Alandra Douglas
@alandradouglas
Results-driven healthcare audit specialist with expertise in process optimization.
United StatesWhat I'm looking for
I am a resourceful and results-driven professional with extensive expertise in healthcare audits, denials management, and process optimization. My systemic thinking allows me to identify patterns and implement effective resolutions, which has led to significant savings and improvements in efficiency. At Reid Hospital, I successfully saved and won over $27 million by conducting root cause analyses of denied claims and educating clinical staff on proper documentation techniques.
Throughout my career, I have served as a liaison between various departments, including patient accounts, billing, coding, and case management, to resolve denial issues efficiently. My ability to analyze payer policies and prepare detailed audit reports has ensured accurate reimbursement rates and improved organizational objectives. I am committed to continuous improvement and have provided extensive denials training to new hires, fostering a culture of excellence within my teams.
Experience
Work history, roles, and key accomplishments
PB Billing and Denials Audit Specialist
Reid Hospital
Aug 2019 - Present (5 years 11 months)
Saved and won over $27 million by conducting root cause analyses of denied claims to identify areas for improvement. Educated clinical staff on proper documentation techniques to reduce claim denials caused by errors or omissions.
Covid Contact Tracer
Mindset PCG
Dec 2020 - Present (4 years 7 months)
Managed hundreds of patient cases and followed them through to close, demonstrating strong organizational and follow-up skills. Provided comfort and support to patients through effective communication.
Billing and Sales Representative
Charter Communications | Spectrum
Dec 2017 - Present (7 years 7 months)
Analyzed billing data to identify trends and areas for improvement, ensuring timely and accurate processing of high volumes of daily transactions. Researched and resolved billing discrepancies with an analytical approach, delivering exceptional customer service.
Supervisor and Alumni Fund Representative
Earlham College | Phonathon
Aug 2013 - Present (11 years 11 months)
Raised over $12,000 in three months as an individual representative, demonstrating strong fundraising and communication skills. Managed and assessed data trends to optimize team performance, and evaluated staff performance to provide feedback and set personal goals.
Intern
New Justice Services
Received comprehensive training in conflict resolution, mediation, and arbitration, developing strong skills in dispute resolution. Applied learned techniques to assist in various justice-related services.
Education
Degrees, certifications, and relevant coursework
ECEarlham College
BS in Business and Non-Profit management, Business and Non-Profit management
Activities and societies: Supervisor and Alumni Fund Representative at Phonathon, raising over $12,000 in three months and managing data trends to optimize team performance.
Studied Business and Non-Profit Management. Gained expertise in healthcare audits, denials management, and process optimization. Developed skills in leveraging trend tracking to develop and execute solutions that improve efficiency.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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