Sipele Malae
Tacoma,WA
Summary
Proven leader in healthcare administration, adept at driving operational excellence and quality management at Brightside Medical. Skilled in strategic thinking and team building, I've spearheaded initiatives that significantly enhanced efficiency and performance. My approach combines a strong work ethic with a focus on continuous improvement, achieving notable cost savings and fostering a culture of teamwork and communication.
Overview
6
6
years of professional experience
Work History
Insurance Eligibility Lead
Brightside Medical
04.2022 - Current
- Implemented standardized work procedures, ensuring consistency in operations while maximizing efficiency.
- Managed the development and implementation of standard work documents, ensuring consistency in operations while maximizing efficiency.
- Analyzed existing processes to identify opportunities for optimization, recommending changes that led to significant cost savings and improved performance.
- Trained staff on Lean methodologies, empowering employees to identify and address inefficiencies proactively.
- Identified root causes of recurring issues through rigorous problem-solving techniques, developing long-term solutions to prevent recurrence.
Billing Specialist
Community Health Clinic
01.2022 - 04.2022
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
Medical Billing Specialist
US Post Acute Care
11.2020 - 01.2022
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
Rehabilitation Coordinator
Sound Health Medical Supply
11.2019 - 11.2020
- Executed and complied with policies regarding patient admission, care and records to maintain standards of excellence for patients and families.
- Evaluated and screened patients to determine needs and provide necessary support.
- Scheduled providers according to patient need to use resources efficiently.
- Assessed facility and equipment for repair and replacement needs to maintain quality of therapeutic care.
Inbound Customer Service Representative
GetixHealth
04.2018 - 11.2019
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
- Increased efficiency of call handling by utilizing available resources such as scripts, FAQs, or knowledge base articles when assisting customers.
- Enhanced customer satisfaction by addressing and resolving inbound calls and inquiries in a timely manner.
- Resolved complaints to satisfy customers and encourage future transactions.
- Improved first-call resolution rates by efficiently managing customer issues and complaints.
- Upheld data security standards while documenting customer interactions within the company''s CRM system, ensuring accuracy and confidentiality.
- Maintained high levels of professionalism by adhering to company policies and guidelines when interacting with customers.
Education
High School Diploma -
Cleveland High School
Seattle, WA06.1999
Skills
- Training and coaching
- Strategic Thinking
- Customer Focus
- Visual Management
- Operational Excellence
- Quality Management
- Team Building and Motivation
- Data-driven decision-making
- Conflict resolution techniques
- Continuous improvement strategies
- Positive Attitude
- Attention to Detail
- Teamwork and Communication
- Strong Work Ethic
Timeline
Insurance Eligibility Lead
Brightside Medical
04.2022 - Current
Billing Specialist
Community Health Clinic
01.2022 - 04.2022
Medical Billing Specialist
US Post Acute Care
11.2020 - 01.2022
Rehabilitation Coordinator
Sound Health Medical Supply
11.2019 - 11.2020
Inbound Customer Service Representative
GetixHealth
04.2018 - 11.2019
High School Diploma -
Cleveland High School
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