revenue cycle specialist i resume example with 15+ years of experience
JessicaClaire
Montgomery Street, San Francisco, CA94105(555) 432-1000, resumesample@example.com
Summary
Proven skills in revenue cycle management for medical facilities such. Proficient in reducing debt, collecting payments and collaborating with insurance companies to resolve concerns. Talented communicator and practiced multitasker. I am highly skilled in analyzing and validating patient information, diagnosis, and billing data that enables the processing of high volumes of patient information to achieve revenue generating goals
Skills
Business Tracking
Problem-Solving
Analytical Thinking
Quality Evaluation
Report Preparation and Presentation
Records Coordination
Claims Review
Insurance Collaboration
Expertise in Insurance Coding
Medical Billing
Team Training and Mentoring
Trends Analysis
Operations Advisory
Performance Analysis
Financial Problem Assessments
Spreadsheet Tracking
Microsoft Office
Experience
01/2019 to CurrentRevenue Cycle Specialist ICuro Health Services | Ocala, FL,
Trained new and existing employees with feedback until mastered
Communicates hospital's financial policies to all patients
Identifies patients who require early financial counseling interventions and Customer Service Skills
Medical scheduling
Performs all aspects of insurance eligibility and benefits verification
Requires knowledge of Medicare, Medicaid and Third-Party carriers and referrals and precertification procedures
Rebill accounts, corrects patient demographics and insurance
Verifies and documents competency and identifies and suggests ways to develop skills
Communicates new insurance rules, changes in policies, procedures and regulations
Monitors compliance with regulatory, licensing, and accreditation standards
Facilitates quality improvement by reporting problems, concerns, and opportunities for increased revenue and decreased denials
Maintains knowledge and is familiar with Health Quest, General Patient Registration (GPR), Power chart, N-thrive, Artiva
Follow-up on delinquent accounts to reduce number of outstanding balances
Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA
Knowledge of Medicare, Medicaid, and other managed care payer’s (HMO, PPO, etc.)
Excellent computer skills
Identified and corrected payment problems involving patients or third-party payers.
Contacted insurance providers to check patient coverage.
Reached out to responsible companies and individuals to collect on outstanding debts.
Completed weekly account reconciliations to identify discrepancies.
Detailed key revenue cycle information into thorough presentations to deliver to executives and management team.
Boosted job efficiency by working closely with other analysts so that tasks and processes could be streamlined and duplication was avoided.
Participated in revenue cycle processes, working to maximize profitability and increase revenue.
Increased overall efficiency of standard practices through design and development of improved forms and expedited procedures.
Monitored revenue status and created detailed reports for senior management.
Performed quantitative analysis and other data research using Excel to identify trends and opportunities.
Extracted and defined record and file data and compared it to business operations information to better understand revenue cycles.
Produced accounting reports and provided targeted recommendations for improving revenue standing.
Presented regular status updates and workflow recommendations to senior management.
Organized and evaluated different metrics and forecasted financial trends.
Created in-depth spreadsheets, which detailed trends and forecasts for revenue, profitability and expenses.
08/2017 to 12/2018Billing Authorization SpecialistFreeman Health System | Parsons, KS,
The Authorization Specialist is responsible for obtaining initial authorization and subsequent re-authorization for managed care contracts - American Imaging Management (AIM)
Retrieving prior authorization request and saving into Central Authorization Shared File for further processing
Confirming if Authorization is required from American Imaging Management (AIM)
If authorization is required – obtain and inform center to set up patient
If authorization is NOT required from AIM, informing the center to follow up with health plan
Puts in PAC note that authorization was requested
Give Confirmation and authorization request to the Authorization person (Initials only)
Enters authorization in AS400 (re-authorizations only)
PAP Supply reorders
Re-authorizations - Request authorizations no later than 72 hours after AIM prior authorization has expired
Answer phones and email questions from the centers
01/2006 to 11/2016Eligibility SpecialistFamily And Children Services | City, STATE,
Determine eligibility for Medicaid, Medicare, and Food Stamps for the elderly, blind, and disabled
Assisted the Aged, Blind and disabled clients with applying for Social Security benefits
Liaison between Federal and State Agencies for clients and their families to vendor relations with social security administration, nursing homes, hospice agencies, and community care service providers
Provide accurate case processing to ensure applicant's needs regarding food and medical services
Attend courtroom hearings regarding appeals to policy and eligibility decisions
Conducted home visits and financial counseling.
Education and Training
Expected in 05/2023 to to Bachelor of Finance | Strayer University, , GPA:
Expected in 05/2021 to to Associate | FinanceGeorgia State University, , GPA:
Expected in 09/2005 to to Medical Insurance Billing and Coding | Georgia, , GPA:
Expected in to to Board of Pharmacy – PHTC022302 | Georgia State, , GPA:
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