With more than 15 years of experience in Business Process Outsourcing, my core competencies are as follows:
Medical Billing
• Generates and analyzes monthly billing statements for accuracy
• Processes accounts receivable billing for various communities or generate ageing reports
• Analyze Explanation of Benefits (EOB) forms to ensure insurance companies have paid for charges
• Review remits and payer correspondence in the course of performing account follow up and escalate any identified issues to the appropriate area for review and response to expedite claim resolution
• Ensure billing of services is handled and paid correctly
• Call insurance companies for any discrepancies in payments, obtain pre-authorization or referrals if necessary in order to get the claim paid
•Research denied claims and follow up unpaid claims to insurance companies or appropriate parties
• Monitor charges and payment process
• Denials Management
• Collect and process information needed to fulfill medical insurance and resolve billing issues which includes reconciling of outstanding and negative balances showing on each of the assigned facilities
• Prepare, review, and transmit claims
Project Management
• Meet with stakeholders and oversee projects
• Build a Project Plan, Monitor Project Progress and Set Deadlines
•Provide updates to stakeholders during a weekly business review
•Issue Resolution
•Performance Evaluation
• Help maintain a list of contacts to be vetted via various talent resource online platforms and provide agency with responses to discuss next steps.
• Build a list of prospects to market and send proposals to
• Request for Proposal (RFPs/ RFIs/RFQs)
• Budget/ Funds Management
Training and Quality:
• Facilitate new hire training and equip trainees with basic and advance skills for support
• Communicate with Clients regarding training endorsement/ fallout
• Conduct intervention/ refresher training for new product and process updates
• Do analysis on contact drivers which affects organizational targets (TNA)
• Develop/ update training modules
• Create/ Update Adherence Reports and Evaluation Tool used by
trainers
• Coordinate with workforce regarding Abandon Rate projection
• Coordinate with HR/ Recruitment for New Hire Quality and Policies
• Standardize processes to be used by Operations/Delivery
• Design flowchart for operational processes using different platforms
• Panel for mock demo of aspiring trainers
• Oversee junior trainers in the same LOB (Level of Business)
• Assign responsibilities/ shifts to different trainers to ensure coverage and facility
