Revenue Cycle Support Team Lead Resume Example
Organized individual with extensive decision making and task prioritization talents. A confident Import Coordinator ensuring that all government agency regulations are followed. Build rapport with customers and promote satisfaction while quickly handling issues. Strong time management, problem-solving and decision-making abilities.
Managed over 10 employees. Responsible for providing cross trained support in all areas of RCM in cash position , Claims resolution, credit balance, Reporting, Sending appropriate notificationletters, 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/changes and findings, UCC/PV, S- Codes and Self pay, Health Savings, Walkouts, and auditing to maintain Appropriate Revenue Integrity, Create job aids, Perform primary duties within legacy systems with new accusations and migrations ( Onboarding/Go-Live), and will serve Credentialing, Application for group practice enrollment, OWCP and Trainer. Partners with other Departments to determine what needs to be completed and assign to team members. Voiding Refunds appropriately on HCA Host. Prepared initial patient charts for admission. Determined interventions and planned support milestones. Performs end to end claims evaluation, manage and adjudication claims.
- Used COMPASS and Benefit Calculator to determine annuitant benefits.
- Develops appropriate business relationships and communications with claimant, broker, sales organization, vendor partners, employer and internal partners (e.g. underwriting, legal, etc.). Communications demonstrate a solid level of customer service and professionalism that support the values of Mutual of Omaha.
- Accurately determines financial liability based on salary, other income sources, medical / vocational information and contract language. Has limited autonomy to approve initial and ongoing payments based upon holistic file evaluation.
- Provides various reports to annuitants per contract requirements with a high level of customer service.
- Determines eligibility based on contract language, payroll records, and other supporting documentation.
- Adheres to ERISA and other federal/state laws concerning group disability insurance.
- Demonstrates flexibility and ability to support unique customer requirements.
- Creates written letters for the purpose of providing concise explanations to claimants regarding: claims determinations.
- Remains abreast of industry changes, federal and state legislation and regulations, as well as changes in internal processes and procedures.
- Peer Mentor to help with onboarding new hires
- 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 the teams monthly goals.
- Resolve billing issues or insurance gap issues following company procedures.
- Proactively made decisions identifying projects and initiatives for the purposes of supporting the sales distribution.
- Made referrals to appropriate services ( Sales Team, Medicare Supplement, Claim Department, Management )
- Obtained appropriate tooling and fixtures.
- Maintained high scores on QA.
- Meet with appropriate prospective borrowers.
- Review / Analyze credit and financial data repots.
- Determine borrower financing objectives and goals to resolve payment issues.
- Demonstrate appropriate Bank of America products and programs and explain guidelines.
- Maintain the general report filing system and file all correspondence using office applications.
Still in progess
- Attention to detail
- Billing
- Competitive
- CPT 1 codes
- Credit
- Customer satisfaction
- EDI Billing
- Filing
- Financial
- Insurance
- Legal
- Managing
- Office applications
- Policies
- Quality
- Receiving
- Sales
- Supervisor
- Telephone
- Internal And External Regulations
- Business Relationships
- Communication
- Decision Making
- Processes And Procedures
- Federal And State Legislation
- Customer Retention
- Customer Service
- Writing
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Resume Overview
School Attended
- LBJ High School
- Texas A&M Health Science Center
- Johns Hopkins University
Job Titles Held:
- Revenue Cycle Support Team Lead
- Retirement Benefit Specialist
- Sale and Solutions Specialist
- Home Retention Specialist
Degrees
- Diploma , 2010
Associate of Science , Information Technology
Certificate , COVID-19 Contact Tracing
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