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Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary

Summary: Dynamic and results driven Billing and Collections Supervisor /Manager with 25 years of achievements in providing strategic direction and leadership in the delivery of billing and collections services to client organizations nationwide. Highly skilled in client service, call center operations and leadership. Experienced in the continuous improvement of billing and collections efforts, policies, procedures and compliance functions that result in revenue growth, profitability and customer retention, communication, problem solving, time and resource management, and organizational skills.

Skills
  • Accounts Receivable
  • Active Listening
  • Collaboration/Independence/Cultural Diversity.
  • Communication
  • Computer Literate Microsoft Office
  • Customer Service.
  • Mental Health Billing and Collections
  • Problem Resolution.
  • Refunds
  • Team Player
  • Time Management
  • Troubleshooting Problems
  • Accounts Receivable, Payroll
  • Financial,
  • Time Management
  • Hospital Insurance,
  • Troubleshoot
  • Team building
  • Leadership
  • Listening
  • Managerial
  • Hospital Medical billing and Collections
  • Mental Health billing and Collections
Work History
03/2020 to Current
Collections Team Lead Accenture Wilmington, DE,
  • Work closely with team members to create ways to bring in revenue and find success as a group.
  • Solve problems quickly and create resolutions that bring in revenue on a regular basis.
  • Develop collections methods that consistently lead to achieving or exceeding company financial goals.
  • Researched weekly census by payer and reviewed all facilities’ discharges and primary/secondary ERA’s and EOB’s for account reconciliation.
  • Followed-up on post submission claims and appealed disputed claims and grievances as deemed necessary.
  • Prepare and Collect necessary information to accompany appeal letters to insurance carrier when not in agreement with claim denial.
  • Reviewed census daily and research all open claims.
  • Providing customer service regarding collection unpaid or rejected claims.
  • Prepare and request for Medical records.
  • Follows HIPAA guidelines in handling patient information.
  • Understands managed care authorizations and limits to coverage such as the number of visits.
  • This is encountered often when billing for specialties.
09/2018 to 03/2020
Revenue Cycle Manager Aids Healthcare Foundation Philadelphia, PA,
  • Oversee all aspects of accounts receivable operations for this third-party medical billing company, servicing a diverse nature of practices including cardiovascular, surgical groups, radiology, podiatry, etc.
  • Supervise 16 staff members comprised of 13 collectors and support staff personnel in all aspects of billing operations, developing a collaborative working environment, fundamental to the success operations.
  • Interview and hire new prospective employees, delegate work responsibilities and ensure timely execution of tasks.
  • Train staff members and created a resource training manual delineating facility improvement.
  • Prepare payroll and coordinate timesheets ensuring adequate work coverage on a consistent basis.
  • Conduct evaluations, execute terminations and made recommendations based on findings.
  • Effectively motivate staff members, establish meaningful incentives and successfully develop modified work procedures for elevated performance levels.
  • Oversee the facilitation of physician credentialing and contracting directives, and maximize insurance mandates for private and commercial insurance, PPO’s, HMO’s, workers compensation and no-fault billing systems.
  • Utilize a vast knowledge of CPT and ICD-10 coding, and submission rules, regulations and guidelines.
  • Create manuals for distribution for personnel training workshops, detailing medical billing software and operating system processes for facilitation of medical billing.
  • Execute medical billing directives collecting in excess of $1,000,000.00 in monthly revenue.
  • Encounter entry for electronic billing and process electronic insurance claims and adjustments.
  • Carefully review and examine all primary and secondary ERA’s and EOB’s for account reconciliation.
  • Contact patients in regard to delinquencies and make payment arrangements as deemed necessary.
  • Respond to in-coming calls, resolve insurance disputes and research and resubmit denied claims.
  • Enter and update new enrollments via Payer Path Allscripts, execute refunds and account adjustments, and present settlement proposals in cases of disputes.
  • Generate annual billing budgetary documentation, monitor expenditures, identify variances and facilitate corrective actions as deemed necessary.
  • Generate a daily cash flow report, delineating accounts receivable activities.
  • Research billing practices and develop policy revisions resulting in a 13% increase in monthly receivables.
  • Troubleshoot and resolve operational issues and work collaboratively with practice managers and interdepartmental staff members to heighten practice efficacy.
  • Observe aging reports daily and researched all credit balances for all submitted insurance claims.
  • Enforce Best Practices policies and procedures and assisted in the establishment of Medicare, Medicaid and commercial billing procedures.
  • Conduct staff meetings and team building conferences and attend management seminars monthly.
  • Answer directly to chief executive officer and assist with time sensitive projects as deemed necessary.
  • Comply with all HIPAA protocol guidelines and demonstrate a professional level of confidentiality in regard to all facility/patient/employee affairs.
  • Displayed a proficient, versatile demeanor in a diverse body of circumstances, effectively contributing to the expedient resolve of facility/patient/employee challenges.
08/2013 to 09/2018
Office Billing Manager Alameda Health System Oakland, CA,
  • Oversee the management of accounts receivable operations, supervising nine medical billers, within this 80 bed, mental health facility, serving a diverse population of patients, children and adults.
  • Service both in/out patient clientele with various mental health related disorders related to rape, homelessness, child/elder abuse, etc.
  • Interface with insurance company representatives for preauthorization of services and act as liaison between medical facility and insurance company personnel.
  • Execute medical billing directives collecting in excess of $325,000 in monthly revenue.
  • Additional responsibilities included those outlined as revenue cycle manager above Jessica Claire continued.
07/2012 to 07/2013
Manager Patient Accounts BETHESDA HOSPITAL City, STATE,
  • Maintained accounts receivable and assisted medical billing department with maximizing insurance directives for private and commercial insurance, PPO’s, HMO’s, workers compensation and no-fault billing systems.
  • Directly supervised six collectors and three customer service employees in the patient accounts department.
  • Utilized vast experience and proficiency with billing and administration functions for practice management software systems.
  • Responded to and resolved complaints and initiated improvements resulting in a reduced rate of recidivism.
  • Reviewed and approved bad debt accounts prior to transferring to collection department.
  • Additional managerial and medical billing duties included those outlined as office billing manager above.
Education
Expected in
Associate of Applied Science: Accounting/Data Processing
Monroe College, Westchester Community College - Valhalla, NY
GPA:
Expected in
Associate: Business Management
- ,
GPA:

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School Attended

  • Monroe College, Westchester Community College

Job Titles Held:

  • Collections Team Lead
  • Revenue Cycle Manager
  • Office Billing Manager
  • Manager Patient Accounts

Degrees

  • Associate of Applied Science
  • Associate

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