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Yyyyyy x. yyyyyy

P.O. Box 0000 xxxxxx xxxx , xxxx , xxxxx 00000 ● (xxx-xxx-xxxx ● abc@xyz.com

Eager to contribute seasoned background in the Healthcare Sector toward securing an opportunity in Management

Patient Access Services ~ Patient Financial Services ~ Insurance Verification ~ Appeals/Denials

Revenue Cycle ~ Medical Audit Reviews ~ Personnel Leadership ~ Business Process Improvements

Profile

 

         Accomplished leader offering 25+ years in healthcare administration encompassing medical office operations, patient access services, staff training, customer service, billing, coding, medical audits, and insurance.

         Well-versed in medical terminology and Medicaid, Medicare, and third-party reimbursement regulations.

         Adept at supporting, promoting, and maintaining a cohesive and respectful workplace climate essential to maximizing staff retention, morale, and satisfaction.

         Advanced knowledge of outpatient oncology billing rules and regulations.

         Autonomous and personable with superb consultative, instructional, interviewing, hiring, and managerial skills.

         Contribute dynamic communication skills toward effectively liaising between executives and internal/external stakeholders in support of achieving corporate objectives.

         Excel in analyzing existing healthcare practices and orchestrating process improvements to elevate patient satisfaction while controlling expenses.

 

Professional Experience

 

University of North Texas Health Science Center, Ft. Worth, TX, 2016 to Present

Business Associate

  • Currently performing temporary assignment within accounts receivable functional area with a strong focus on quality assurance and accuracy.

 

Dallas Independent School District, Dallas, TX, 2016 to Present

Substitute Teacher

         Proficiently administer lesson plans for all subjects in accordance with curriculum objectives and outlines.

         Demonstrate excellent talents in student behavior/classroom management, tutoring, and test monitoring.

         Foster and maintain a healthy, safe, and secure classroom environment for grades 6 through 8.

         Continually strive to build students confidence while establishing reasonable and understandable expectations.

 

AmerisourceBergen Specialty Group, Dallas, TX, 2015 to 2016

Business Practice Coach

         Delivered influential coaching to oncology practices by conducting assessments, translating key performance metrics into action plans for improvement, and serving as primary point of contact for technology solutions.

         Uncovered areas of overstaffing, financial waste/losses and inefficiency, and drove business process optimization and best practices to garner rapid improvements for clients.

         Partnered with sales team as key business advisor and solution advocate for Division s products.

 

University of Texas Southwestern Hospital, Dallas, TX, 2012 to 2015

Quality Assurance Analyst

         Meticulously audited back-end claim processing for quality assurance as well as front-end processes to validate revenue cycle via Epic HB/ADT system.

         Leveraged considerable industry expertise toward training and coaching multiple departments in performing patient access and patient financial service activities.

Continued ►

 

 

Professional Experience continued Yyyyyy x. yyyyyy Page 2 of 2

 

The Methodist Health System, Houston, TX, 1996 to 2012

Revenue Integrity Analyst Infusion/BMT Transplant Clinic (2007 to 2012)

         Conducted detailed quality audits of oncology infusion billing processes for revenue capture and enhancement.

         Diligently ensured CPT/ICD 9 codes and charges aligned with best practice guidelines.

         Communicated daily with clinical staff, physicians, and healthcare information management to prevent denials prior to claim submission.

         Handpicked to lead Six Sigma Black Belt Lean project, successfully recouping $2M in unpaid/denied revenues.

 

Patient Access Services Supervisor (2005 to 2007)

         Supervised, coached, motivated, counseled, and coordinated 20 clerical personnel within cell and gene therapy access services area.

         Frequently reviewed patient accounts to ensure completeness and accuracy of insurance/precertification data.

         Liaised with physician offices to validate CPT/ICD-9 codes for treatment plans and primary/secondary diagnoses.

         Formulated and submitted reports to upper management detailing areas needing improvement.

         Proactively generated dashboards to streamline and expedite audit processes for patient access services.

         Revised patient access manuals to augment department training especially related to revenue cycle.

Appeals and Denials Coordinator (2001 to 2005)

         Scrutinized third-party payer denied claims and filed appeals when appropriate.

         Documented and inputted denials in database, promptly responded to appeal letters, and played an integral role in establishing Appeals unit and Contract & Compliance unit to bolster departmental organization.

         Assembled training manuals to effectively guide new staff in navigating appeal and denial processes.

Insurance Verification Supervisor / Coordinator (1999 to 2001)

         Applied sharp organizational skills toward disseminating verification workload to staff, inputting data into hospital information system, and completing production reports.

         Facilitated training for new hires and provided counseling and conflict resolution as appropriate.

         Promoted from role as insurance verifier (1996 to 1999) based on exceptional performance and results.

Prior experience includes role as Admission Representative & Collections, Methodist Medical Center Dallas in Dallas, Texas from 1992 to 1995.

Education & Certifications

 

MBA, Specialization in Healthcare Management, American InterContinental University, Schaumburg, IL, 2015

Delta Mu Delta Honor Society; Honors Medallion (GPA: 4.0)

 

Master of Education, Specialization in Leadership and Administration, graduated sum cum laude

Jones International University, Denver, CO, 2010

 

Certified Medical Office Professional, Texas School of Business, Houston, TX

Certificate of Completion in Claims, Express Claims Training, Houston, TX

Outpatient Billing Specialist Certification, American Institute for Medical Professionals, Houston, TX

 

Technology

 

Medisoft, Microsoft Office, Visio, Epic, 10-key by touch, Salesforce, G4/ULS systems, hospital information systems

 

Memberships

 

Practice Manage Institute for Medical Office Professionals

Texas Hospital Association

American Institute of Healthcare Compliance

 

Yyyyyy x. yyyyyy

P.O. Box 0000 xxxxxx xxxx , xxxx , xxxxx 00000 ● (xxx-xxx-xxxx ● abc@xyz.com

 

 

 

 

 

 

 

INSERT DATE

 

 

 

HIRING AGENT NAME

TITLE

COMPANY NAME

ADDRESS

CITY/STATE/ZIP CODE

 

Dear__________________:

 

I am currently seeking a challenging career opportunity in a (INSERT JOB TITLE) capacity and am submitting my resume for your review. In advance, thank you for your time and consideration.

 

As demonstrated, I offer a seasoned career in the healthcare administration arena and considerable success in the complete spectrum of patient financial services. Along with proficiency in accounts receivable management, I m equally comfortable in orchestrating patient access processes and completing and auditing complex documentation related to billing and insurance. My administrative skills are top-notch and I ve developed a solid reputation for streamlining department operations and driving measurable process improvements. To complement these qualifications, I offer exemplary strengths in training, teaching, and employee performance management.

 

As a proactive contributor to your hospital, you will find me to be a stellar leader committed to supporting you in achieving your objectives through a superior blend of financial savvy, managerial talents, and rigorous attention to quality assurance. I am confident that I could be a valuable asset to (INSERT NAME OF ORGANIZATION), and will call you later in the week to see if we can schedule a time to meet.

 

Sincerely,

 

 

 

Yyyyyy x. yyyyyy

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