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EMAIL AVAILABLEPHONE NUMBER AVAILABLEStreet Address  Townhouse RdSaegertown, PA Street Address
SummarySkilled claims analyst with diverse and abundant experience in billing, collecting, and diagnosing claim payments from the provider side as well as contractual analysis. Effective trainer and teacher of both new and old team members on how to learn and improve as well as solve complicated payment issues daily. Extremely friendly people person who both helps answer questions with other team members as well as communicates on the phone with customers and Insurers. Extremely analytical numbers cruncher and organizer. Very good communicator and ad hoc creator whom has great ideas for efficiency.ExperienceBilling and Reimbursement Team LeadInnovative Renal Care - Beverly, Massachusetts02/2019 - PresentWorked as a billing and reimbursement specialist for the commercial insurance financial class where I was able to get all balances either refunded or written off once the final payment was received and the claim was closed for further processing and was promoted after only one year.Worked as an overpayment specialist for 3 years where I was promoted 2 times. Once to Sr and once where I currently reside as the Team Lead. I was promoted for my efficient processing of all credits in our system for all financial classes and payers. I have audited contracts, billers, collectors, admissions specialists and cash posting specialist son each and every claim in order to insurance accuracy on our claim coverage, bill, payment expectation, receipt and posting of the funds and come to conclusions on how much money to refund if any.Trained multiple new hires as well as new supervisors all the way up to vice president level on our systems as well as how to process and read claims properly.The "go to" stand bye person who took on any task, any question, any overflow and any project. Created an entire process for our Overpayment/Suspense accounts.Speak regularly over the phone with a variety of collections agencies, billers and directors in order to make sure our payment was correct or our refund was described as well as contractual conversations in order to come to conclusions on over or underpayments. Also spoke with patients to help them resolve any questions or issues they had on claims and was well received by all of them for my explanatory skills on how to expect payments on claims. I also run and participate as the first line call queue for overpayment requests which acts as a front desk attendant as well.SkillsCommunication skills, Time management, Documentation review, Leadership, Organization, Research, Computer Skills, Insurance, Numbers cruncherEducationOperations and Research MathematicsCarnegie Mellon University  Pittsburgh, PAStudied a verity of Mathematical Sciences including but not limited to Accounting, Matlab, R Programming, Java, Operations & Research, Linear Programming, Business, Economics, Differential Equations, 3D Calculus, Probability, Statistics, and Matrix Algebra.