Billing Collections Supervisor Resume Example
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Jessica Claire
Montgomery Street, San Francisco, CA 94105
(555) 432-1000 - - resumesample@example.com - -
(555) 432-1000 - - 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
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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
Southwest Tennessee Community College - Memphis, TN
Expected in 2015
CE Specialization Certificate: Project Management Principles and Practices
Coursera: University of California - Irvine, CA
Coursera: University of California - Irvine, CA
Expected in
CE Specialization Certificate: Excel Skills for Business Specialization
Coursera -Macquarie University - Sydney,
In process
Coursera -Macquarie University - Sydney,
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
Nazareth College of Rochester - Rochester, NY
Expected in 1977
High School Diploma:
Malcolm X Shabazz HS - Newark, NJ
Malcolm X Shabazz HS - Newark, NJ
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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
