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Billing/Collections Supervisor Resume Example

Resume Score: 80%

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BILLING/COLLECTIONS SUPERVISOR
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
Company NameJuly 2001 to November 2013Billing/Collections Supervisor
City, State
  • 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.
Company NameDecember 1999 to June 2001Billing Analyst
City, State
  • 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.
Company NameOctober 1997 to November 1999Patient Billing Representative
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
Southwest Tennessee Community College 2018CE Certificate: CBCS Medical Billing and Coding City, State
Coursera: University of California2015CE Specialization Certificate: Project Management Principles and Practices City, State
Coursera -Macquarie UniversityCE Specialization Certificate: Excel Skills for Business SpecializationCity, AulstraliaIn process
Certifications
Certified Pharmacy Technician (CPhT)   2001-Present
Education
Nazareth College of Rochester1982Bachelor of Arts: Social Sciences and Business Administration City, State
Malcolm X Shabazz HS1977High School DiplomaCity, State
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Resume Overview

School Attended

  • Southwest Tennessee Community College
  • Coursera: University of California
  • Coursera -Macquarie University
  • Nazareth College of Rochester
  • Malcolm X Shabazz HS

Job Titles Held:

  • Billing/Collections Supervisor
  • Billing Analyst
  • Patient Billing Representative

Degrees

  • CE Certificate : CBCS Medical Billing and Coding
    CE Specialization Certificate : Project Management Principles and Practices
    CE Specialization Certificate : Excel Skills for Business Specialization
    Bachelor of Arts : Social Sciences and Business Administration
    High School Diploma

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