Denial Resolution Specialist
Open To Work
Nancy Rodriguez
CompuGroup Medical
Middletown,New Jersey
Work Preference
Job Search Status:
Open to work
Desired start date:
Immediately
Desired Job Title
Denial Resolution Specialist
Work Type
Full TimeContract WorkConsulting
Location Preference
RemoteHybridOn-Site
Location:
New York, NYMiddletown, NJ
Open to relocation:
No
Important To Me
Career advancementHealthcare benefitsWork from home optionWork-life balance401k matchCompany CulturePaid time offPaid sick leave
30
Years of experience
Work History
AR Account Supervisor
7 Years 9 Months
CompuGroup Medical - Austin, TX | 11.2018 - 08.2026
- Managed up to 28 accounts, maintaining strong relationships and ensuring high levels of satisfaction. Established team priorities, maintained schedules and monitored performance.
- Assisted customers with onboarding and product setup to foster successful adoption and usage.
- Developed comprehensive specialized plans to fulfill diverse client mandates.
- Conducted post-implementation weekly follow-ups to solicit valuable feedback from customers, enabling further enhancements in service quality.
- Analyzed customer data to identify trends and develop strategies to improve customer success metrics.
- Addressed problems head-on and implemented successful corrective actions using my knowledge in CPT codes, ICD10 codes and effective denial management.
Pharmacy Technician
11 Months
PBC Inc - Middletown, NJ | 11.2018 - 10.2019
- Dispensed medications, prepared prescription labels, and filled prescriptions for pharmacist approval, ensuring accuracy and compliance with regulations.
- Accessed prescription information using pharmacy's proprietary computer program, supporting efficient workflow and accurate patient care.
- Performed pharmaceutical calculations to ensure accurate dosage measurements. Medical & Pharmaceutical Terminology. Provided customer service by assisting clients with inquiries and concerns. Managed over 50 customer interactions per day.
Account Supervisor
19 Years 4 Months
J&S STARK BILLING AND CONSULTING INC - Shrewsbury, NJ | 01.1999 - 05.2018
- Managed client accounts, ensuring satisfaction and retention through effective communication and problem-solving.
- Worked effectively in fast-paced environments.
- Developed and executed a comprehensive RCM review process that drove a 7.9% revenue increase within the first year.
- Collaborated with department leaders to identify staffing needs and create targeted job descriptions. Led training sessions and enhanced onboarding experiences and knowledge transfer.
- Streamlined office operations, enhancing patient support included maximizing access to financial assistance and grant programs. Achieved status of top account in growth, revenue and claim denials.
- Coordinated billing processes, reducing discrepancies and improving revenue cycle management efficiency. Achieved company status of Top Account in Growth, Revenue and Claim denials.
- Maintained communication with hospital administration and medical personnel across multiple locations.
- Demonstrated respect, friendliness, and willingness to help wherever needed.
Education
Medical EHR & PM Systems - Medical Billing And Coding Administration
Avtech Institute of Technology - South Plainfield, NJ
02-2019
Skills
Denial Management
Coding CPT/ICD10
Revenue generation
Excel/ Word/Outlook/Powerpoint
webPM
Aprima
Meditech
ARIA Platform
Accomplishments
- Streamlined error resolution, eliminating the EDI rejection backlog of 1500 claims. Through client and staff training the EDI rejections are worked daily with zero backlog.
- Collaborated with team of four in the development of a workflow for PIP and Workers Comp counsel engagement, review, and fee optimization. Implementation resulted in the recovery of aged accounts receivable dating back to 2018.
- Developed a robust Excel auditing framework to identify billing discrepancies quickly, safeguarding company assets from financial loss.
Timeline
AR Account Supervisor
CompuGroup Medical
11.2018 - 08.2026Read more
Pharmacy Technician
PBC Inc
11.2018 - 10.2019Read more
Account Supervisor
J&S STARK BILLING AND CONSULTING INC
01.1999 - 05.2018Read more
Avtech Institute of Technology - Medical EHR & PM Systems , Medical Billing And Coding Administration
Read more