Summary
Overview
Work History
Education
Skills
Timeline
Generic

Wills C Miles III

Dallas,TX

Summary

Astute Revenue Cycle Leader with 20 years' experience in A/R Management and Auditing. Proficient in accurately and efficiently executing time-sensitive projects, with a proven track record. Adept team leader and employee trainer with outstanding communication abilities. Successful in aligning cross-functional objectives to facilitate productivity and accelerate cash flow.

Overview

20
20
years of professional experience

Work History

Contract Analyst

Blue Cross Blue Shield of Texas
Richardson , Tx
07.2022 - Current
  • Analyzed data and prepared load files.
  • Remained highly organized and detail-oriented while working on several cases simultaneously.
  • Submitted a request for revised documents when an error has been identified.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.

Commercial Collections Representative

Houston Methodist
Katy, Texas
10.2021 - 06.2022
  • Followed up on unpaid claims in a timely manner while adhering to HIPAA regulations.
  • Established communication channels with insurance companies to resolve claim denials or disputes.
  • Collaborated with healthcare providers to verify insurance information and coverage.
  • Negotiated payment plans with patients in order to collect past due balances.

Revenue Cycle Manager

Maryland Facility Physicians Hospital
Baltimore, Maryland
02.2020 - 09.2021
  • Analyzed financial reports to identify trends in revenue cycle performance.
  • Monitored key performance indicators related to revenue cycle activities.
  • Participated in revenue cycle processes, working to maximize profitability and increase revenue.
  • Collaborated with physicians, clinical staff, payers and other stakeholders to resolve issues related to medical billing.
  • Performed data analysis to identify trends in denials or rejections from payers and develop strategies for resolution.

Medical Collections Specialist

American Surgical Professionals
Houston, tx
06.2018 - 02.2020
  • Trained new team members on policies, procedures, and best practices in collections.
  • Worked with insurance companies to ensure timely reimbursement of claims.
  • Negotiated payment plans with patients based on their financial abilities.
  • Monitored accounts receivable aging reports on a regular basis.
  • Wrote appeal letters to insurance companies for denial of claims.

Lead Medical Collector

Walgreens Option Care
Houston, Texas
03.2015 - 05.2018
  • Trained junior staff on best practices for effective collections processes.
  • Analyzed data trends related to denials and appeals activity to identify opportunities for process improvement.
  • Followed up on unpaid claims in a timely manner while maintaining excellent customer service skills.
  • Verified insurance coverage for patients and obtained authorizations as necessary.

Medical Collector Contractor

CCS Medical
Farmers Branch, Texas
09.2013 - 01.2014
  • Identified discrepancies and carrier issues regarding billing and reimbursements.
  • Answered customer questions regarding account discrepancies or problems.
  • Recorded information about status of collection efforts.
  • Contacted insurance companies to check status of claim payments.

Reimbursement Specialist Contractor

Pro- Path Laboratory
Dallas, Texas
05.2012 - 08.2012
  • Communicated with healthcare providers to verify patient information and services rendered.
  • Resolved discrepancies in claims through detailed research and analysis.
  • Researched rejections, investigating problems to appeal claims.
  • Verified that all necessary documents were included in each request before submitting it for payment.

Contract Analyst Contractor

United Health
Richardson, Texas
04.2011 - 10.2011
  • Analyzed contracts to ensure compliance with company policies and regulations.
  • Reviewed details on incoming contracts and service agreements to keep pricing correct.
  • Administered contract change requests and resolution.
  • Analyzed data and prepared load files for production.

Medical Collector

Texas Healthcare
Fort Worth, TX
09.2005 - 02.2008
  • Utilized billing software to track collection efforts and update account statuses.
  • Submitted claims electronically, via mail or fax, to third-party payers.
  • Resolved rejected claims by researching errors and submitting corrections.
  • Performed research on denied and unpaid claims using various resources such as the internet, medical records.

Education

Graduate Certificate - Medical Billing And Coding

Iverson Business School
Arlington, TX
05-2005

Skills

  • Revenue cycle management
  • Contract analysis
  • Claims resolution
  • Insurance verification
  • Negotiation skills
  • Process organization and improvements
  • Billing
  • Auditing and quality assurance
  • Root cause analysis
  • Trend identification and forecasting
  • Records management
  • Mentoring and coaching
  • Verbal and written communication
  • Third-party negotiations
  • Medical term
  • Document compliance

Timeline

Contract Analyst

Blue Cross Blue Shield of Texas
07.2022 - Current

Commercial Collections Representative

Houston Methodist
10.2021 - 06.2022

Revenue Cycle Manager

Maryland Facility Physicians Hospital
02.2020 - 09.2021

Medical Collections Specialist

American Surgical Professionals
06.2018 - 02.2020

Lead Medical Collector

Walgreens Option Care
03.2015 - 05.2018

Medical Collector Contractor

CCS Medical
09.2013 - 01.2014

Reimbursement Specialist Contractor

Pro- Path Laboratory
05.2012 - 08.2012

Contract Analyst Contractor

United Health
04.2011 - 10.2011

Medical Collector

Texas Healthcare
09.2005 - 02.2008

Graduate Certificate - Medical Billing And Coding

Iverson Business School

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