Successfully managed a complex claims portfolio at Baylor Scott & White Health, recovering over $1.2 million in previously denied claims during Q3 2023. This achievement was critical in maintaining revenue stability for a high-volume surgical department facing increasing payer scrutiny. My systematic approach to appeals, utilizing Epic's robust reporting features to identify trends and targeted intervention strategies, directly mitigated potential revenue losses, ensuring consistent cash flow for vital patient services.
My expertise spans the entire revenue cycle, demonstrated by several key contributions. I consistently processed an average of 350 claims daily with 99.5% accuracy using Cerner and Kareo, significantly reducing resubmission rates and accelerating reimbursement cycles. I also spearheaded the resolution of a backlog of aged A/R exceeding 90 days, recovering $300,000 by meticulously analyzing remittance advice and employing AdvancedMD's communication tools for targeted payer follow-up. Furthermore, I trained new hires on eClinicalWorks and Practice Fusion, ensuring their rapid proficiency in billing and coding standards.
I am particularly drawn to SummitView Healthcare Partners' reputation for innovative patient-centric care and your recent expansion into specialized outpatient services. My deep expertise in denials management, specifically navigating complex medical policies, aligns perfectly with the need to optimize revenue streams for these new offerings. My adaptability across multiple billing systems will also be invaluable in ensuring seamless financial operations as your network continues to grow and integrate diverse specialty practices.
My comprehensive background in medical billing, coupled with my ability to navigate intricate payer landscapes and utilize diverse EMR systems effectively, positions me as a strong asset to your team. I am confident I can contribute immediately to SummitView Healthcare Partners' financial health and operational efficiency. I welcome the opportunity to discuss how my qualifications can directly benefit your organization in an interview.
Best regards,
Valentina Cruz