Cynthia Kelly
Merrillville
Summary
Dynamic healthcare professional with extensive experience at The University of Chicago Medicine, excelling in claims processing and staff training. Proven track record in resolving complex billing issues and enhancing revenue cycle management. Adept at fostering teamwork and collaboration, driving efficiency, and implementing strategic solutions to reduce claim denials.
Overview
32
32
years of professional experience
Work History
Government Insurance Coordinator
The University of Chicago Medicine
Chicago
04.2016 - Current
- Review/edit/submit Medicare/MAP/MMAI claims for services involving clinical trials/studies/registries based on insurance guidelines and requirements
- Review/complete insurance claims audits
- Review/submit claim appeals
- Work with the clinics on solving claim issues
- Assist the staff with complex claims issues and resolutions
- Assist Medicare staff with claim issues, billing assignments and claim resolutions
- Review and report Medicare updates and guidelines
- Monitor claims for accuracy and proper reporting
- Assist other departments with claim issues based on Medicare's regulations and guidelines
- Assist in implementing policies/procedures and process initiatives to reduce claims delay and denials
- Monitor the daily activities of the Medicare staff
- Assist in monitoring and reporting the staff productivity metrics
Government Insurance Supervisor
Advocate Healthcare
Oakbrook
09.2012 - 12.2015
- Conducted performance reviews for staff members to identify areas of improvement.
- Assigned tasks to staff members to ensure timely completion of projects.
- Resolved customer complaints regarding insurance coverage and billing issues.
- Analyzed information to assess current or future NGS/CMS billing changes.
- Managed daily operations within the department including staffing schedules, billing, and follow-up.
- Ensured that all documents related to insurance are properly filed according to the NGS/CMS guidelines.
- Coordinated preparation of external audit materials and external financial reporting.
- Conducted reviews and evaluations for staff performance.
- Provided training on new processes and procedures as they become available in the NGS/CMS website.
Government Insurance Supervisor
Ingalls Memorial Hospital
Harvey
06.2011 - 09.2012
- Conducted performance reviews for staff members to identify areas of improvement.
- Assigned tasks to staff members to ensure timely completion of projects.
- Resolved customer complaints regarding insurance coverage and billing issues.
- Provided training on new processes and procedures as they become available in the NGS/CMS website.
- Ensured that all documents related to insurance are properly filed according to company guidelines.
- Managed daily operations within the department including staffing schedules, billing, and follow-up.
Medicare Supervisor
Methodist Hospitals
Merrillville
08.2001 - 03.2011
- Assist/monitor the team daily billing/collection assignments
- Trained staff on update billing requirements and changes
- Provided monthly claim reports to senior leadership
- Developed/implemented training programs/webinars to maximize account receivables
- Reviewed/resolved customers questions/issues and complaints
- Assist clinics with update billing requirements and guidelines as issued by government insurance payers
- Monitor the staff daily/weekly activities and responsibilities
- Created training manuals to assist in resolution of complex claims issues
- Interviewed and trained new hired staff
- Provided monthly departmental claims/revenue report to senior leadership
- Effectively communicated with Medicare staff to maintain clear defined individual goals and expectations
- Developed rapport with insurance payers in solving claim issues
Healthcare Insurance Representative
St. Anthony Medical Center
Crown Point
01.1993 - 08.2001
- Submitted/monitor government claims for processing
- Reviewed claims audits and reports
- Submitted Medicare claim appeals
- Assist in patient's registration and admission
Education
Business Management - Business Administration
Purdue University Calumet
Hammond, IN01.1994
Bachelor of Science - Health Care Administration And Management
Southern New Hampshire University
Hooksett, NHSkills
- Claims processing
- Accounts receivable
- Revenue cycle management
- CPT coding
- Strategic thinking skills
- Teamwork and collaboration
- Problem-solving aptitude
- Staff training
- Effective communication
- Organizing and prioritizing work
- Claim appeals
- Medical billing proficiency
References
References available upon request
Timeline
Government Insurance Coordinator
The University of Chicago Medicine
04.2016 - Current
Government Insurance Supervisor
Advocate Healthcare
09.2012 - 12.2015
Government Insurance Supervisor
Ingalls Memorial Hospital
06.2011 - 09.2012
Medicare Supervisor
Methodist Hospitals
08.2001 - 03.2011
Healthcare Insurance Representative
St. Anthony Medical Center
01.1993 - 08.2001
Business Management - Business Administration
Purdue University Calumet
Bachelor of Science - Health Care Administration And Management
Southern New Hampshire University
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