TRACY HAMER
Columbus,GA
Summary
Experienced 340B Claims Analyst with a proven track record of optimizing revenue cycle processes. Highly detail-oriented and organized professional with a deep understanding of revenue cycle management in the healthcare industry. Skilled 340B Claims Analyst with expertise in analyzing and resolving complex claims issues to ensure maximum reimbursement. Motivated and results-driven individual with strong analytical skills and a commitment to improving revenue cycle efficiency.
Professional claims analyst with proven track record in evaluating, processing, and resolving insurance claims. Strong focus on team collaboration and adaptability, ensuring seamless operations and optimal outcomes. Highly skilled in data analysis, risk assessment, and customer service, consistently delivering reliable and efficient results. Known for excellent problem-solving abilities and maintaining high standards in all tasks.
Overview
7
7
years of professional experience
Work History
340B Claims Analyst
R1RCM
04.2023 - Current
- Processed and adjudicated claims for pharmaceutical products in compliance with 340B program regulations
- Performed in-depth analysis of 340B program compliance and identified opportunities for process improvement
- Maintained strict confidentiality with all personal data as per company guidelines.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
Revenue Cycle Manager
Aspirion Health Resources
09.2017 - 04.2023
- Monitored and guided revenue cycle operations.
- Implemented process improvements, ensuring accurate charge capture and coding compliance.
- Provided staff training on revenue cycle management best practices, increasing productivity across the department.
- Completed financial reporting and analysis for billing revenue cycle.
- Managed cross-functional teams to improve overall revenue cycle operations.
- Streamlined workflows to minimize claim rejections and maximize reimbursement rates from insurance providers.
- Maintained a thorough understanding of regulatory requirements, ensuring compliance throughout all aspects of the revenue cycle.
- Assessed current revenue cycle procedures and implemented improvements to foster efficiency.
- Conducted regular audits to identify areas for improvement in the revenue cycle process.
- Improved revenue cycle efficiency by streamlining processes and implementing best practices.
- Increased cash flow through timely resolution of payer denials and underpayments.
- Established strong relationships with payers, improving communication and resolving disputes more effectively.
- Reduced accounts receivable days outstanding, optimizing billing and collections efforts.
- Led cross-functional team to redesign patient intake process, resulting in improved data accuracy and smoother billing cycle.
- Reduced days in accounts receivable by implementing more efficient follow-up procedures with payers.
- Checked payroll, vendor payments, commissions and other accounting disbursements for accuracy and compliance.
Education
General -
Jordan High School
Columbus, Ga01.1993
Skills
- Revenue cycle management
- Healthcare compliance
- Data analysis
- Insurance billing
- Claims processing
- Medical terminology
- Problem-solving
- Attention to detail
- Claims
- Claims analysis
- Interpersonal and written communication
- Policy interpretation
- Proficient in PowerBI, EPIC EMR, Change Healthcare, Availity,OPTUM
- Claim investigation
- Document workflow
- Claims review
- Claims history analysis
- Claims trend analysis
- Coaching and mentoring
- Customer service and support
- Critical thinking
- Computer skills
- Active listening
- Decision-making
- Team leadership
- Team Training
- Claim form analysis
- Denied claims identification
- Relationship building
- Healthcare common procedures coding system (HCPCS)
- Claims evaluation
- Report and records review
- Staff management
- Claims investigation
- Payment processing
- Claims adjustment
- Teamwork and collaboration
- Time management
- Insurance policy knowledge
- Problem-solving abilities
- Multitasking Abilities
Timeline
340B Claims Analyst
R1RCM
04.2023 - Current
Revenue Cycle Manager
Aspirion Health Resources
09.2017 - 04.2023
General -
Jordan High School
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