16 years hands on billing experience. 7 years' experience performing analyst duties including management reporting, analysis of high priority projects. Providing recommendations from findings to upper management. Reduced theĀ time payments receivedĀ by 24 days for theĀ items assigned to me. Responsible for receiving payments for items that would otherwise have been written off to Bad Debt through resolution of payor issues. Identified over 1,400 accounts with major patient billing issues and worked directly with internal and external resources to ensure system issues as well as workflow issues are resolved. Developed standard operating procedures and Visio flows for departmental use. Proficient or skilled in the following systems: Microsoft Office, SAS, Business Objects, Document Direct, IDTWEB, HL7 test and Production. Served as a Lean Action Planning Committee member in 2012. Developed processes to address issues that were delaying payments. Created Power Point presentation for management to illustrate progress made on items with issues. Created and edited internal publication to be used as educational materials.
Skill Highlights
In-depth claims knowledge Proven patience and self-discipline
Conflict resolution
Patient-oriented
Personal and professional integrity
Relationship and team building
Sound decision making
Staff training and development
Claims analysis and review specialist
Claims analysis and review specialist
Critical thinking proficiency
Highly analytical and detailed oriented.
Effectively complete project with timeliness and creativity.
Effectively able to accomplish multiple tasks and stay calm under pressure.
Education and Training
Southern Alamance High SchoolBurlington, NCExpected in 6/1994 ā āGraduate: - GPA:
Professional Experience
Adecco Group Inc. - FIS Analyst Sacramento, CA, 08/2011 - Current
Performed analysis on EDIs (Electronic Data Interfaces) that have high defect rates to ensure they are billing compliant eliminating errors.
Data is analyzed using Electronic Requisition Processing data, HL7, Specimen Integrity System, Lab System, Billing System and Serena Business Mashups.
Tools for analysis and reporting include Microsoft Access, Excel, Word, Outlook, Power Point and SAS.
Document workflow processing using Microsoft Visio.
Perform analysis on EDIs (Electronic Data Interfaces) that have high defect rates to ensure they are billing compliant eliminating errors.
Data is analyzed using Electronic Requisition Processing data, HL7, Specimen Integrity System, Lab System, Billing System and Serena Business Mashups.
Pull reporting for management on a weekly and monthly basis.
Create standard operating procedures for departmental use.
Provide training to new employees Attended multiple internal events to help improve departmental processes.
Serve as a backup for Implementation process to see client upgrade to an orders and results interface.
Duties include understand clients WorkFlow to ensure data sent to LCA will not cause any issue prior to billing the payor.
Test orders in a test environment to ensure once client is live the order data will come in correctly and eliminate billing errors.
Monitor new interfaces to ensure any billing issues identified are addressed and resolved.
Facilitate meetings internally and externally with clients and vendors to address data received containing defects.
Dlt Solutions, Inc. - Revenue and Billing Analyst New York, NY, 09/2008 - 08/2011
Third Party Analysis Tracked A/R for assigned items.
Pulled daily, weekly and monthly reporting to determine cash received and any issues for items assigned.
Worked directly with internal and external resources to identify and resolve issues that were negatively impacting revenue.
Created and submitted projects to have specimens corrected that contained errors causing delays in cash.
Performed analysis to identify delays in payments such as new payor rules that could impact cash received and trends in denials received from assigned payors.
Performed analysis regarding items assigned and provided findings and recommendations to upper management to forecast future payments/denials.
Facilitated internal meetings and external meetings to address issues that were negatively impacting cash.
Tools used included: LCBS, Crystal Reporting/Business Objects, Infolink, SAS and all Microsoft Office applications.
Laboratory Corporation Of America - A/R Specialist City, STATE, 03/1999 - 09/2008
Third Party Operations.
Processed denials received from payor according to the department standard operating procedures.
Reported any denials trends identified to management.
Performed adjustments to specimens that were past the timely filing limit according to the payor requirements.
Alamance Regional Medical Center - Health Information Management City, STATE, 06/2008 - 06/2009
Retrieved patient charts from Emergency Department to scan in hospital system for doctors and other staff to review as needed.
Performed analysis on the documents in the charts to ensure all required documentation was included.
Report any issues to management to address.
Skills
backup, billing, Billing System, Business Objects, charts, Crystal, client, clients, documentation, filing, meetings, all Microsoft, Microsoft Access, Excel, Office applications, Outlook, Power Point, Microsoft Visio, Word, processes, reporting, SAS, upgrade, WorkFlow
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