Renata Parker

North Charleston *****, United States 843-***-**** ad2ov9@r.postjobfree.com

Profile

Highly skilled Medical Claims Processor with expertise in leadership, delegation, negotiating, empathy,

problem-solving, and data analysis. Proficient in

utilizing Salesforce, Athena, AdvancedMD, and

NextGen. Seeking a challenging role in Medical Billing to utilize my extensive experience and contribute to the efficient management of healthcare claims.

Work Experience

Supervisor Insurance Analyst

United Biosource Corporation

Supervise and oversee insurance analysts

responsible for verifying new patient insurance

benefits and handling claim rejections. Work

proactively with staff and cross-functional groups to develop creative solutions to challenging patient access issues regarding prior authorization, and

denied coverage requests to ensure patient care.

Partner with Leads to monitor work flow and adjust workload and staffing requirements to see to it that all activities are addressed in a timely and efficient manner.

Monitor calls and perform case reviews to ensure

accuracy of information, adherence to policies, and excellent customer service. Provide additional

coaching and training to individuals as needed.

Meet regularly with direct reports to provide direct feedback on their performance and progress

against goals. Responsible for writing and

communicating performance reviews.

Perform administrative tasks such as work hour

scheduling, attendance monitoring and counseling,

vacation request scheduling, and overtime

scheduling. Participate in the hiring process and

handle all employee issues for their direct reports. 01/2023 – 12/2023

Medical Billing Analyst

Parker Medical Billing & Consulting LLC

Conducted thorough analysis of medical billing

records to identify and resolve discrepancies,

resulting in a 25% reduction in billing errors and increased revenue by $100,000 annually.

Developed and implemented streamlined processes

08/2017 – 01/2023

Work Experience

for medical billing procedures, resulting in a 30% improvement in efficiency and reduced

turnaround time by 20%.

Collaborated with cross-functional teams to secure accurate and timely submission of insurance

claims, leading to a 15% reduction in claim denials and improved cash flow.

Research, initiate follow-up and resolve all health care insurance claim accounts with existing credit balances (claim(s) paid more than expected by

payer); actions included but not limited to

initiating refunds, retractions, and/or adjustments to claims

Medical Practice Manager

VASCULAR SURGERY ASSOCIATES, P.C.

Oversaw daily operations of a busy medical

practice, coordinating schedules, managing staff,

and controlling optimal patient flow, resulting in improved efficiency and patient satisfaction.

Developed and implemented strategic initiatives to streamline billing and collections processes,

resulting in a 25% increase in revenue within the

first year.

Led a team of 20 medical professionals, fostering a collaborative work environment, conducting

performance evaluations, and providing ongoing

training and development, resulting in a highly

motivated and high-performing team.

Implemented electronic medical record (EMR)

system, training staff on its usage, resulting in a 30% reduction in administrative errors and

improved accuracy in patient records.

01/2017 – 08/2019

Medical Billing Specialist

Roper St. Francis

Processed and submitted medical claims accurately

and efficiently, resulting in a 20% increase in

revenue for the healthcare facility.

Collaborated with healthcare providers to resolve

billing discrepancies and ensure accurate coding of medical procedures, resulting in a significant

reduction in claim denials.

Conducted thorough insurance verification and

12/2012 – PRESENT LADSON, SOUTH CAROLINA

Work Experience

eligibility checks for patients, ensuring all

necessary documentation and prior authorizations

were obtained, leading to a seamless billing process. Implemented and maintained a comprehensive

electronic billing system, streamlining the medical billing process and reducing manual errors by 30%. Issued refunds to patients and Insurance

companies. Health care and medical overpayment

remediation and refunding

Patent Access Rep

Medical University of South Carolina

Conducted comprehensive patent searches using

online databases and legal resources to identify

relevant patents and prior art for clients.

Collaborated with patent attorneys and inventors

to draft and file patent applications, securing

accurate and timely submission to the United

States Patent and Trademark Office.

Assessed patentability criteria by analyzing

technical specifications and conducting thorough

evaluations of prior art, resulting in successful

patent grants for clients.

Provided expert advice and guidance to clients

regarding patent laws, procedures, and best

practices, leading to increased client satisfaction and retention.

07/2012 – 10/2012

A/R Specialist

McKesson

Managed the full cycle of accounts receivable

process, including invoicing, cash applications, and collections, resulting in a 15% reduction in

outstanding receivables.

Researched and resolved customer billing disputes, effectively negotiating payment plans and reducing dispute resolution time by 20%.

Health care and medical overpayment remediation

and refunding

Collaborated with cross-functional teams to

develop and implement credit and collection

policies, leading in a 10% decrease in bad debt

write-offs.

01/2011 – 06/2012

Medical Claims Processor

SEIU National Benefit Fund

Processed and reviewed medical claims to

guarantee accuracy and adherence to insurance

policies and procedures.

Collaborated with healthcare providers and

insurance companies to resolve claim discrepancies and facilitate prompt reimbursement.

Conducted thorough investigations and analysis of

complex claims, utilizing medical coding

knowledge and documentation expertise.

Maintained detailed records and documentation of

claims processing activities, ensuring compliance

01/1999 – 04/2010

Work Experience

with regulatory requirements and company

guidelines.

Education

Trident Technical College

Accounting

Bergen Community College

References

Britney Toney

United BioSource Corporation

720-***-****

Kentera Jones

United BioSource Corporation

901-***-****

Skills

Leadership

Delegation

Negotiating

Empathy

Problem Solving

MANAGMENT

Microsoft Office Suite

(Word, Excel, PowerPoint,

Outlook)

Data analysis and

visualization

COMPUTER SKILLS

Salesfore Professional

Athena Professional

AdvancedMD Professional

NextGen Professional

MEDICAL BILLING SOFTWARE

Strengths

Time Management Adaptable

Responsible Detail-oriented Organized

Efficient Analytical Thinking

Communication skills Technical expertise

Contact this candidate