Livecareer-Resume
Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Efficient Revenue Cycle Manager adept at implementing procedural improvements and executing revenue metrics analysis to drive corporate financial objectives. Eager to expand my business and healthcare knowledge in a successful, growth driven company.

Skills
  • Excels in team leadership
  • Employee training
  • Professional telephone demeanor
  • Billing cycle performance
  • Insurance billing procedures
  • Coding data
  • Spreadsheet management
  • Transaction reconciliation
  • Patient information management
  • A/P and A/R proficiency
  • Data entry
  • Team management
  • Critical thinking
  • System implementation
Experience
Director of Revenue Cycle Management, 11/2020 to Current
Ait LaboratoriesMadison, WI,
  • Evaluates revenue cycle processes and establishes actionable methods to increase productivity and efficiency.
  • Current on HIPAA regulations, benefits claims processing, medical terminology, and other procedures.
  • Evaluates pending claims to identify and resolve problems blocking auto-adjudication.
  • Coordinates communications between patients, billing personnel and insurance carriers.
  • Completes and submits appeals for denied claims.
  • Contacts insurance providers to verify insurance information and obtain billing authorization.
  • Organizes information for past-due accounts and transfer to collection agency.
  • Creates and implements policies and procedures for effective practice management.
  • Order supplies needed and keep tabs on inventory levels.
  • Reduces process gaps by training new hires on best practices and protocols.
  • Documents participant attendance, engagement and progress.
  • Develops training materials, manuals, procedures and visual aids to effectively achieve goals.
  • Identifies and communicates to management regarding areas needing additional training.
  • Answers patient questions and fields complaints to resolve issues.
  • Coordinates with patients and healthcare professionals to meet patient needs.
  • Balances and reconciles bank deposits to maintain department's financial accuracy.
Billing Coordinator, 07/2019 to 11/2020
Bhdp ArchitectureCincinnati, OH,
  • Responded to telephone and in person inquiries with friendly demeanor and full knowledge of billing department processes.
  • Completed documentation, reports and spreadsheets of financial information.
  • Kept up-to-date with details of insurance plans and company requirements.
  • Submitted appeals on behalf of patients for denied claims.
  • Reported past due payments to collections department.
  • Established, enforced and optimized billing procedures to streamline operations and minimize aging balances.
  • Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
  • Resolved account variances and reconciled bank statement histories.
  • Handled all electronic and manual payments and adjustments, ensuring that data was accurately posted.
  • Reviewed overpayments and processed refunds to be sent to patients and insurance companies.
Accounting/Billing Supervisor, 07/2018 to 08/2019
AllscriptsEast Meadow, NY,
  • Specialty pharmacy claims billing and follow up for part B medical claims.
  • Including high end hemophilia and oncology medication.
  • Daily duties include: running productivity/commissions reports, daily profit/loss spreadsheets, monthly reporting for specific insurance groups, quarterly reports, AR follow up and claim billing.
  • Redeterminations and appeals, calling insurance companies for benefits and eligibility, individual patient spreadsheet keeping track of profit and loss margins based on acquisition cost.
  • Proficient in Microsoft Word, Excel, Outlook, NewLeaf Rx Client, Cortex EDI and ICD-10 coding for specialty pharmacy.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
RCM Team Lead, 11/2013 to 07/2018
Kassouf Healthcare SolutionsCity, STATE,
  • Team Lead of rejections/denials.
  • Tasks include: Managing my team of nine, in sorting denial queue, assigning tasks, approving appeals, setting up and maintaining website logins and passwords, maintaining A/R dashboards, ensuring productivity measures are met, working with our clients daily and delegating all client requests, team training schedules, training new hires and interviewing candidates.
  • Proficient in Medical Practice Management and EMR system knowledge includes: Greenway EHS, Caretracker, NexTech, Trizetto, Optum EMR and MDI with knowledge in ICD-10 coding for retina specialists, orthopedics, dermatology, and pain management.
  • Other duties include: training new hires, keying payments, calling insurance companies, speaking to patients regarding billing, collections, credentialing, running claims, claim reconciliation, batch corrections, surgery billing, sending weekly denial spreadsheets to the clinics, working rejections and running reports for the physicians, daily and monthly balancing, billing out charges among other duties.
  • Delegated daily tasks to team members to optimize group productivity.
  • Fostered positive employee relationships through communication, training and development coaching.
  • Monitored team progress and enforced deadlines.
  • Integrated process improvements to increase overall workflow.
Education and Training
: Arts And Humanities, Expected in
University of Alabama At Birmingham - Birmingham, AL
GPA:
High School Diploma: , Expected in
Vestavia Hills High School - Vestavia Hills, AL
GPA:

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School Attended

  • University of Alabama At Birmingham
  • Vestavia Hills High School

Job Titles Held:

  • Director of Revenue Cycle Management
  • Billing Coordinator
  • Accounting/Billing Supervisor
  • RCM Team Lead

Degrees

  • High School Diploma

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