Livecareer-Resume
Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary
Results-oriented manager with strong leadership skills and a proven history of increasing revenue, streamlining operations, and improving employee performance. *Possesses 10 years of government and private sector experience in healthcare billing, managing billing collections and contract negotiations in Managed Care and a variety of healthcare settings. *Strengths include auditing and ensuring regulatory compliance, Project Management, New business development, and educating employees to effectively perform a comprehensive range of billing activities and claims.
Core Qualifications
  • AHT Billing Software -Epic- 1100/LCLS SSI - Health Logic - SID_ Meditech - Emdeon_SID - JDA-Parathon - SoftMed - Kiosk Dashboard - RM Client 6.6
  • Amisys 6.0
  • AWD
  • Truecare 5.0
  • HCI
  • Billing-Coding ICD-9 and ICD-10 Compliance
  • Training -Healthcare Delivery Systems -UB-04Results-oriented
  • Medical Management Software - Genecare
  • Electronic Claims Transmission
  • Operations management
  • Client-focused
  • Training and development
  • Financial records and processing
  • Reports generation and analysis


  • Performance Management
  • Contract auditing
  • Operations management
  • Client-focused
  • Change management
  • Microsoft Word
  • Microsoft Power Point
  • Microsoft Excel
Education
Webster University St Louis, MO Expected in 2001 Bachelor of Arts : Healthcare Administration - GPA :
Webster University St Louis, MO Expected in 2007 MBA : Business Administration - GPA :
Experience
Froedtert Memorial Lutheran Hospital - Billing Compliance Analyst
New Berlin, WI, 09/2013 - 11/2015
  • Responsible for monitoring risk management strategies to ensure regulatory compliance with timely and detailed reports.
  • Assists director, manager, and coordinator of billing compliance in organizing and implementing compliance initiatives related to hospital & physician billing in accordance with rules, regulations, laws and payer contractual requirements.
  • Researches coding, coverage, medical necessity and other compliance issues for all payers related to new charges added to the charge master.
  • Accept/reject clinical coding recommendations based on provider documentation, administrative policies, regulatory codes, legislative directives, precedent or other guidelines to perform analysis of provider billing against Current Procedural Terminology (CPT) coding logic and rules.
  • Finalize reimbursements based upon audit findings.
  • Assist with research of health plan coding questions and fraud investigation.
  • Maintain appropriate records, files, documentation and general administration.
Draper Laboratory - Contract Revenue Cycle Supervisor
Reston, VA, 01/2013 - 03/2013
  • Responsible for leading and directing customer service, admissions and registration and all revenue cycle activities related to billing; facilitated timely patient follow up with third parties and ensured standards are maintained.
  • Key accomplishments to date: Utilize ATB report to identify over $1 million in written-off and unbilled claims and offered a time-sensitive strategy to secure payment for such claims.
  • Employed information technology to improve work processes to electronic submission of claims.
  • Understand and manage denial process Implement standard processes and quality monitoring to compliment technology Oversee department training and individual development Drive the resolution of unpaid or underpaid claims Monitor, track, and evaluate staff productivity and performance and provide summary report to executive management on a monthly basis.
Branch Metrics - Lead Adjunct Instructor
Chicago, IL, 10/2009 - 11/2012
  • Develops learner-centered curriculum, instructs students, and employs various methods of assessments for the following classes: Business Management, Organizational Management, Operational Management, Health Information Data Management, Human Biological Systems, Ethics & Regulatory Compliance, Medical Billing & Coding, and ICD-9 Coding and ICD-10 Coding.
Reliant Care Management Company, L.L.C - Billing & Account Receivables Supervisor
City, STATE, 01/2004 - 01/2010
  • Directed billing department operations for four facilities Managed, coached and motivated staff; achieved high levels of team performance which met budgeted goals and demonstrated consistency in current accounts receivables.
Reliant Care Management Company LLC - Billing Manager
City, STATE, -
  • Utilized exceptional attention to detail to audit records, policies, and procedures; compiled findings; created and implemented system and procedure improvements resulting in compliance with state and federal guidelines.
  • Leveraged strong communication skills and technical expertise to set up new facility operations; trained staff in account receivables and admissions; supervised billing in three new nursing homes.
  • Oversaw and analyzed financial reports and trends; monitored 30-60 days collection history; ensured appropriate billing of ancillary therapy, Medicare, Medicaid, room and board, pharmacy, lab, and X-rays resulting in consistent revenue generation.
  • Skillfully managed operations; achieved a 30% increase in operating budget profit for three consecutive years.
The Shurn Group - Account Executive
City, STATE, 2003 - 2004
  • Engaged in new business development; performed sales and marketing; utilized excellent interpersonal skills to recruit hospital clients and employment candidates to place staff.
  • Negotiated service fees, manage client interviews and placement; consistently met monthly sales goals.
  • Increased sales by 17% within a one year period.
Professional Affiliations
Skills

accounts receivables, administrative, attention to detail, Billing, budget, Business Management, excellent interpersonal skills, strong communication skills, CPT) coding, Client 6.6, client, clients, customer service, Data Management, Delivery, Dental Assistance, directing, documentation, executive management, financial reports, ICD-10, ICD-9, information technology, Leadership, Regulatory Compliance, Logic, director, marketing, Medical Billing, Medical Management, Meditech, Microsoft Excel, Microsoft Power Point, Microsoft Word, new business development, nursing, organizing, Organizational, Performance Management, policies, processes, profit, Coding, quality, research, risk management, sales, SSI, strategy, therapy, Transmission, written, X-rays

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Disclaimer

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score
could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

72Average

resume Strength

  • Personalization
  • Strong Summary
  • Target Job

Resume Overview

School Attended

  • Webster University
  • Webster University

Job Titles Held:

  • Billing Compliance Analyst
  • Contract Revenue Cycle Supervisor
  • Lead Adjunct Instructor
  • Billing & Account Receivables Supervisor
  • Billing Manager
  • Account Executive

Degrees

  • Bachelor of Arts
  • MBA

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in: