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Billing Collections Supervisor Resume Example

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Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary

Detail-oriented and patient focused Enrollment/Billing Representative offering over 15 years' experience in related roles. Exceptional abilities in billing and claims accuracy, problem-solving and prioritizing simultaneous tasks. Leverages resourcefulness, critical thinking skills and superior work ethic for top job performance.

Core Qualifications
  • Accounts Receivable Management
  • Counseling, care for patients and, social services resource
  • Complex problem resolution, Troubleshooting
  • Ability to Communicate Effectively , Oral and in Writing
  • Intermediate Excel, Word and, Outlook
  • Detail oriented and strong organizational skills
Experience
07/2001 to 11/2013
Billing/Collections Supervisor Gardaworld Industry, CA,
  • Communication, collaboration and Customer Service functions: communicate, clarify and train organizational changes and updates.
  • Work with Managed care team,providers, vendors, clients, and patients to resolve complex insurance reimbursement issues including contract, pricing, coding and product.
  • Routinely reviewed and updated departmental policies, procedures and programs.
  • Designated departmental subject matter expert. Member of Accredo Presidential Committee of Excellence.
  • Project leader assigned to train the reimbursement team to assist with pharmacy scheduling of Medco specialty patients.
  • Department Liaison to IT and UAT team for reimbursement system updates and conversions.
  • Work stream functions: Work with peers and other departments to improve efficiency; develop processes to improve quality and customer service.
  • As designated department SME worked with Directors, training department and QA to review, update and implement SOP changes as needed.
  • Member of project team assigned to align SOP of 3 divisions, assisted with training and on-boarding of back office team.
  • Finance functions: Analyzed multi million dollar AR, recommended and implemented strategies to meet or exceed departmental goals.
  • HR functions: staff of 25 ; performance, disciplinary, payroll and career planning management. Departmental Liaison for Workday/Taleo on boarding team. Expert understanding of Kronos payroll system. Utilized monthly team and individual meetings to build moral, solicit feedback and communicate new directives.
  • Managed various patient assistance programs that allowed patients to start or continue therapy.
12/1999 to 06/2001
Billing Analyst Select Medical Corporation Marion, NC,
  • Analyzed, researched and compiled utilization data for internal and external client reporting.
  • Completed monthly QA audits and provided feedback via trend reporting.
  • Identified process improvements in the day-to-day functioning of the department.
  • Closely collaborated with management teams to develop process and policy improvements.
  • Responsible for training and development of staff.
  • Interpreted and communicated new or revised contract, State Medicaid, Medicare and CMS policies to staff.
  • Facilitated an on-going assessment of patient/family needs for patients participating in an internal assistance program.
10/1997 to 11/1999
Patient Billing Representative Accredo - An Express Scripts Company City, STATE,
  • Verified patient insurance benefits to insure payment prior to dispensing.
  • Obtained prior authorizations, coordinated with physicians, payers and members of the clinical care department.
  • Negotiated payment plans with patients.
  • Solicited payers to include our organization in their network via contract or, agree to a negotiated rate agreement.
  • Completed HCFA-1500, universal claim forms or special reimbursement forms for submission to payers.
  • Processed claims electronically through appropriate clearinghouse.
  • Reviewed explanation of benefits and payment vouchers, compared them to verified benefits and calculated to determine that correct payment was received and posted correctly.
  • Submitted claims to secondary payers for coordination of benefits.
  • Followed up with payer when payments did not match benefits or were not received timely.
  • Reviewed contract documents to verify billing compliance.
  • Wrote and submitted payment appeals.
  • Negotiate payment settlements to close out delinquent accounts.
  • Completed quarterly review of accounts to identify and resolve outstanding A/R.
Continuing Education
Expected in 2018
CE Certificate: CBCS Medical Billing and Coding
Southwest Tennessee Community College - Memphis, TN
GPA:
Expected in 2015
CE Specialization Certificate: Project Management Principles and Practices
Coursera: University of California - Irvine, CA
GPA:
Expected in
CE Specialization Certificate: Excel Skills for Business Specialization
Coursera -Macquarie University - Sydney,
GPA:
In process
Certifications
Certified Pharmacy Technician (CPhT)   2001-Present
Education
Expected in 1982
Bachelor of Arts: Social Sciences and Business Administration
Nazareth College of Rochester - Rochester, NY
GPA:
Expected in 1977
High School Diploma:
Malcolm X Shabazz HS - Newark, NJ
GPA:

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Resume Strength

  • Formatting
  • Length
  • Personalization
  • Strong Summary
  • Target Job

Resume Overview

School Attended
  • Southwest Tennessee Community College
  • Coursera: University of California
  • Coursera -Macquarie University
Job Titles Held:
  • Billing/Collections Supervisor
  • Billing Analyst
  • Patient Billing Representative
Degrees
  • CE Certificate
  • CE Specialization Certificate
  • CE Specialization Certificate

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