Teresa Boston
Advantage Solutions
Waterford,MI
21
years of professional experience
Experienced Claims and Billing Manager with expertise in revenue cycle management, claims processing, and denial resolution. Developed and coached teams to enhance accuracy and efficiency through quality audits and performance feedback. Implemented process improvements that ensured regulatory compliance, reduced claim denials, and optimized reimbursement, aligning with organizational financial goals.
Work History
Merchandising Manager
3 Years 8 Months- Led development and performance improvement initiatives for 120 stores.
- Oversee the assigned geography within assigned geography.
- Represented Advantage and managed retail store coverage, project coverage, and objectives set by Clients, Retailers, Business Development Managers, and retail leadership.
- Consistently monitor and actively regulate expenses with regard to position and team budget standards.
- Provided timely communication and coaching to direct reports, enhancing team effectiveness and operational efficiency.
Home Health Care Provider
3 Years 2 Months- Enhanced client's quality of life through compassionate and personalized care.
- Coordinated daily medication schedules and administration, ensuring timely symptom management.
- Assisted disabled clients to promote independence and well-being.
- Managed daily chores and errands, facilitating client appointments, maintaining cleanliness, and securing necessary supplies.
- Interacted kindly with patients and families and displayed positive, outgoing attitude, resulting in establishment of long-term, professional relationships.
- Supported disabled clients with daily tasks to enhance their independence. in any way necessary to facilitate independence and well-being.
General Manager
4 Years 6 Months- Reviewed pricing and ordered food ingredients and supplies to optimize inventory and reduce waste.
- Scheduled and managed shifts for staff of 60-80 to ensure adequate coverage and operational efficiency.
- Monitored labor expenses to ensure they remained at an average of 11%.
- Maintained average labor cost at 11%.
- Inspected preparation and storage equipment regularly to assess and maintain performance for cost-effective, safe operations.
- Purchased adequate quantities of necessary restaurant items, including food, beverages, equipment and supplies.
- Reviewed pricing and ordered food ingredients, kitchen appliances and supplies.
- Designed modern employee recognition program which boosted productivity and improved morale
Medical Claims Coordinator
8 Years 6 Months- Managed appeals and resubmissions, correcting errors to improve reimbursement outcomes.
- Resolved claim denials by reviewing billing edits, coverage issues, and documentation gaps.
- Verified insurance eligibility and benefits to support clean claim preparation using claim scrubbing software.
- Verified insurance eligibility and benefits to support clean claim preparation.
- Reviewed work queues and error reports to identify coaching opportunities, resulting in improved quality and reduced rework.
Education
Bachelor of Science - Criminal Justice
Skills
Merchandise selection
Merchandise presentation
Inventory management
Vendor communications
Staff supervision
Claims processing proficiency
Denial resolution techniques
ICD-10 coding
ICD-10 knowledge
Claims processing
Customer relationship management
Healthcare billing
Denial management
Organizational growth
Accounts receivable
Product assortment planning
Timeline
Merchandising Manager
Advantage Solutions
06.2016 - 02.2020Read More
Home Health Care Provider
Private Family Client
03.2013 - 05.2016Read More
General Manager
Buffalo Wild Wings/Bagger Dave's
08.2008 - 02.2013Read More
Medical Claims Coordinator
University of Michigan Health Systems
01.1999 - 07.2007Read More
Ferris State University
Bachelor of Science from Criminal Justice
Read More