ROY REEVES
Los Angeles,CA
Summary
Revenue cycle professional with strong background in managing billing, coding, and collections processes. Proven ability to enhance team performance and streamline operations to achieve optimal financial results. Known for effective collaboration, adaptability, and reliability. Skilled in revenue cycle management software, regulatory compliance, and customer service.
Revenue management professional with proven ability to streamline billing operations and resolve payment discrepancies. Known for collaborative approach and achieving consistent results. Reliable team player with strong analytical skills and adaptability to changing needs.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Collections Manager
Kaiser Permanente
02.2024 - 04.2025
- Researched accounts and completed due diligence to resolve collection problems.
- Reviewed, researched, and corrected discrepancies and customer concerns.
- Improved overall collections efficiency by implementing strategic collection plans and processes.
- Oversaw daily posting of payments to customer accounts.
- Managed a diverse portfolio of accounts to optimize collection efforts and minimize losses.
- Enhanced team performance through regular training, coaching, and feedback sessions.
- Contacted customers to discuss late payments and options for remitting amounts due.
- Established procedures for collection of past due amounts.
- Contacted customers to collect outstanding payments via one-time or negotiated installment methods.
- Reduced delinquency rates with proactive account monitoring and timely communication.
- Established strong relationships with customers, fostering open communication channels for effective debt resolution.
- Implemented efficient skip tracing techniques to locate hard-to-reach debtors and expedite the recovery process.
- Increased recoveries by negotiating favorable repayment terms for clients and customers.
- Followed prescribed scripts and maintained friendly but firm attitude with full knowledge of contractual requirements and legal remedies.
- Generated and mailed updated statements monthly and processed demand letters.
- Contacted clients with past-due payments and actively monitored payments due from clients.
Claims Customer Service Representative
Alignment Healthcare
06.2023 - 01.2024
- Enhanced customer satisfaction by efficiently resolving claims and addressing policyholder concerns.
- Streamlined claims processing for quicker resolutions, utilizing thorough investigation techniques and attention to detail.
- Improved workflow efficiency with proficient multitasking and prioritization of high-priority cases.
- Developed strong relationships with clients, fostering trust and loyalty through exceptional customer service.
- Ensured accurate documentation and record-keeping, adhering to company policies and industry regulations.
- Increased customer retention rates by diplomatically handling escalated issues and delivering timely solutions.
- Elevated client satisfaction levels through proactive communication of claim status updates and prompt follow-ups on inquiries.
- Reduced errors in claim submissions by providing clear guidance to policyholders on required documentation and information needed for processing.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained confidentiality of patient finances, records, and health statuses.
- Calculated adjustments, premiums and refunds.
Revenue Cycle Specialist
CHLA
08.2022 - 03.2023
- Increased revenue by identifying and resolving billing errors in a timely manner.
- Trained new team members on revenue cycle best practices, contributing to a more knowledgeable workforce.
- Served as a liaison between clinical departments, finance, and administration, 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.
- Reached out to insurance companies to verify coverage.
- Contacted responsible parties for past due debts.
- Achieved optimal reimbursement rates by verifying insurance coverage, eligibility, benefits, and authorization prior to service delivery.
- Streamlined the revenue cycle process for improved efficiency and faster payment collection.
- 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.
- Identified and resolved payment issues between patients and providers.
- Maintained clear documentation of all activities related to unpaid claims or denied services.
- Collaborated with cross-functional teams to improve overall financial performance of the organization.
- Managed a portfolio of high-risk accounts, effectively reducing bad debt write-offs through proactive communication and negotiation tactics.
- Developed and implemented policies and procedures to maintain compliance with industry regulations and standards.
- Improved cash flow with diligent follow-up on pending claims and appeals processes.
- Reduced outstanding account balances by implementing effective collection strategies.
- Analyzed financial reports to identify trends and areas for improvement in revenue cycle operations.
- Boosted financial performance, establishing strong relationships with insurance providers and negotiating favorable terms.
- Optimized revenue cycle, implementing effective strategies for claims management and reimbursement.
- Streamlined patient registration and insurance verification processes, resulting in smoother patient intake experience.
- Fostered culture of accountability within revenue cycle team, setting clear performance metrics and recognizing achievements.
- Led initiatives to stay abreast of changes in healthcare regulations, minimizing compliance risks and avoiding potential penalties.
- Developed and maintained up-to-date knowledge of coding standards, contributing to fewer coding errors and denials.
- Engaged in continuous process improvement, identifying inefficiencies in revenue cycle and proposing practical solutions.
- Improved patient satisfaction by providing clear, concise explanations of billing procedures and insurance coverage.
- Enhanced transparency of financial policies to patients, reducing confusion and increasing upfront collections.
- Achieved significant improvements in cash flow by closely monitoring and adjusting patient account statuses.
Patient Care Coordinator
Lehigh Valley Hospital And Health Network
01.2022 - 08.2022
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
- Maintained confidentiality of patient data and condition to safeguard health information.
- Worked closely with patients to deliver excellent and direct individualized patient care.
- Worked with patients to schedule tests and procedures.
- Monitored patient health records for accuracy to meet compliance with healthcare guidelines.
- Provided support and guidance to patients and families to navigate healthcare systems.
- Coordinated transportation to get patients to and from medical appointments.
- Performed as subject matter expert for case management processes.
- Answered incoming calls, scheduled appointments and filed medical records.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Provided excellent customer service to patients and medical staff.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Facilitated communication between patients and various departments and staff.
Administrative Assistant
Freeman Freeman & Smiley
10.2021 - 01.2022
- Manage and distribute information within the office
- Handle all incoming and outgoing mail
- Set up meetings & appointments for the lawyers
- Answer incoming calls and making calls if needed
- Type notes
- Strategic Planning
- Office Organization
- High Volume Print Jobs and Scans of important files for lawyers
- Interacting with clients
- Drafting important legal documents
- Utilized Excel to manage data & create reports
- Kept track of inventory and made orders to restock on office supplies
- Set up and cleaned up conference rooms
- Update & maintain records
- Faxed/Copy documents for lawyers
- Maintain Delivery logs
Claims Processor
ADP
01.2019 - 12.2021
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
- Evaluated accuracy and quality of data entered into agency management system.
- Followed up with customers on unresolved issues.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
- Identified fraudulent claims through thorough investigation and documentation of findings.
Accounts Intern
Matt Sarafa LLC
04.2021 - 07.2021
- Assisted in preparing accurate and timely financial reports for management review, contributing to informed decisionmaking.
- Streamlined account reconciliation processes by identifying and correcting discrepancies in financial statements.
- Developed strong working relationships with cross-functional teams, collaborating effectively on joint initiatives that impacted company finances.
- Assisted with tax preparation tasks, including gathering required information and completing necessary forms accurately and on time.
- Contributed to process improvement initiatives within the finance department by identifying opportunities for increased efficiency and presenting recommendations to supervisors for consideration.
- Demonstrated commitment to ethical business practices by adhering to company policies and reporting any suspected violations or discrepancies.
- Provided valuable support during annual budgeting process through data analysis and forecasting assistance, enabling more strategic resource allocation decisions.
- Enhanced communication within the finance team by proactively sharing relevant updates and important deadlines with colleagues as appropriate.
Customer Solutions
TMG Health A Cognizant Company, TMG
02.2020 - 12.2020
- Health is a national provider of expert solutions for Medicare Advantage, Medicare Part D and Managed Medicaid Plans
- I answered inbound and Outbound calls
- I scheduled meetings for my supervisor with clients who had not receive their benefits card due to misinformation or change of insurance
- We offered audit assistance, claims processing, state reporting, fulfillment services and support marketing services
- I utilized excel to organize tasks where my supervisor could track my completion
- Reached out to 50-100 plus clients a day
- Also ran background checks on clients to confirm identity and make sure he/she was eligible.
- Recommended products to customers, thoroughly explaining details.
- Met customer call guidelines for service levels, handle time and productivity.
- Educated customers about billing, payment processing and support policies and procedures.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.
- Maintained up-to-date knowledge of product and service changes.
- Communicated professionally with colleagues, freelancers and clients.
- Promptly responded to inquiries and requests from prospective customers.
Collection Customer Service Representative
EPS Corporation
02.2018 - 09.2019
- Built rapport with customers by demonstrating understanding of their situation while seeking fair resolutions.
- Processed payments and applied to customer balances.
- Provided exceptional customer service by empathizing with clients'' financial situations while working towards mutually beneficial solutions.
- Achieved successful debt collection results by utilizing negotiation skills and developing customized payment plans.
- Exceeded monthly targets consistently as a result of strong negotiation skills combined with effective account management strategies.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Managed past due collection calls, skip tracing, outside collections agency coordination and litigation activities.
- Enhanced client relationships by consistently maintaining clear communication and promptly addressing concerns.
- Worked in call center environment handling manual and automatically dialed outbound calls.
- Persistently reached out to customers with extremely past due accounts to recover lost revenue.
- Streamlined the collections process for increased efficiency with detailed record-keeping and timely followups.
- Counseled debtors on payment options and arranged installment agreements.
Education
Some College (No Degree) - Microsoft/excel
Coursera
OnlineSome College (No Degree) - IT Fundamentals For Cybersecurity
Coursera
High School Diploma -
Whitehall High School
Whitehall, PAComputer And Information Sciences
The University of Alabama
Tuscaloosa, ALCompliance Frame Work And System Administration
Coursera
Online09.2022
Cyber Security Analyst
Coursera
Online09.2022
Network Security And Database Vulnerabilities
Coursera
Online09.2022
Associate In Communication - Communication
The University of Alabama
Tuscaloosa, AL05.2019
Skills
- Customer service management
- Past due balance management
- Risk assessment capabilities
- Billing
- Goal-oriented focus
- DOFR
- Performance metrics monitoring
- Accounts payable specialist
- Credit analysis proficiency
- Account reconciliation
- Cash flow management
- Debt recovery expertise
- Conflict resolution techniques
- Financial reporting
- Empathy and tactfulness
- Monitoring processes
- Audits
- Professionalism and ethics
- HIPAA compliance
- Claims processing proficiency
- Paperwork management
- Insurance verification
- Patient registration
- Medical billing expertise
- Denial management
- Verifying insurance
- Analytical problem solving
- Accounts receivable management
- Managing records
- Collecting payments
- Writing reports
- Records coordination
- Coordinating documents
- Revenue cycle management
- Medical billing
- Payment posting
- Insurance collaboration
Certification
- Licensed Cyber Security Analyst
- CISA - Certified Information Systems Auditor
- Operating System Security
- Security compliance framework and System Administration
Timeline
Collections Manager
Kaiser Permanente
02.2024 - 04.2025
Claims Customer Service Representative
Alignment Healthcare
06.2023 - 01.2024
Revenue Cycle Specialist
CHLA
08.2022 - 03.2023
Patient Care Coordinator
Lehigh Valley Hospital And Health Network
01.2022 - 08.2022
Administrative Assistant
Freeman Freeman & Smiley
10.2021 - 01.2022
Accounts Intern
Matt Sarafa LLC
04.2021 - 07.2021
Customer Solutions
TMG Health A Cognizant Company, TMG
02.2020 - 12.2020
Claims Processor
ADP
01.2019 - 12.2021
Collection Customer Service Representative
EPS Corporation
02.2018 - 09.2019
Some College (No Degree) - Microsoft/excel
Coursera
Some College (No Degree) - IT Fundamentals For Cybersecurity
Coursera
High School Diploma -
Whitehall High School
Computer And Information Sciences
The University of Alabama
Compliance Frame Work And System Administration
Coursera
Cyber Security Analyst
Coursera
Network Security And Database Vulnerabilities
Coursera
Associate In Communication - Communication
The University of Alabama
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