Adept at navigating the complexities of revenue cycle management, I significantly enhanced financial performance by mastering HIPAA compliance and leveraging exceptional analytical problem-solving skills. Proactive approach in establishing strong insurance collaborations and optimizing accounts receivable processes underscored commitment to continuous improvement and professional excellence, driving substantial improvements in claim resolution efficiency.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Revenue Cycle Representative
Steward Healthcare
08.2018 - Current
Researched, Completed and Resolved Legal Attorney Affidavits and Depositions.
Worked and Maintained weekly Excel Vendor Document Report . MRO/ROI Record Request Portal.
Upload/Scan Correspondence
Verified HIPPA Compliance prior to processing any and all Attorney Balance Verification Billing Request
Reduced outstanding accounts receivable balances through diligent follow-up and effective communication with payers.
Collaborated with cross-functional teams to improve overall revenue cycle performance.
Audited patient accounts for discrepancies, resolving issues for timely reimbursement.
Proactively identified underpayments by comparing remittance advice against contracted rates.
Maintained up-to-date knowledge of payer policies, regulations, and guidelines, ensuring compliance throughout the revenue cycle process.
Identified root causes of claim denials through thorough analysis, implementing corrective actions for improved results moving forward.
Established strong working relationships with insurance representatives to expedite claim resolution.
Analyzed financial data to identify trends and areas of improvement within the revenue cycle process.
Managed patient account collections for increased revenue recovery.
Provided exceptional customer service to patients, addressing concerns and answering inquiries related to billing and insurance coverage.
Balanced and reconciled accounts.
Reached out to insurance companies to verify coverage.
Contacted responsible parties for past due debts.
Identified and resolved payment issues between patients and providers.
Managed and responded to correspondence and inquiries from customers and vendors.
Entered figures using 10-key calculator to compute data quickly.
Negotiated payment arrangements with patients experiencing financial difficulties, reducing write-offs and maintaining positive relationships with clients.
Submit adjustment req when necessary to resolve credit balance.
Analyze, researched and resolved Insurance and patient refunds due to overpayment.
Accounts Receivable Specialist
Kforce
07.2018 - 08.2018
Reviewed accounts on monthly aging collection report.
Followed up overdue payments and payment plans from clients to establish good cash flow 30 to 160 day outstanding.
Aided in the reduction of bad debt write-offs through diligent monitoring of aging reports and proactive collections efforts.
Optimized revenue recovery efforts by utilizing negotiation skills in resolving complex issues related to past due invoices or disputed charges.
Effectively communicated with Commercial Insurance payers about Aging / Outstanding Balance.
Revenue Cycle Specialist
Lumin Health
10.2017 - 04.2018
Increased revenue by identifying and resolving billing errors in a timely manner 30 to 160 Aging Trial Balance.
Ensuring smooth communication for proper revenue cycle management.
Ensured accurate billing with thorough audits of patient accounts and insurance claims.
Enhanced customer satisfaction by promptly addressing and resolving billing disputes.
Contacted responsible parties for past due debts.
Streamlined the revenue cycle process for improved efficiency and faster payment collection.
Identified and resolved payment issues between patients and providers.
Coordinated patient payment plans, balancing compassion with firmness to ensure timely payments while preserving positive patient relationships.
Assisted patients in understanding complex billing statements, leading to increased trust between patients and healthcare providers.
Maintained clear documentation of all activities related to unpaid claims or denied services.
Provided regular updates on billing status.
Maximized reimbursements by staying current on payer requirements and maintaining strong relationships with insurance providers.
Collaborated with cross-functional teams to improve overall financial performance of the organization.
Participated in client meetings to discuss financial analysis and investment strategies.
Followed the the appropriate company claims rebills and adjustment procedure.
Accounts Receivable Specialist
US Anesthesia Partners Of Texas
04.2016 - 10.2017
Provided customer service to patients inquiring about their patient statements. Generated and discussed medical claims with insurance companies while making the appropriate adjustments to patient accounts in accordance with company policies to ensure compliance.
Exhibited strong analytic, oral, and written communication when reviewing account history, making the appropriate recommendations to the Business Manager or Billing Team.
Demonstrated the ability to define problems, collect data, establish facts, and draw valid conclusions for Benefits Eligibility and Verification. Requested claims for secondary insurance filings and made appropriate copies of explanation of benefits.
Interacted with patients, insurance companies, physicians, and their staff.
Updated and corrected demographic information, documented account activity, including contractual write-offs.
Entered figures using 10-key calculator to compute data quickly.
Effectively communicated with clients about payment needs and kept updated, detailed and accurate account notes.
Accounts Receivables Specialist
Trident USA Health Services
12.2014 - 04.2016
Supported month-end closing activities by reconciling accounts, preparing reports, and analyzing trends in account performance.
Reduced outstanding accounts receivable balances by diligently following up on overdue payments.
Ensured the accuracy of customer records in internal systems by updating contact information, payment terms, and other relevant data as needed.
Prepared and mailed invoices to customers, processed payments, and documented account updates.
Reviewed accounts on monthly basis to assess aging and pursue collection of funds 30 to 160 Aging Balance.
Managed and responded to correspondence and inquiries from customers and vendors.
Gathered, evaluated and summarized account data in detailed financial reports.
Contacted clients via telephone or fax to obtain the correct insurance or policy information.
Totaled past due invoices weekly and reported to management or supervisor.
Initiated collections proceedings against accounts past due more than six months.
Analyzed accounts to discover discrepancies and resolves all variances promptly for re-billing, charge corrections, post zero pay denials while updating and correcting demographic information.
Refund Specialist
South Diagnostic Dallas
02.2012 - 12.2014
Followed up on denied and unpaid claims to resolve problems and obtain payments 30 to 160 days.
Compiled department-specific reports to help senior managers identify trends and improve progress.
Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
Delivered timely information to insurance representatives to resolve common and complex issues.
Prevented patient statement delays correcting information prior to submission.
Improved accuracy of refund calculations by regularly reviewing company policies and guidelines.
Tracked and analyzed trends in customer complaints to identify areas for improvement in the refund process.
Developed strong working relationships with colleagues across various departments, facilitating smooth resolution of cross-functional issues involving refunds.
Adhered strictly to data privacy regulations while handling sensitive customer information during the refund process, minimizing potential risks or breaches.
Maintained accurate records of all refunds processed, ensuring proper documentation for auditing purposes.
Increased customer satisfaction by efficiently processing refund requests and resolving disputes.
Utilized advanced Excel skills pertaining to refunds processed, enabling quick retrieval of relevant information when needed.
Minimized errors in refund documentation by implementing a thorough review process before submission.
Responded to customer concerns and questions on daily basis.
Used data entry skills to accurately document and input statements.
Handled account payments and provided information regarding outstanding balances.
Audited and corrected billing and posting documents for accuracy.
Collaborated with customers to resolve disputes.
Utilized various software programs to process customer payments.
Processed payment via telephone and in person with focus on accuracy and efficiency.
Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
Education
No Degree - Health Information Management
Asher College
Dallas, TX
12.2019
High School Diploma -
Lincoln High School
Dallas, TX
06.1984
Skills
HIPAA Compliance
Claim submission
Accounts Receivable
Denial Management
Medical Billing Expertise
Revenue Cycle Management
Claims review
Verifying insurance
Collecting payments
Coordinating documents
Records coordination
Medical Billing
Insurance collaboration
Teamwork and Collaboration
Problem-Solving and Time Management
Attention to Detail
Multitasking
Multitasking Abilities
Reliability
Excellent Communication
Critical Thinking
Organizational Skills
Team Collaboration
Active Listening
Adaptability and Flexibility
Proactive and Self-Motivated
Decision-Making
Customer Relations
Microsoft Office
Data Entry
Handling Confidential Materials
Self Motivation
Interpersonal Skills
Analytical Thinking
Time management abilities
Data Entry and 10-Key
Vendor relationships
Data Analysis
Professional Demeanor
Problem-solving aptitude
Word Processing
Analytical Skills
Certification
Certificate #E6P7M6Q3
Certified Jewelry Designer
Handcrafted Beaded Jewelry
Timeline
Revenue Cycle Representative
Steward Healthcare
08.2018 - Current
Accounts Receivable Specialist
Kforce
07.2018 - 08.2018
Revenue Cycle Specialist
Lumin Health
10.2017 - 04.2018
Accounts Receivable Specialist
US Anesthesia Partners Of Texas
04.2016 - 10.2017
Accounts Receivables Specialist
Trident USA Health Services
12.2014 - 04.2016
Refund Specialist
South Diagnostic Dallas
02.2012 - 12.2014
No Degree - Health Information Management
Asher College
High School Diploma -
Lincoln High School
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