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Emanuel
RCM specialist
Contato
Competências
Applied statistical techniques to interpret complex datasets, supporting business decision-making.
Created interactive dashboards and reports to visualize key metrics for stakeholders.
Developed and optimized queries for data extraction, transformation, and loading processes.
Built financial models to forecast business growth and analyze investment opportunities.
Formação acadêmica
Resumo
Experienced Data Analyst specializing in financial services, skilled in data visualization, reporting, and analysis. Adept at translating complex data into clear insights to support strategic initiatives.
Principais conquistas
- Led data analysis projects to identify market trends, informing strategic decisions.
- Developed dashboards in Power BI that improved reporting efficiency by 30%.
- Collaborated with cross-functional teams to enhance data collection processes and improve data quality.
Experiência
RCM specialist
Specialist on clinical denials department, Specialist in verification of denied claims, solving the sending of appeals or reconsiderations to insurance companies for their timely payment, understanding the clinical processes in the revenue billing cycle (denial letters, CPT codes involved in denial decisions) through mailing or faxed communications.
QA Analyst
Quality Analyst, Evaluated agent performance by listening and assessing calls according to quality standards, giving report to the team leader through excel template, Documented call information and validated the effectiveness of agent transfers, Achieved weekly metric targets, team meeting to get calibration.
Authorization Representative
Patient Service Advisor, solved requests for patients enrolled on Community Dual Plans (DSNP) authorized sleep apnea device, using insurance portals, calls and documentation request by fax, asked for medical records in EHR System, resolving concerns and requests rides to the appointments, refills with pharmacies, refund for prescriptions, find Providers In network according each plan, Third-party calls with Physicians and patient to resolve concerns and give them information according to their services.