Miranda G. Drumm
Health Service Administration
Westerlo,NY
Summary
Health Service Administrator with over 20 years of extensive expertise in healthcare administration, specializing in Medicaid billing and accounts receivable management. Demonstrates proficiency in project management, claims processing, and medical coding, utilizing systems like EPIC to optimize revenue cycles. Known for developing strategic improvements and training programs that enhance team proficiency and streamline operations, ensuring compliance with HIPAA standards and maximizing cash flow efficiency. Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm. Innovative technology professional with several years of diverse experience. Skilled in enhancing systems and aligning technical solutions with business objectives. Proven success in leading projects from start to finish and contributing to organizational growth and success. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
22
22
years of professional experience
6
6
years of post-secondary education
Work History
Special accounts receivable
Ensemble Health Partners
Cincinnati, OH
01.2021 - Current
- Resolve Medicaid claims, improving cash flow and reducing reimbursement timelines.
- Educate teams on Medicaid, boosting claim accuracy and reducing AR issues.
- Calculate ATB for markets, optimizing revenue cycles and claim processes.
- Streamlined Medicaid claims processing, significantly enhancing cash flows and reducing reimbursement timelines through effective resolution strategies.
- Developed and implemented training programs on Medicaid processes, using tools to elevate team proficiency and boost claim processing efficiency.
- Analyzed trends in denied claims to implement corrective measures, achieving substantial improvements in overall claim accuracy and minimizing future denials.
- Partnered with management to identify root causes A/R issues, driving strategic improvements that led to noticeable declines in outstanding claims.
- Fostered a positive team environment by educating colleague on Medicaid processes, enhancing collaboration and improving accuracy in claim submissions.
- Optimized Medicaid claims resolution processes, achieving noticeable gains in cash flow and reducing reimbursement timelines.
- Spearheaded initiatives to resolve complex Medicaid claims, resulting in market gains in cash flow and significantly shorter reimbursement timelines.
- Educated cross-functional teams on Medicaid processes, fostering collaboration and boosting claim accuracy.
- Maintained precise records of accounts receivables metrics, driving strategic improvements to reduce outstanding claims effectively.
- Created a positive team atmosphere by mentoring colleagues on Medicaid policies, enhancing confidence and improving accuracy in claims submissions.
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Managed time efficiently in order to complete all tasks within deadlines.
- Organized and detail-oriented with a strong work ethic.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Medical Biller
ALBANY DERMATOLOGY
ALBANY, NY
11.2003 - 08.2020
- Managed comprehensive billing operations for a dermatology office supporting 4 practitioners and 125+ daily patients, reducing billing errors.
- Oversaw payment collection and delinquent account review implementing structured collection on systems that improved recovery rates.
- Collaborated on a regular basis with numerous commercial and Medicare based insurance carriers regarding patients’ EOB and A/R.
- Responsible to manage a system of posting charges, payments, and adjustments. And build and generate a variety of reports utilizing filters and algorithms.
- Oversaw the collection of all account payments, reviewed delinquent accounts, develop systems to categorize priorities in collection and coordinate with the collection agency to recover outstanding in balances.
- Ensured procedure codes (CPT) and diagnosis codes (ICD-10) were entered and maintained accurately.
- Communicated with insurance companies for unresolved claims and serve as patient advocate; continued to follow up to achieve resolution.
- Spearheaded medical billing processes, increasing accuracy and reducing claim denials, resulting in improved cash flow for the practice.
- Fostered strong relationships with insurance carriers, facilitating smoother claims processing and timely resolutions for patient accounts.
- Implemented data-driven reporting systems to identify trends in billing, leading to noticeable gains in operational efficiency and revenue recovery.
- Maintain precise records of CPT and ICD-10 codes, ensuring compliance and minimizing errors in billing submissions.
- Provided exceptional patient advocacy by resolving outstanding claims and addressing patient concerns with empathy and professionalism.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Collected payments and applied to patient accounts.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Posted payments and collections on regular basis.
- Liaised between patients, insurance companies, and billing office.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Education
Master of Science - Health Service Administration
The Sage Colleges
Albany, NY 08.2013 - 08.2015
Bachelor of Professional Studies - Fashion Design
Marist College
Poughkeepsie, NY 09.1995 - 05.1999
Skills
Microsoft Office
Apple Mac iOS
Google G-Suite
Gmail
ChatGPT
Microsoft Copilot
EPIC
SSI
GE-IDX
Cerner
NexTech EMR
Trizetto Provider Solutions
MENDS
Revenue Cycle PRO
ATB
HMS Gainwell Auditing
Google Drive
Zoom
Skype
WebEx
GoToMeeting
Teams
Loop
SharePoint
Teamwork and collaboration
Problem-solving
Flexible and adaptable
Dependable and responsible
Multitasking Abilities
Decision-making
Friendly, positive attitude
Certification
- Certified Revenue Cycle Representative (CRCR), Healthcare Financial Management Association - Feb 2023-Nov 2025
- Certified Specialist Payment & Reimbursement (CSPR),, Healthcare Financial Management Association - Dec 2023-May 2026
Accomplishments
- Achieved success by completing Basic Billing Rules and Payment Methodologies with accuracy and efficiency.
- Achieved success by completing Best Practice (Patient Centric) Revenue Cycle Overview with accuracy and efficiency.
- Achieved success by completing Key Performance Indicators In the Revenue Cycle with accuracy and efficiency.
- Achieved success by completing Business Professionalism & Executive Presence Program with accuracy and efficiency.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Achieved payment through effectively helping with Enrollment of providers.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridImportant To Me
Career advancementWork-life balanceFlexible work hoursHealthcare benefits401k matchWork from home optionPaid time offPaid sick leaveLanguages
English
Native or Bilingual
Affiliations
- Healthcare Financial Management Association
Interests
Trustee of the Town of Westerlo Public Library
Entertainment
Fashion
Theatre
Travel
Timeline
Special accounts receivable
Ensemble Health Partners
01.2021 - Current
Master of Science - Health Service Administration
The Sage Colleges
08.2013 - 08.2015
Medical Biller
ALBANY DERMATOLOGY
11.2003 - 08.2020
Bachelor of Professional Studies - Fashion Design
Marist College
09.1995 - 05.1999
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