Bachelor of Science -
University of Texas At Tyler