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Revenue Cycle Support Management Resume Example

Resume Score: 80%

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REVENUE CYCLE SUPPORT MANAGEMENT
Professional Summary
Motivated individual seeking team-based environments. Driven and proven successful at achieving established targets and team goals as Provider Enrollment Analyst.
Skills
  • Retain operational procedures
  • Strong attention to detail
  • Able to handle multiple tasks and key deliverables
  • Proven ability to work on own initiative, under pressure, capable of prioritising and managing multiple tasks
  • Detailed Gap product knowledge
  • Strong diplomacy skills and ability to communicate effectively in stressful and antagonistic situations
  • Strong interpersonal skills and ability to interact with all levels of employees
  • Able to think analytically and strategically, with ability to make decisions within scope of responsibility
  • Attention to detail
  • Balance
  • Benefits
  • Billing
  • Strong interpersonal skills
  • Competitive
  • Draw
  • CPT 1
  • Credit
  • Customer satisfaction
  • EDI
  • Email
  • Filing
  • Financing
  • Financial
  • Coverage Assessments
  • Decision Marking
  • Settement Determinations
  • Office applications
  • Processes and Procedures
  • Supporting Documentations
  • Federal and State Legislation
  • Sales
  • Business Relationships
  • Evaluation
  • Customer Service
Work History
10/2018 to Current
Revenue Cycle Support ManagementHCA Healthcare – Nashville, TN

Responsible for providing cross trained support in all areas of RCM in cash position , Claims resolution, credit balance, Reporting, Sending notification letters, Refunds, Adjustments, reconciliation and daily revenue spreadsheet entry pertaining to all insurance billing revenue. Daily review of charge items, Analyze bills and charges, Claims processing ( Charger Entry ) Charge master, Revenue integrity, Initial Enrollment, Reports trends and findings, UCC/PV, S- Codes and Self pay, Health Savings, Walkouts, and auditing to maintain Appropriate Revenue Integrity, Create job aids, Perform appropriate primary duties within legacy systems with new accusations and migrations ( Onboarding/Go-Live), and will serve appropriate Credentialing, Application for group practice enrollment, OWCP and Trainer. Partners with other Departments to determine what needs to be completed and assignments to team members. Voiding Refunds appropriately on HCA Host. Prepared initial patient charts for admission. Determined appropriate interventions and planned support milestones.

04/2017 to 06/2018
Retirement Benefit Specialist Team LeadMutual of Omaha Life Insurance Company – Omaha, NE
  • Identify issues and inquiries over 10,000 annuitants weekly from plan participants regarding health and welfare benefits and deductions through telephone, email and in-person interactions.
  • Enroll Retirees to start receiving there pension benefits by calculating monthly payment, reconcile figures, writing up benefit applications, making photocopies of important documents, provide data on different annuities available for retirees. Analyzed and modified benefit compensation and benefits policies to establish competitive programs and ensure compliance with legal requirements.
  • Makes decisions in partnership with management throughout life of claim (initial adjudication and ongoing claims management) based upon claim facts, thorough evaluation and gathering of pertinent information to formulate appropriate action plans. Develops case files that demonstrate appropriate decision making based on documented procedures using claim facts, pertinent policy provisions, customer expectations and special handling agreements.
  • Determines eligibility based on contract language, payroll records, and other supporting documentation. Adheres to ERISA and other federal/state laws concerning group disability insurance. Remains abreast of industry changes, federal and state legislation and regulations, as well as changes in internal processes and procedures.
07/2015 to 04/2017
Sale and Solutions Team LeadMutual of Omaha Life Insurance Company – Omaha, NE
  • Managed over 40 calls per day and exceeded Monthly scorecard every month.
  • Develop and maintain current knowledge of company's products, policies and services.
  • Reported to supervisor when training team members to discuss what maybe impacting team members scorecard.
  • Professionally helping them meet teams monthly goals.
  • Resolve billing issues or insurance gap issues following company procedures.
  • Proactively identified projects and initiatives for purposes of supporting sales distribution.
  • Issued payouts to claimants.
  • Communicated with claimants, employers and medical professionals regarding open claims.
  • Took initial concepts and developed project plans.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Made referrals to appropriate services.
  • Completed initial site preparation and maintained neat work areas for duration of job.
07/2012 to 05/2015
Home Retention Team Lead Penncro Associates – Bryan, TX

Manage an investor, insurer or portfolio specific portfolio. Receive inbound or make outbound calls to assist members with inquiries regarding their home retention option, supporting documentation requirements or general loan servicing questions. Meet investor and or state-specific guidelines to set up approved repayment, trial or forbearance plans. Update member financial information based off change in circumstance or to address member hardship at plan. Respond to member communications and authorized third parties to ensure items are acknowledged and processed in a timely manner. Ensure investor and state specific letters and call attempts are completed as required. Collaborate and coordinate with servicing departments, including collections, property preservation, foreclosure and bankruptcy. Accountable for performing all duties in accordance with company policies and procedures and state and federal laws. Demonstrate behaviors which are aligned with organization's desired culture and values. Evaluated employee skills and knowledge regularly, providing hands-on training and mentoring to individuals with lagging skills. Managed schedules, accepted time off requests and found coverage for short shifts.

Education
06/2010
High School Diploma
Lbj High School - Austin, TX
Associate of Science: Information TechnologyTexas A&M Health Science Center - College Station, TX

In progress

12/2020
Certificate: COVID-19 Contact Tracing
Johns Hopkins University - Baltimore, MD
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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.

Resume Overview

Companies Worked For:

  • HCA Healthcare
  • Mutual of Omaha Life Insurance Company
  • Penncro Associates

School Attended

  • Lbj High School
  • Texas A&M Health Science Center
  • Johns Hopkins University

Job Titles Held:

  • Revenue Cycle Support Management
  • Retirement Benefit Specialist Team Lead
  • Sale and Solutions Team Lead
  • Home Retention Team Lead

Degrees

  • High School Diploma
    Associate of Science : Information Technology
    Certificate : COVID-19 Contact Tracing

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