Livecareer-Resume
Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Summary
Industrious and forward-thinking Senior Executive Assistant with an accumulated 5+ years of experience in professional healthcare and administrative work. Actively seeking immediate employment. Capable of smoothly handling strategic planning, operational and administrative requirements. Results-driven and hardworking with skill and resilience to achieve daily operational goals. Focused on maximizing executive productivity by providing exceptional service and coordinating team activities.
Skills
  • Epic/Maestro
  • Microsoft Office Expertise: Word, Excel, Publisher,
  • PowerPoint, Exchange, and Outlook
  • Team and detailed Oriented
  • Professional Development
  • Management information systems
  • Organized and detail-oriented
  • Time management and prioritization
  • Interpersonal and Communication skills
  • Skills
  • Administrative, Multi-tasking
  • Benefits, Negotiation
  • Billing, Network
  • Budgets, Problem resolution
  • Call center, Profit
  • CMS, Coding
  • Interpersonal and Communication, Researching
  • Clients, Scheduling
  • Client, Supervision
  • Customer service, Telephone
  • Database, Phone
  • Detail-oriented, Time management
  • Product development
  • Documentation
  • Email
  • Finance
  • Financial
  • Insurance
  • Maestro
  • Access
  • Excel
  • Exchange
  • Microsoft Office
  • Office
  • Outlook
  • PowerPoint
  • Publisher
  • Word
  • Management information systems
  • Multi-line telephone
Education and Training
Liberty University Lynchburg, VA Expected in 2018 Master of Arts : Human Service Counseling - GPA :
Shaw University Raleigh, NC Expected in 2015 Bachelor of Arts : Criminal Justice - GPA :
Experience
St. Charles Health System - Him Specialist 1
Sisters, OR, 03/2020 - 01/2021

Streamlined daily operational efficiency by serving as a frontline catalyst with task as described (but not limited to) below:

  • Analyzed (EMR) electronic medical records to ensure compliance with regulatory, government, and facility specific policies.
  • Promoted company viability by utilizing internal database to house account specific information such as : provider specific-deficiencies, qualitative and quantitative resolutions for provider related issues, and quality assurance documentation.
  • Monitored the status of incomplete medical records, generated physician reminder notices, prepares and submits a list of delinquent providers Medical Staff and Administrative Leaders.
  • Provided knowledgeable and accurate explanation of the record completion process within Maestro Care to medical providers.
Riccobene Associates Family Dentistry - Revenue Cycle Analyst
Charlotte, NC, 09/2016 - 10/2020

Operational/Administrative Task:

  • Managed accounts daily and effectively via EPIC.
  • Communicated with clients/patients on product development, product availability, and documentation and price options to increase profit margins.
  • Delivered exceptional account service to strengthen customer integrity and retain accounts while increasing revenue growth on an average of 90% under minimal supervision.
  • Coordinated and oversee special projects, establishing deadlines, monitoring open actions and maintaining the scope of project.
  • Analyzed insurance coverage and benefits for services provided to ensure accurate and timely reimbursement.
  • Was responsible for account and product reconciliations.
  • Accessed patient information through a variety of office software applications, mainly EPIC systems.
  • Maintaining strict confidentiality to remain compliant with HIPAA regulations.
  • Generated detailed reports outlining billing, flagged items, and other important data.
  • Maintained current working knowledge of CMS, Medicare and Medicaid reimbursement, billing and collection requirements, including federal and state payers.
  • Researched and coordinated over 100 claim denials and appeal strategies in coordination with other departments such as Patient Access, HIM, Case Management, etc.
  • Managed DRG and APC reimbursement, OCE, CCI and Medicare billing edits used by Patient Financial Services.
  • Collaborated with all relevant parties to resolve billing issues, insurance claims and patient payments.
  • Provided complete and accurate medical records for review by attorneys, outside agencies and/or third-party payers.
  • Identified, reviewed, analyzed, processed and completed first party and third party encounters and billing-related activities.
  • Processed requests ensuring timeliness, accuracy and completeness of information.
  • Reviewed third party payer payments, explanation of benefits/payments and other correspondence received to assure accurate processing has occurred through EPIC systems.
  • Interacts with the business stakeholders and subject matter experts in order to understand their problems and needs.
Devoted Health - Billing Administrative Representative
Tampa Bay, FL, 09/2014 - 08/2016
  • Provided general supervision, operates as part of the care team performing a variety of functions Greeting patients, registered and pre-registered patients with accurate patient demographic and financial data, insurance coverage and reliability verification, scheduling and telephone management, verifying insurance and benefits.
  • Consistently updated patient insurance coverage and complete managed care waivers for patients considered out of network.
  • Assisted with Prior authorizations and verification of benefits/insurance, Billing and Coding Co-payments.
  • Provided front desk support and customer service satisfaction to patients in a courteous and professional manner in accordance with performance standards.
  • Balanced cash sheet and cash drawer in accordance with performance standards.
  • Operated a multi-line telephone console, answering phone calls, contacting current patients to confirm appointments, Route calls to appropriate resources EPIC Maestro Care Software.
  • Assisted with insurance posting and billing, contacting insurance companies and Medical Plan carriers, contacting current patients to schedule appointments; other general duties as required.
Blue Cross Blue Shield Of NC - Membership operations Analyst
City, STATE, 06/2011 - 09/2014
  • Assisted BCBSNC agents via incoming call center with member and insurance related questions.
  • Enrolled members for plans and provided information on claims, co-pays, deductibles and co-insurance.
  • Processed all insurance claims.
  • Working knowledge of CMS on and off exchange Marketplace products and guidelines.
  • Proactively service agents with researching member enrollment, finance and commission questions.
  • Provided timely resolution to agent inquiries in writing and by phone regarding billing, benefits, claims, underwriting and pharmacy.
  • Communicated with attorneys, realtors, customers and third-party servicers via phone and email daily in order to ensure communication throughout membership process.
  • Regulated over 25 billing and account adjustments to maintain departmental budgets and infrastructure.
  • Provided daily reports and suggestions to senior level management to identify and eliminate potential problems concerning status of work and case files.
  • Exercised effective negotiation skills with customers involving client enrollment and maintenance.

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:

82Good

resume Strength

  • Formatting
  • Measurable Results
  • Personalization
  • Strong Summary
  • Target Job
  • Typos

Resume Overview

School Attended

  • Liberty University
  • Shaw University

Job Titles Held:

  • Him Specialist 1
  • Revenue Cycle Analyst
  • Billing Administrative Representative
  • Membership operations Analyst

Degrees

  • Master of Arts
  • Bachelor of Arts

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

*As seen in: