senior account administrator resume example with 16 years of experience
JessicaClaire
Montgomery Street, San Francisco, CA94105609 Johnson Ave., 49204, Tulsa, OK
H: (555) 432-1000
C:
resumesample@example.com
Date of Birth:
India:
:
single:
:
Work History
Senior Account Administrator, 01/2012 - Current Caterpillar – Green Valley, AZ,
Educate, train, and advise 10 physicians on billing and coding issues and offer them other billing and coding alternatives
Provide onboarding Revenue Cycle training for all new administrative staff members
Create written job aids and protocols, pertaining to insurance registrations tips, insurance concepts and terminology, guarantor accounts, no fault and worker's compensation coverage
Train and oversee productivity of 3 Account Administrators while reviewing their coding and billing accuracy and daily tasks
Assign revenue cycle projects amongst account administrators, including open encounter reports, credit reports, payment over postings, insurance denials, and refunds
Responsible for accurately handling of all cash, check, and credit card transactions while safeguarding daily cash activities
Perform batches reconciliations and perform cash deposits via the cahier's office
Conduct payment posting investigations and create strategies to avoid future payment posting discrepancies
Audit all inpatient and emergency room billing charges and address any charge entry errors with the account administrators
Facilitate the credentialing process of new faculty and fellows as needed; update established physician's credentialing files through re-credentialing processes via CAQH, Apperture, and PO-Managed Care
Attend workshops and seminars to keep abreast of new information, including billing and coding changes, insurance contracts updates, Epic updates, and new insurance website features
Serve as the Revenue Cycle Epic liaison and communicate new Epic workflows and changes to the clinical and administrative staff while creating and using existing material to coach both teams
Responsible for maintaining a record of all Retina patients enrolled in drug assistance programs while reviewing and requesting funds to cover all insurance patient responsibilities
Collaborate with the Practice Specialist to decipher and create appropriate front office educational opportunities
Manage monthly reports to analyze reimbursement, denials, and medical coding trends to develop training opportunities for the account administrators
Analyze and review all patient billing disputes while delegating the suitable course of action account administrators should take to resolve the situation
Managed costs and billing and resolved financial discrepancies effectively through organizational management of account information using Epic and Cognos software
Develop and implemented office management procedures to increasing training team productivity and accuracy
Mentor office employees on proper administrative procedures and how to use programs such as Epic, Cognos, and EncodePro, keeping operations consistent and efficient for maximum performance
Supervise five Revenue Cycle team members and provided constructive feedback, resulting in higher morale and increased employee retention
Optimize organizational systems for payment collections, AP/AR, deposits, and recordkeeping
Develop highly efficient revenue cycle, patient coordinator and prior-authorization team through ongoing coaching and professional development opportunities
Monitor front areas so that questions could be promptly addressed
Review incoming compliance items for conformity with governing documents
Set up new business accounts on internal systems and process corporate actions and other adjustments
Coordinate individual duties after careful evaluation of each employee's skill level and knowledge
Improve customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
Account Administrator, 01/2010 - 01/2011 Fm Global – Parsippany, NJ,
Responsible for reviewing TES work files and resolving edits daily
Lead of monthly Tidbits newsletter committee; organized meetings, prepared and discussed agenda, assigned Tidbit newsletter topics to committee members, and created newsletter using Microsoft Publisher
Worked rejection reports, researched accounts, and resolved disputes; contacted patients and or third-party carriers regarding delinquent accounts unsolvable disputes to be escalated to the Senior Account Administrator
Reviewed and processed all research encounters ensuring that they are processed to the appropriate Grant, eliminating the possibility of erroneous bills to insurance plans
Utilized GE (IDX) Transaction editing System (TES) to post physician services, according to PO service benchmarks
Assisted Senior Account Administrator with Aged Balance reports by FSCs, Physician and or Procedure regularly; conducted follow-up of all focused A/R projects with both carriers and patients/guarantors on a timely basis presented findings for resolution of individual accounts; processed write-offs as directed
Identified and processed credit balances and refunds to patients and or/or 3rd party payers in an accurate and timely fashion
Answered patient, insurance carriers and in-house billing inquiries directly in person, via telephone and by mail; refer to Billing Manager and/or Practice Manager as appropriate
Prepared patient invoices and receipts when necessary
Assisted in all projects involving inappropriate registration and revenue enhancement
Assisted Check-in and Check-out staff as needed with revenue cycle processes (including but not limited to Check-in coverage, processing of co-payments and other time of service payments)
Created, explained/educated, and answered questions regarding estimate forms for self-pay patients as requested
Posted insurance checks and/or forwarded to posting department
Covered, answered, and assisted department with all billing and insurance related requests in the absence of the Revenue Cycle Manager
Created all necessary appeal letters for re-processing of insurance denied claims
Ensured reimbursement of costly Retinal Injectable Drugs by reviewing insurance policies of each drug, running reimbursement reports and following-up with carriers
Reviewed inpatient superbills entered through New York Hospital Eclipses system for accurate billing
Maintained communication with Kress Vision Program, Weill Cornell Community Clinic (WCCC), and International Services representatives to ensure collection of proper reimbursements
Secured high-value accounts through consultative coding strategies, effective customer solutions and promoting compelling business opportunities
Improved account management by predicting potential insurance denial threats and outlining proactive solutions
Addressed problems with accounting, billing, and service delivery to maintain and enhance patient satisfaction
Contributed to annual revenue goals by coaching staff, identifying denial trends, and creating new coding rules in Epic
Evaluated report data to proactively adjust and enhance operations
Applied customer feedback to develop process improvements and support long-term business needs
Improved operational planning and business frameworks to enhance resource utilization and reduce insurance denials
Compiled data highlighting key metrics to report information, determine trends and identify methods for improving revenue results
Reviewed performance data to monitor and measure productivity, goal progress and activity levels
Maximized productivity by keeping detailed records of daily progress and identifying and rectifying areas for improvement.
Collected copayments and fee for services balances
Reviewed all patient demographic information; verified patient insurance eligibility and benefits using all technology tools available, including, but not limited to the phone, Internet, and GE eligibility tools
Explained billing procedures and troubleshot patient billing issues
Reconciled and recorded all daily monetary collections
Assisted patient needs with transportation and interpreter request
Assisted with the training of new patient coordinators
Processed medical records requests, assuring release only to appropriate parties’ proper authorization
Evaluated HCFA-1500 forms and supporting documentation for completeness, validity, and compliance with applicable regulations
Assisted patient coordinators with front desk duties, answering questions and accurately using IDX system
Handled complaints and resolved conflicts involving billing and insurance concerns
Recorded costs accurately and explained any additional fees to the patients
Processed cancellations, changes or special billing or scheduling requests promptly
Communicated with management when customer issues escalated and worked to find resolutions
Maintained accurate and current customer account data with manual forms processing and digital information updates
Educated patients about billing, payment processing and support policies and procedures
Cross-trained and provided back up for customer service managers
Collaborated with staff members to enhance customer service experience and exceed team goals through effective patient satisfaction scores
Reduced process inconsistencies and effectively trained team members on best practices and protocols.
Lead Medical Secretary, 01/2005 - 01/2008 Murray Hill Medical Group – City, STATE,
Managed master calendar and scheduled appointments for providers based on optimal patient loads and clinician availability
Enhanced office productivity by handling high volume of callers per day
Managed office logistics by scheduling appointments, maintaining files, and collecting payments
Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls
Retrieved imaging, biopsy, post-operative reports, and consultations from other medical providers
Entered and updated patient's demographics and medical insurance
Confirmed patient eligibility via Internet and telephone
Proactively followed-up with pharmacies and patients regarding medication request
Reviewed messages from the answering service and voicemail system
Opened, sorted, and prioritized mail, picked up and delivered materials as required
Assisted in additional secretarial coverage when necessary
Facilitated medical records requests: collected appropriate signatures and necessary payments
Maintained records through filing, retrieval, retention, and storage
Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing
Used knowledge of medical terminology to transcribe patient information from written copy, electronic equipment, or verbal direction
Proofread documents and correspondence for accuracy and completeness
Located, checked in and pulled medical records for patient appointments and incomplete charts
Prioritized calls through screening process and transferred calls and recorded messages for appropriate personnel
Supported office staff and operational requirements with administrative tasks
Maintained office supplies inventory by checking stock, anticipating department needs and placing and expediting orders
Managed office logistics by scheduling appointments, maintaining files and collecting payments
Coordinated referrals through insurance and other medical specialists and documented details in patient charts
Contacted hospitals to confirm patients’ medical histories and prevent inaccurate diagnoses and treatments
Facilitated new patient prescriptions, refills, and prescription pre-authorizations
Kept office equipment operating by troubleshooting breakdowns, performing preventive maintenance, and coordinating repairs
Placed new supply orders, managed inventory, and restocked clerical spaces.
Education
Master of Arts: Liberal Studies, Expected in 12/2023 - The Graduate Center-CUNY - New York, NY, GPA: Status -
Bachelor of Arts: Psychology, Expected in 05/2020 - Lehman College - The Bronx, NY, GPA: Status -
Summary
Educated professional offering 14+ years of experience streamlining processes, managing talented team members and performing administrative tasks. Tireless team player known for staying poised and calm in fast-paced environments.
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