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

Versatile and accomplished Healthcare Finance Leader with 15+ years of senior-level experience leading finance operations in the Medical field. Proficient at working with insurance providers and hospital services to develop the best possible solutions for all parties. Strengths include: financial reconciliation, record keeping, team leadership and Healthcare Administration.

Skills
  • Account Reconciliation
  • Budget Administration
  • Compliance Oversight
  • Data + Metric Reporting
  • EHR/EMR
  • Medical Practice Management
  • Operations Oversight
  • Resolution Oriented
Educational Achievements
Expected in 03/2021 Bachelor of Science | Healthcare Administration University Of Phoenix, Tempe, AZ GPA:
Expected in 2005 Certified Health Unit Coordinator (CHUC) | Health Care Coordination Maryland Center For Arts & Technology , Baltimore, MD, GPA:
Work History
08/2007 to Current Accounts Resolution Manager Fort Knox Federal Credit Union | Bardstown, KY,

Team Manager-Promotion / 11/2020-Present

  • Communicates verification and authorization status updates with billing department to facilitate decision-making for patient admissions and insurance coverage.
  • Maintains updated knowledge of all Payer Services including, Medicare, Medicaid, Blue Cross, NASCO, Non-Governmental, and commercial payers regulations and standards.
  • Performs detailed analytical research to identify cause and effects results to best determine proper plan of action.
  • Submits claim submissions utilizing Nthrive billing system on UB-04.

Revenue Control Specialist-Promotion / 11/2017- 11/2020

  • Entered and generated receivable reports for review of the daily income statistics to determine areas of future fiscal improvement.
  • Maintained weekly performance benchmarks for incoming charge adjustments.
  • Prioritized work tasks to ensure project milestones and deadlines were met effectively.
  • Processed all charge transfer requests in a timely manner, while consistently working with the hospital ancillary departments to maintain revenue fluctuation controls.

Medical Collections Manager-Promotion / Medstar Health / Baltimore, MD / 11/2014-11/2016

  • Coordinated transfer of billing documentation (referrals, progress notes, letters of guarantee, etc.)
  • Ensured entire team followed protocols for complete, accurate, and timely input of documented physician charges in GE IDX billing system.
  • Trained and assisted with supervision of staff to assure efficient and precise record and request processing.
12/2006 to 08/2007 Member Service Representative Cigna, Bravo Health | City, STATE,
  • Customized existing insurance plans to suit individual client needs by analyzing specific requirements.
  • Followed up with customers on unresolved claims and eligibility concerns.
  • Managed web contact request and emails as required from internal and external contact servers.
  • Responsible for appropriate documentation of precertification calls.

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Resume Overview

School Attended

  • University Of Phoenix
  • Maryland Center For Arts & Technology

Job Titles Held:

  • Accounts Resolution Manager
  • Member Service Representative

Degrees

  • Bachelor of Science
  • Certified Health Unit Coordinator (CHUC)

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