Proactive, innovative and motivated Claims Operations and Revenue Cycle Manager skilled in production solutions and support, claims operations, workflow management, patient billing and business process re-engineering with more than 20 years of experience working with insurance companies, reviewing claims, determining coverage, reducing delinquency and improving collection efforts. Highly effective at business analysis, process improvement, team building and documentation. I possess a high degree of integrity, outstanding work ethic, strong leadership qualities and strong interpersonal skills. Looking to share this expertise with a top-notch, cutting edge organization.
Manage the contracting, training, documentation, quality review, benefit verification, billing, payment posting, collection, pharmacy support and incoming call processes for 40+ health centers across 6 states.
Led a team of Supervisors, Team Leads, Senior Claims Processors and Provider Data Administrators
Responsible for configuring, implementing, maintaining and upgrading the EXP Macess Database
Supervised a team of 20 Claims Specialists.
Learned to capture, store, retrieve and analyze information in meaningful ways. Familiar with the fundamentals of database management technology, design, development and administration. Gained experience working in distributed, mainframe, client-server and desktop environments. Learned the roles and responsibilities of a database administrator and how to diagnose and troubleshoot database issues.
Coursework in Business Communications and Management Information Systems
Studies prepared me to enter the global industries of Fashion, Visual Arts, Interior Design, Buying and Entertainment.
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