Patient Account Rep Resume Samples
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Patient Account Rep Resume Samples
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EW
E Wilkinson
Era
Wilkinson
41998 Dickinson Mountain
Dallas
TX
+1 (555) 746 2703
41998 Dickinson Mountain
Dallas
TX
Phone
p
+1 (555) 746 2703
Experience
Experience
Detroit, MI
Patient Account Rep
Detroit, MI
Rath-Wintheiser
Detroit, MI
Patient Account Rep
- Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks. Researches overpayments, identifies root causes or trends, processes refunds, takes corrective action, and reports findings to supervisor. Responsible for working on credit work queues and processing refunds for any transaction, unmatched in Epic, that results in the amount remaining undistributed
- 24/7 Department. Mid-day/2nd shift hours will vary with shift times starting between 11a and 2p and varying in length between 7.5 and 9.5 hours 4-5 days per week. Mandatory every other weekend and 50% of holidays
- Participate and attend meetings, training seminars and in-services to develop job knowledge. Attend various conference calls, webinars or advanced training to provide assistance to the team members
- Provide enhanced training and assist staff with techniques to increase production, quality and collections. Participate in the new hire peer interviewing process
- Update registration information, post denial codes and adjustments in practice management systems
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Identify issues or trending and provide suggestions for resolution
Detroit, MI
Workers Comp-patient Account Rep
Detroit, MI
Braun Inc
Detroit, MI
Workers Comp-patient Account Rep
- Researches delinquent claims to identify problems with employer/carrier. Identify trends and report findings to manager. Works with manager to resolve issues
- Consistently reaches A/R aging goals for Workers' Compensation (W/C) accounts
- Researches denials. Processes and/or appeal denials according to established PFS guidelines
- Knowledge of Work Comp payers and policies including Department of Labor
- Performs other projects and duties as related to organization's objectives
- Resolves patient, carrier, employer group and other department staff inquiries according to established PFS protocols
- Understands coverage and registration guidelines as they apply to Workers' Compensation accounts and coverages
present
Philadelphia, PA
Lead-patient Account Rep
Philadelphia, PA
Kunze Group
present
Philadelphia, PA
Lead-patient Account Rep
present
- Participate and attend meetings, training seminars and in-services to develop job knowledge. Attend various conference calls, webinars or advanced training to provide assistance to the team members. Respond timely to emails and telephone messages from the staff, management and the client. Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions
- Provide assistance, coaching and training to staff members, including new hires
- Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary. Accurately and thoroughly document the pertinent collection activity performed
- Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions
- Provide assistance, coaching and training to staff members, including new hires. Provide enhanced training and assist staff with techniques to increase production, quality and collections. Participate in the new hire peer interviewing process. Assist in special projects assigned by management
- Assist in special projects assigned by management
- Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites. May maintain a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged
Education
Education
Bachelor’s Degree in Initiative
Bachelor’s Degree in Initiative
University of Virginia
Bachelor’s Degree in Initiative
Skills
Skills
- Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times
- Actively participates in quality improvement initiatives (i.e. CQI, TQM, Lean, 100% participation, etc.)
- Very good written and verbal communication skills
- Strong interpersonal skills
- Quality Improvement
- Advanced knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
- Advanced knowledge of CPT and ICD-9 codes
- Advanced knowledge of insurance billing, collections and insurance terminology
- Good written and verbal communication skills
- Account Research/Patient Education: Assists patients with difficult billing issues and researches patient accounts, bank reconciliation, etc. as applicable
11 Patient Account Rep resume templates
Read our complete resume writing guides
1
Bwpo Senior Patient Account Rep Resume Examples & Samples
- Thorough knowledge of Physician third party billing and collections required
- Proficient knowledge of Microsoft Word and Excel
- Excellent organizational skills
- Strong interpersonal skills, service orientation, and teamwork
2
Patient Account Rep Resume Examples & Samples
- Demonstrates professional, appropriate, effective and tactful written, verbal, and nonverbal communication with patient, families, medical staff, colleagues, vendors, and other departments throughout the continuum of care to promote continuity of care and services and enhance clinic image
- Demonstrates positive professional customer service in all patient, staff, and visitor contacts
- Utilizes interpersonal skills to establish and maintain healthy interpersonal relationships with healthcare members, patients, and families
- Acknowledges patient’s rights on confidentiality issues, maintains patient confidentiality at all times, and follows HIPAA guidelines and regulations
- Proactively acts as patient advocate, responding to and working to resolve patient concerns
- Responsible for following equipment maintenance protocol, identifying problems, and coordinating appropriate repairs
- Operation of various office machines (i.e. fax, copier, phone, and computer)
- Participates effectively as a team member in the clinic
- Work includes cross coverage in other areas as team needs
- Misc. office duties
- One year experience in accounts receivable or health insurance in a medical setting required
- One-year experience on personal computers and/or mainframe terminal and office calculators required
- Coder certification preferred
- Successful completion of a medical terminology class preferred
- A minimum of one year current experience of CPT, ICD-9, and HCFA 1500 required
3
Patient Account Rep Resume Examples & Samples
- Participate and attend meetings, training seminars and in-services to develop job knowledge. Attend various conference calls, webinars or advanced training to provide assistance to the team members
- Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions
- Very good written and verbal communication skills
4
Lead-patient Account Rep Resume Examples & Samples
- Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites. May maintain a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged
- Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary. Accurately and thoroughly document the pertinent collection activity performed
- Review the account information and necessary system applications to determine the next appropriate work activity
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory. Proactively identify issues or trending and provide suggestions for resolution
- Participate and attend meetings, training seminars and in-services to develop job knowledge. Attend various conference calls, webinars or advanced training to provide assistance to the team members. Respond timely to emails and telephone messages from the staff, management and the client. Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions
- Advanced knowledge of CPT and ICD-9 codes
5
Senior Patient Account Rep Resume Examples & Samples
- Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites and filing appeals
- Effectively resolves complex or aged inventory, including payment research and payment recoups with minimal or no assistance necessary
- Identify and communicate issues to management, including payer, system or escalated account issues as well as assist in the development of solutions
- Assist with special projects assigned by management as needed
- Assist new or existing staff with training or techniques to increase production and quality as well as provide A/R support for the team or team members that may be absent or backlogged
6
Patient Account Rep Resume Examples & Samples
- Ability to handle multiple priorities at once with minimal supervision
- Ability to organize and communicate clearly
- Provide or willing to obtain CPR certification
- Must be able to work variable shifts including days, evenings and weekends
7
Patient Account Rep Resume Examples & Samples
- Work in a multitude of healthcare patient accounting systems to assist patient in resolving account
- Follow established call model to collect balance in full or secure payment arrangements prior to the account moving to Bad Debt
- Assist the Unit Manager or Team Lead in working priority reports promptly, effectively, and efficiently and serve as a mentor to new employees by assisting with their training and development
- Work with insurance companies as needed and complete any necessary correspondence to facilitate account resolution
- Accept constructive criticism and listen to recorded calls in an effort to improve call quality and collection dollars
- Strict adherence to HIPAA, HiTech and all state and federal regularions relating to account collections and patient privacy
8
Patient Account Rep Patient Access Days Resume Examples & Samples
- Enters data for patient accounts, registration, finance and reimbursement functions
- Prepares intake packet and sends requisite paperwork to appropriate staff, providers, and departments
- Ensures that all documentation and verification required is finalized prior to billing
- Exhibits and adheres to CHI Franciscan Health’s Core Values of Reverence, Integrity, Compassion and Excellence
- Successful completion of an accredited medical terminology course(s) or equivalent on-the-job training, and two years of related work experience in patient registration, insurance verification, or related function that demonstrates attainment of the requisite job knowledge skills/abilities
9
Patient Account Rep-frisco NIC Resume Examples & Samples
- Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites
- Advanced technical skills including PC and MS Outlook
- 3-6 years experience in Medical/Hospital Insurance related collections
10
Patient Account Rep-dme Resume Examples & Samples
- Ensure patient satisfaction through timely and effective patient account maintenance including assistance with billing, third-party payments, adjustments, information verification and record maintenance
- Submit claims to government agencies, medical service bureaus, and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data and patient information submitted
- Interpret and communicate information regarding credit policies and procedures, billing practices, insurance submission and out-of-pocket patient responsibility. Keeps abreast of current/revised regulatory requirements (e.g. Medicare/Medicaid) relating to the billing of durable medical equipment, orthotics, prosthetics and related products, as well as pharmacy billing; provides information regarding implementation of new codes and revision of charge documents as requested
- Accurately and timely post private payments, insurance payments, disallows and/or denials to appropriate patient account, calculate patient responsibility, interpret explanation of benefit message codes, identify payment discrepancies by contacting insurance carrier, and determine if rebilling is necessary
- Function as liaison between patients and clinic staff on claims, billing questions or insurance related issues. Provides feedback and in-service training to retail pharmacy and hospital staff with respect to billing/documentation requirements and restrictions on supplies and equipment. Act as a resource to physicians, providers administrators and patients regarding health insurance claim policies, procedures and requirements. Respond to inquiries from agencies, bureaus, and insurance companies to assist in the claim payment process. Effectively process patient, clinic and insurance correspondence, including requests for refunds and collections when warranted
- Accurate batch balancing and reporting. Trace errors, record adjustments to proper accounts and determine the appropriate destination for unidentified funds
- Submit claims to secondary insurers as required. Ensure deposits balance to posting and resolve any discrepancies
- Manages monthly renewals of all rental equipment, including notifying appropriate department for pickup due to length of need expiration
- High School Diploma or GED equivalent required
- A basic course in medical terminology, medical billing and/or accounting preferred
- Within the last 18 months, 12 – 18 months charge and payment posting experience in a healthcare environment required. Knowledge of insurance companies, CPT and diagnosis codes as well as experience following billed and denied claims
- Knowledge of DME medical billing and reimbursement standards, procedures and documentation
- Knowledge of pharmacy billing and reimbursement standards, procedures and documentation
11
Lead-patient Account Rep Resume Examples & Samples
- Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Provide enhanced training and assist staff with techniques to increase production, quality and collections
- Attend various conference calls, webinars or advanced training to provide assistance to the team members
12
Patient Account Rep-collections Resume Examples & Samples
- One year computerized medical billing or related experience preferred
- Knowledge of medical terminology. Knowledge of Medicare and Medi-Cal reimbursement processes. Basic knowledge of accounting procedures and computer based accounts receivable systems
- Thorough understanding of HCFA 1500 and UB-04 billing required; basic understanding of coding
- Can verify adequacy of demographic information
- Basic knowledge of managed care programs and billing requirements necessary
- Typing, data entry, 10-key, PC, and word processing skills, preferred
13
Patient Account Rep Resume Examples & Samples
- Reviews and researches claims for denials reason. Prepares and files appeals timely. Completes Request for Reconsideration forms following payor requirements and submits within timely filing periods. Includes all applicable clinical documentation in accordance with HIPAA Privacy Standards and to ensure maximum reimbursement. Follows established Patient Accounts appeal guidelines. Processes insurance/patient correspondence, VOC, and ticklers follow-up based on established Midwest Physician Administrative Services Insurance Follow Up unit policies and procedures. Researches delinquent claims to identify payer and/or claim office trends, applies approved payer rule adjustments, resubmits missing claims, and reports findings to supervisor. Identifies coding errors and prepares clinical coding reviews. Maintains confidentiality of all information as stipulated in the HIPAA Privacy Rules and MPAS Confidentiality Policy. Identifies coding errors and facilitates clinical coding review
- Deal directly with customers either by telephone. Answers patient questions, inquires and concerns regarding their accounts & respond promptly to their inquiries. Works with patient to set up credit card payment and appropriate payment plans on their accounts where applicable. Identifies any billing or insurance errors and knows where to direct the issue for a resolution. Follows-up on inquires sent to see that a resolution has been made. Handle and resolve customer complaints. Obtain and evaluate all relevant information to handle inquiries and complaints. Answers patient questions on general information regarding physicians and our different locations/sites
- Assist with answers phones for customer service
- Review Department and clinical department coding coordinators on retro authorization requests and appeals. Involves Team Lead on complex issues or unanswered requests. Participates in the rotation of unit responsibilities. Attends available classes pertaining to position. Responsible for maintaining accurate and current resource material. Utilizes material appropriately when making determinations for claim appeals. Maintains department's policies and procedure timeliness and accuracy standards. Performs other projects and duties as related to organization's objectives
- Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks. Researches overpayments, identifies root causes or trends, processes refunds, takes corrective action, and reports findings to supervisor. Responsible for working on credit work queues and processing refunds for any transaction, unmatched in Epic, that results in the amount remaining undistributed
- Typing, computer knowledge, proficiency in excel and word. Insurance knowledge and background of CPT and ICD codes helpful. Familiarity with 5010, claims payments and customer service background helpful
14
Patient Account Rep-patient Accounting Resume Examples & Samples
- Two years of recent employment in a medical environment handling medical insurance claims
- Medical billing, cashiering and/or collection experience
- Proficient knowledge and ability to accurately utilize all reimbursement tools and working experience with MediTech
- Ability to coordinate projects involving planning, research, training and appropriate delegation
- Experience with Microsoft Word, Excel and Outlook
- Medical terminology completion
15
Patient Account Rep-patient Financial Services Resume Examples & Samples
- Reviews and makes recommendations on patient financial statements
- Acts as Iowa Heart Center representative with outside collection agencies
- Follow up on non-sufficient funds checks
- Review and prepare accounts for outside collection placement
- Work with pre-registration staff on difficult accounts
- Performs other special projects as assigned by supervisor
- Monitors patient payment plans
- Provides Customer Service coverage during absence of representative
16
Workers Comp-patient Account Rep Resume Examples & Samples
- Consistently reaches A/R aging goals for Workers' Compensation (W/C) accounts
- Confirms and documents W/C cases in accordance with established PFS policies and procedures
- Researches denials. Processes and/or appeal denials according to established PFS guidelines
- Researches delinquent claims to identify problems with employer/carrier. Identify trends and report findings to manager. Works with manager to resolve issues
- Identifies coding errors and facilitates clinical coding reviews
- Resolves patient, carrier, employer group and other department staff inquiries according to established PFS protocols
- Researches overpayments, identifies root causes or trends, processes refunds, and reports findings to supervisor
- Researches undistributed W/C payments. Confirms liability and processes refunds accordingly
- Obtains medical records for documentation review using established DuPage Medical Group guidelines for order and return of medical records
- Knowledge of Work Comp payers and policies including Department of Labor
- Prepares claim payment, carrier, and employer issues and problems for review with supervisor
- Monitors appeals and reports status to supervisor
- Adheres to reporting requirements as established by supervisor
- Understands and applies Workers' Compensation rules and regulations. Complies with adjustment and appeal procedures in conjunction with DMG Coding and Reimbursement guidelines
- Understands coverage and registration guidelines as they apply to Workers' Compensation accounts and coverages
- Interacts with other group, administration and PFS department staff to successfully reduce the A/R
- Participates in the rotation of unit responsibilities
- Attends available classes pertaining to position
- Responsible for maintaining accurate and current resource material. Utilizes material appropriately when making determinations for claim appeals
- Maintains department's policies and procedure timeliness and accuracy standards
- Performs other projects and duties as related to organization's objectives
- Maintains confidentiality of all information as stipulated in the HIPAA Privacy Rules and DMG confidentiality policy
- Effective in communicating verbally with other staff and departments related to Workers' Compensation claims and remittance
- Schedules and prioritizes for self. Establishes strategies to accomplish specific results and produces desired results
- Effective in identifying and analyzing problems. Generates alternatives and identifies possible solutions
- Fosters teamwork and positive rapport within all departments to maximize achievement of goals
- Knowledge of ICD-9, CPT and HCPCS
- No licensure requirements
17
Patient Account Rep Senior Resume Examples & Samples
- Researches and responds to patient and/or commercial payor inquiries timely, effectively and according to policies and procedures resulting in resolution
- At all times, provides professional and exceptional customer service when interacting with internal and external customers resulting in resolution
- Documents all communications in the financial system and updates demographics ensuring accuracy and appropriate information to move the account towards payment
- Meets productivity goals as set by Management
- Reviews and processes Commercial payor refunds in the financial system by insuring the refund amount is appropriate
- Uses critical thinking skills to monitor and follow-up on Commercial claims to ensure correct hospital reimbursement in a timely and accurate manner, with minimal supervision
- Demonstrates and shares knowledge of Commercial payor hospital account management, billing and collections skills with co-workers and offers assistance, when needed
- Demonstrates appropriate, aggressive telephone and/or online follow-up as necessary to expedite payment of billed charges with minimal supervision
- Makes suggestions for enhancements within the department and seeks to improve collection efforts
- “Other duties as assigned”
- Minimum 3 years hospital business office experience, preferred
- Understanding of commercial insurance collections processes including denial resolution and appeals, preferred
- Positive work ethics
18
Patient Account Rep Resume Examples & Samples
- 2 years of Medicaid/Medicare hospital collections experience
- Prefer three years of hospital business office or medical related experience
- Responds promptly to inquiries
- Updates account information accordingly
19
Patient Account Rep-medicaid Resume Examples & Samples
- Some knowledge of business office, patient billing, or collection/reimbursement procedures in a healthcare setting preferred
- Ability to multi-task in a fast paced, high volume environment
- Proficient in Microsoft office with emphasis on Excel, 10-key and math
- Reviews incoming correspondence and takes appropriate action
- Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary
- Documents communications accurately and completely
- Adheres to all Memorial Hermann policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice
- Serves as a mentor and resource for less experienced staff
20
Patient Account Rep Resume Examples & Samples
- High School diploma or equivalent preferred
- Previous call center experience of 1 year or more handling multiple incoming phone lines
- Direct customer service experience in face to face environment is also a plus
21
Patient Account Rep, Comm Resume Examples & Samples
- High School diploma or GED equivalent, required
- 1-year hospital, medical or medical insurance experience, required
- Medical terminology/advanced training, preferred
- ICD-9, HCPC, Revenue Codes, preferred
22
Patient Account Rep Resume Examples & Samples
- Minimum 2 years’ experience and understanding of Commercial payor hospital collections processes required
- Knowledge of medical terminology and coding, preferred
- Use of 10-key calculator by touch preferred
23
Patient Account Rep-referrals Resume Examples & Samples
- May be responsible for keeping department specific calendars (physical or electronic) up-to-date and accurate
- Collects patient records, labs, charts, and other items necessary for patient appointments
- May verify and/or re-verify insurance benefits and eligibility on all patient accounts prior to appointment
- May explain and obtain pre-authorization for services and the number of visits to ensure timely payment
- May collect and record patient co-pays
- Administrative duties may vary according to department needs, but may include answering phones, greeting patients, checking patients in, creating and distributing reports, assembling charts, obtaining medical records, maintaining record and filing systems, handling mail, and other duties of a similar nature
24
Patient Account Rep Resume Examples & Samples
- Answer business office telephones and assist patients with account inquiries by routing calls to appropriate departments
- Audit patient accounts for accuracy, verification of patient balances versus insurance balance
- Notify manager with patient account and insurance issues
- Skilled in researching insurance requirements to facilitate claim payment. Abilities
- Ability to use EMR, other relevant computer hardware and software, telephone, copier, fax machine and other standard medical office equipment. Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, calculators, etc. Work Environment: Position is in a well-lit office environment. Occasional evening and weekend work. Mental/Physical Requirements: Involves sitting approximately 75 percent of the day, walking or standing the remainder, using computers and telephones
25
Patient Account Rep Resume Examples & Samples
- Must have proficiency with the following Microsoft Office programs: Office and Outlook
- Excellent customer service skills and must be able to work successfully with a diverse group of faculty, other staff, and patients
- Must be able to follow directions and work as part of a team
- Must be able to follow patient safety and confidentiality (HIPAA) guidelines
26
Patient Account Rep-pfs Resume Examples & Samples
- Process simple medical billing and collection claims
- Contact patients and third party payers to resolve past due accounts
- Verify assigned accounts have been billed to and received by the appropriate third-party payer
- Other duties as assigned or required
- Knowledge of medical insurance terminology
- Knowledge of and proficiency using basic office equipment
- Organizational skills and the ability to maintain information in a logical and well thought out manner
27
Patient Account Rep-pfs-prn Resume Examples & Samples
- Review and verify the receipt of third party claims; identify errors and seek resolution
- Investigate accounts status and determine follow up action needed
- Identify any delays in the processing and payment of claims by third party payers; take the appropriate corrective action to ensure payments are applied
- No experience required. Six (6) months of medical billing and collections is preferred
- Proficiency using basic Personal Computer (PC) hardware and software applications (i.e., Microsoft Word and Excel)
- Proficiency using moderately complex medical record/billing software platforms
- Good communication skills and the ability effectively communicate verbally and in writing
- Good interpersonal skills and the ability to develop and maintain relationships with internal and external contacts
28
Patient Account Rep-as Needed Resume Examples & Samples
- Two plus years experience verifying insurance eligibility, customer service, registration and cash posting experience in a healthcare environment required
- Excellent customer service and interpersonal skills
- ICD-9 and CPT knowledge preferred
- EPIC experience preferred
- Keyboard skills of 35-40 wpm
29
Patient Account Rep-collections Resume Examples & Samples
- High School graduate or equivalent technical training with some additional education (i.e.: computer training, communication classes, etc.) Knowledge of medical terminology
- Knowledge of Medicare and Medi-Cal reimbursement processes
- Basic knowledge of accounting procedures and computer based accounts receivable systems
30
Patient Account Rep, Govt Resume Examples & Samples
- Minimum of six months experience performing customer service duties in the retail, service or medical industry, required
- Experience in understanding and usage of computers as well as the ability to learn applications relavant to the position, required
- Knowledge of medical insurance billing/collections software, preferred
31
Patient Account Rep Resume Examples & Samples
- Two years prior experience in a hospital business office preferred
- Previous medical collection experience preferred
- Good communication skills, both oral and written
32
Patient Account Rep Resume Examples & Samples
- Act as an advisor to less experienced employees
- Participates in supporting the organization’s vision, mission and values and adheres to DeKalb Medical IREACH Standards of Behavior
- Minimum 5 years of job related experience working with claim edits/denials, EOBs/ERAs within a Centralized Business Office or Physician Billing/Collections related environment
- Competent on computerized patient billing and operating system
- Strong working knowledge of standard CPT and ICD-10 coding
- Certified Patient Account Representative (CPAR) preferred but not required
- Certified Professional Coder (CPC) preferred but not required
- Working experience with medical terminology
- Working experience with Human Anatomy
- Working knowledge of third-party insurance in regards to plan types: HMO, PPO, POS and Indemnity
- Knowledge of Government/Managed Care plans
- Skill and ability to effectively manage multiple tasks and priorities within a fast-paced environment
- Skill and ability to anticipate, manage, and adapt to change
- Knowledge and skill to gather and summarize data from multiple sources and analyze using common statistical functions
- Skill and ability to lead and take initiative