Medical Billing Project Manager
Resume:
+ ** WALNUT CREEK CT, DALLAS, US, ***** • ********@*****.*** •
MYTAWAII BENTON
Medical Coder and Billing Insurance / Administrivia Professional PROFESSIONAL SUMMARY
Results-driven and detail-oriented Project Manager with over 9 years of experience in medical billing, coding, and insurance operations, specializing in ICD-10 and CPT coding systems. Proven expertise in optimizing workflows, managing cross-functional teams, and implementing advanced software solutions to enhance revenue cycle management and compliance. I am skilled in leveraging tools like Salesforce, Advanced MD, and all Medical Tech Application to streamline processes and improve operational efficiency. Holds a Bachelor of Science in Medical Billing and Coding and a Project Management Certification from Georgia Tech Institute. Adept at leading projects, resolving complex billing issues, and delivering exceptional results in fast-paced healthcare environments Morale-building abilities to enhance employee engagement and boost performance. Knowledgeable and dedicated customer service professionals with extensive experience in PMP industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed, and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships, and growing businesses. Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Use independent decision-making skills and sound judgment to positively impact company success. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain a full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Hardworking and passionate job seeker with strong organizational skills and eager to secure an IT Business Analysts position. Ready to help team achieve company goals.
CORE COMPETENCIES
• Medical Billing & Coding (ICD-10, CPT, HCPCS)
• Project Management & Workflow Optimization
• Revenue Cycle Management & Collections
• Advanced Software Proficiency (Salesforce, Advanced MD, OMNI, VPN)
• Medicare & Medicaid Compliance
• Team Leadership & Training
• Data Analysis & Reporting
• Healthcare Database Management
• Customer Service & Telecommunications
Professional Experience
BENEFITS VERIFICATION & CODING SPECIALIST Oct 2024 - Present Cencora/Spectra force Company Remote
Streamlined application for Medicare Part D processing a variety of medication, ensuring Medicare compliance Leveraged Salesforce/Fusion Lightning for efficient data management Collaborate & resolved Medicare eligibility issues with presents and insurance companies Ensured regulatory compliance through meticulous documentation REMOTE AGENT, MEMBER SERVICE CALL REP SPECIALIST Nov 2022 - Present Teleperformance USA / Centene (Vendor) Salt Lake City, UT Facilitated health insurance consultants via Ambetter Marketplace Orchestrated insurance plan details using the OMNI system Pioneered service-centric environment to solve Medicaid SSHP billing and service concerns MEDICAL BILLING/CODER - PART TIME May 2022 - Nov 2022 Psychiatrist Weichbrodt Gary D MD Smyrna, GA
Orchestrated a seamless billing process with patients, physicians, and third-party payers. Maintained and updated healthcare databases, ensuring correct billing through accurate medical history. Utilized Advanced MD system and knowledge of ICD-10, CPT, and HCPCS coding to optimize operations. Competently managed various third-party payers including Medicare, Medicaid, PPO, HMO, among others. PROJECT MANAGER SYSTEMS TECHNICIAN Dec 2016 - May 2022 GIH Events Decatur, GA
Devised automation scripts, improving system reporting efficiency Collaborated with tech teams, resolving complex system issues Managed financial data for blockchain contracts, ensuring accuracy Modified PHP and SQL scripts, increasing automation efficiency Troubleshot Oracle database issues, enhancing system performance.
EDUCATION
• BA & ASSOCIATE OF SCIENCE DEGREE - MEDICAL INSURANCE CODING BILLING Nov 2023
• Ultimate Medical Academy Clearwater, FL
• ASSOCIATE OF SCIENCE - IT & PROJECT MANAGEMENT CERTIFICATE Jul 2013
• North Georgia Technical College Atlanta, GA
• MEDICAL BILLING AND ADMINISTRATIVE CERTIFICATE 2006 Everest Institute Atlanta, GA
• IT PROJECT MANAGEMENT CERTIFICATE
• PMP Certification 2013
• Georgia Technical College
TECH SKILLS
1. Medical Billing Software: Advanced MD, CIPROMS 80, Salesforce 2. Coding Systems: ICD-10, CPT, HCPCS
3. Database Management: Oracle, SQL, PHP
4. Spreadsheet Tools: Excel, Google Sheets
5. CRM Systems: Salesforce, Fusion Lightning
6. VPN & Remote Access Tools
7. Artificial Intelligence
8. Achievement
9. Successfully opened and operationalized medical billing offices, increasing revenue 10. by X%.
11. Developed and implemented coding systems that reduced errors by X% and improved 12. workflow efficiency.
13. Trained and mentored X medical coders, achieving a X% improvement in coding accuracy.
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