Ronnie Cruz

*** ********* ****, ***********, ** *9064 215-***-**** adznlr@r.postjobfree.com

SUMMARY

As a healthcare business professional, I have gained and applied strong interpersonal skills and management tactics to contribute to over thirty years of growth and accomplishments of organizations in the healthcare industry.

CORE COMPETENTCIES

Proficient in Client Services and Team Management

Strong attention to detail and organizational skills

Effective leadership and motivational skills

Articulate communicator

Interactive skills to engage team members, establish a bond, and develop strong relationships

Medical Office Management Certification

PROFESSIONAL EXPERIENCE

Cotiviti Healthcare, Blue Bell, PA

Client Service Manager 2018 – 2023

Managed various client accounts across multiple lines of businesses as primary liaison between clients and audit operations

Analyzed data for gaps and quality during data ingestion and enhancements

Maintained open inventory and system accesses for the team

Developed five new audit concepts to grow accounts and increase overpayment identification

Maintained and grew client relationships for new and existing clients virtually and on-site

Senior Payment Accuracy Specialist, Team Lead 2015 – 2018

Managed team of auditors and strategically planned projects to achieve quality goals and budget objectives

Developed and executed dispute and reconsideration process for multiple clients

Established and maintained client relationship for over ten Blue Cross accounts

Created and implemented new workflow processes to increase operations efficiencies

Senior Auditor 2012 – 2015

Datamined and audited hospital, professional, and pharmacy data to identify overpayments of over $10M to contribute to contract expansions

Trained, mentored, and provided quality control to build audit operations team

Lead team and provided subject matter expertise on the contract development

Managed open inventory of identified overpayments by analyzing export and import files

Kennedy Health System

Manager, Patient Financial Services 2000 – 2011

Managed billing and collections departments for Medicare, no-fault, workers’ compensation, managed care, and commercial insurances

Hired, supervised, trained, and mentored up to twenty employees

Developed a new pre-collection system for problematic accounts

Created a mail merge letter process for all workers’ compensation and no-fault patients