- 6103 57^th Ave W Ÿ Xxxxxx, XXXXXX xxxxxx ( (xxx-xxx-xxxx * abc@xyz.com

(Date)

(HR Department

Name of Company/Recruitment Firm

Street Address

City, State, ZIP code

Job Reference Number, if any)

Dear Hiring Manager,

        In response to a job vacancy posting for the position of ________________, I am pleased to formalize and tender my application to be considered for the role. Attached is my resum is attached for your review.

What I offer is my extensive training degree in several administrative and management courses and backed by more than 16 years providing high-performance customer service, program management, compliance and contract management, and operations support in the healthcare industry. I am currently with DaVita, Inc. based in Tacoma, XXXXXX as a Senior Single Patient Agreement Negotiator following a tenure as Contract Specialist. For more details, please take a moment to go through my resum .

In leveraging my managerial and administrative competencies, I also bring to the table my personal strengths that include a passion for achieving business objectives through sustainable people-centric and results-driven work excellence. In addition, my social and interpersonal communication skills have helped build professional relationships with the people I work with, including clients, senior management, and industry professionals that create a harmonious and collaborative work environment in achieving shared commitments.

I am confident that my extensive training, experience, and personal strengths offer the right mix of qualifications with which I can help achieve your objectives as part of your team. Should you need further clarification, or would prefer to schedule an interview, please do not hesitate to reach me through my phone or email address indicated in the heading. Thank you for considering me, and I look forxxxxxxrd to hearing from you soon.

Sincerely,

YYYYYY X. YYYYYY

Attachment: Resum

- 6103 57^th Ave W Ÿ Xxxxxx, XXXXXX xxxxxx ( (xxx-xxx-xxxx * abc@xyz.com

Single Patient Agreement Negotiator -Lead

Qualifications Profile

    Self-assured, and results-driven management professional with more than 16 years providing customer service, program management, compliance and contract management, and operations support in the healthcare industry.

-    Proven dedication to process efficiencies in delivering outstanding customer service, contract and compliance administration, program management, and staff development that create completive advantages for the company.

-    Detail-oriented, analytical and methodical with critical thinking to resolve work issues even under stress.

    Well-organized with multitasking and prioritization skills that optimize resources to achieve outstanding results.

    Strong people management and interpersonal communication skills that inspire confidence across diverse ethnicities.

Key Expertise

Healthcare Operations Management

    Medical Billing & Coding

    Concurrent Project/Program Management

    Process/Workflow Improvement

    Relationship Management (Clients, Stakeholders, Public, & Suppliers)

    Negotiations & Diplomacy

    Vendor/Contract Management

Administration

    Policies & Regulatory Compliance (i.e., HIPAA, etc.)

    Staff Supervision & Training

    Office & Staff Administration

    Records & Document Management

    Bilingual in English & Filipino

Technical

    Apps: Concur, Focus 2000, Maxine, Reggie Next Generation, Sovera, Boris Imaging, RADAR, Nautilus (billing system), & Snappy

    ERP: Oracle

    Productivity Tools: MS Office (Word, Excel, Access, & Outlook)

Professional Experience

Customer Service Management

    Monitor team workflow to ensure established priorities are met, negotiating patient specific agreement with health insurance companies and hospitals across the county to maximize revenue and minimize patient out of pocket.

    Establish and maintain professional relationships with both insurance payors and internal customers.

Administration

    Collaborate with supervisor in setting departmental goals, resolving operating issues, and escalating problems to proper management level for resolution.

    Contact 3^rd party administrators and insurance payers to verify benefits and eligibility, authorizations or pre-certifications (in-and out-of-network medical benefits), reviewing patient notes and history, claims, benefits and eligibility, and prior payments or non-payments.

Contract Management

    Review, negotiated, and asses DaVita Single Patient or payer Letter of Agreement (LOA), obtaining appropriate resolutions within DaVita HealthCare Partners guidelines, escalating letter of agreement language issues with legal counsel, approving agreements in accordance with guidelines to secure new and existing patient dialyzing at DaVita facilities, and providing documents to DaVita, Inc. legal counsel for litigation as needed.

    Oversee billing system changes as needed, maintaining accurate data for all SPAs for payment trend analysis and future contact negotiations.

Project/Program Management Support

    Participate in special project related to patient research by coordinating with Payor Contracting and other departments

    Know, understand, and follow teammate guidelines, employment policies, and department or company procedures.

    Manage multiple projects, ensuring completion within deadlines and budgets in an evolving work environment with shifting priorities and deadlines.

Staff Development

    Coach, and develop teammates, escalating teammate performance issues to supervisor, assisting management in performance evaluation, while supporting cross-training in other departments to widen exposure to business functions.

    Collaborated with Directors to support contract negotiations, audit, system set-up for reimbursement, diagnostic procedures, updating contract database, and payment analysis

Education & Credentials

Professional Training & Certifications

    HIPAA Compliance Training Effective Negotiating 1& 2 by: Sam Karras Account Receivable Insurance 101

    Claim form: CMS 1500/ B04 Networking Critical Thinking Crucial Conversation Mastering Conflict

    Emotional Intelligence Project Management Executive Presence ServiceNow Oracle Revenue Cycle Concur

    Edge Training Institute Franklin Covey Training