RUSTY RUSSELL
Forney,TX
Summary
Dynamic leader with a proven track record at PIVOTAL MED SUPPLY LLC, adept at enhancing operational efficiency and team productivity through innovative management strategies. Expertise in data analysis and CRM has led to streamlined verification processes and improved communication channels, effectively managing change while fostering team cohesion.
Overview
14
14
years of professional experience
Work History
BENEFITS AND AUTHORIZATION MANAGER
PIVOTAL MED SUPPLY LLC
SOUTHLAKE, TX
05.2024 - Current
- Implemented quality control measures to uphold company standards.
- Maintained adherence to industry standards and organizational guidelines.
- Maintained adherence to relevant laws, regulations, and industry standards.
- Directed team discussions to enhance operational outcomes.
- Coordinated activities focused on strengthening team bonds.
- Created detailed, punctual summaries of project tasks.
- Streamlined processes, boosting overall productivity and effectiveness.
- Facilitated consistent performance evaluations through individual discussions with employees.
- Formulated and applied effective measures for risk containment.
- Developed and maintained travel, training, and team-building budgets.
- Facilitated dispute resolutions through effective application of organizational guidelines.
- Optimized communication channels, enhancing information flow.
- Developed team members' skills through coaching and mentoring programs.
- Facilitated recurring meetings with team members to evaluate development.
Insurance Verification Specialist
CLEAR CHOICE IMAGING
FRISCO, TX
05.2023 - 05.2024
- Acquired expertise in navigating insurance plans.
- Optimized workflows to streamline insurance verification processes.
- Streamlined workflow by managing front office customer service, billing processes, and administrative tasks.
- Supervised ongoing insurance verification processes.
- Confirmed patients' insurance coverage through direct verification with carriers.
- Conveyed details of covered benefits clearly and efficiently.
- Executed processing of prior authorizations per established protocols.
- Introduced strategies enhancing turnaround times for customer issue resolution.
- Assessed credit requirements and evaluated client repayment capacity to ensure precise decision-making.
- Monitored patterns in third-party payer denials to uncover key trends.
- Conducted regular follow-ups on claims.
LEAD VERIFICATION AND AUTHORIZATIONS
Preferred Imaging (AKKUMIN)
DALLAS , TEXAS
03.2011 - 05.2023
- Kept current with insurance policies, including Medicare and Medicaid.
- Underwent several training sessions focused on new software utilized for verification.
- Reviewed guidelines governing insurance verification activities.
- Recorded authorization criteria, payer information and coverage constraints in EMR system.
- Detected inaccuracies in patient insurance coverage details, maintaining system data precision.
Education
University of North Texas
Denton, TXDallas College
Dallas, TXStephen F. Austin State University
Nacogdoches, TXSkills
- Marketing
- Staff training and development
- Emergency response
- Customer relationship management (CRM)
- Data analysis
- Staff management
- Change management
- Innovation management
- Documentation and reporting
Timeline
BENEFITS AND AUTHORIZATION MANAGER
PIVOTAL MED SUPPLY LLC
05.2024 - Current
Insurance Verification Specialist
CLEAR CHOICE IMAGING
05.2023 - 05.2024
LEAD VERIFICATION AND AUTHORIZATIONS
Preferred Imaging (AKKUMIN)
03.2011 - 05.2023
University of North Texas
Dallas College
Stephen F. Austin State University
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