Adeline M. Quintiliano
Summary
Medical Records Coordinator and Medical Billing Specialist with a successful record of increasing department efficiency, reducing errors, and eliminating bottlenecks. Diligent commitment to improving and streamlining processes for maximum productivity. In-depth knowledge of HIPAA constraints and medical records management. Demonstrated over 20 years of industry expertise.
Overview
30
30
years of professional experience
Work History
Medical Records Specialist
Advanced Radiology
05.2024 - Current
- Maintained patient records in compliance with security regulations.
- Kept accurate log of requests for medical information and records.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Reviewed charts and flagged incomplete or inaccurate information.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Printed and photocopied documents to provide patients with copies of medical records.
- Responded to patient inquiries to provide information and details of medical records.
- Scanned medical records in digital format for easy retrieval and accessibility.
Medical Billing Specialist
Optum 360/ United Healthcare
10.2018 - 08.2023
- Entered CPT codes and DX into OnBase and Working Centricity preprocessor. Performed test edits and charge entry.
- Followed up on electronic denials and processed refunds and billing re-submittals to insurance carriers.
- Conducted data entry of patient account records, including address and insurance information.
Medical Billing Specialist
Ameripath Diagnostic
01.2006 - 01.2018
- Utilized comprehensive knowledge of medical billing processes and procedures to accurately code and submit claims for reimbursement.
- Analyzed and validated patient information, diagnoses, and billing data to ensure accuracy and compliance with insurance requirements.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Communicated with insurance providers to resolve denied claims and resubmitted.
Medical Billing Specialist
Neurological Specialist, p.c
01.2004 - 01.2006
- Conducted thorough research and investigation to resolve billing inquiries and discrepancies, providing exceptional customer service to patients and insurance companies.
- Collaborated with healthcare and insurance carriers to resolve claim denials and discrepancies, ensuring timely and maximum reimbursement.
- Filed and updated patient information and medical records.
Third Party Medical Rep.
Billing
01.2003 - 01.2004
- Generated and analyzed reports to monitor and manage patient aging, identifying and addressing outstanding balances and delinquent accounts.
- Working at Medistar not only provided me with valuable experience in medical billing, but it also allowed me to grow both professionally and personally, gaining confidence in my abilities and expanding my expertise.
Third Party Medical Rep
Diann Systems
01.2000 - 01.2003
- Followed up on electronic denials. Heavy telephone contact with customer and insurance carriers. Entered data into patient accounts. Verified insurance information and obtained authorization.
- Utilized electronic billing systems and software to enter and update patient account information, including address and insurance details.
Customer Services Rep.
Milford Surgical/ Phils Pharmacy
01.1996 - 01.2000
- Managed customer supply orders for both wholesale and retail clients.
- Verified insurance information and obtained authorizations.
- Assisted pharmacists with customer prescriptions as a pharmacy technician.
- Entered supply orders and patient information accurately.
Education
High School -
Bass's High School
Bridgeport, CT01.1981
Skills
- HIM Digital Medical Records
- Epic, On Base, Sector, PowerShare, Ambra
- Medical Billing Revenue Cycle
- Data Entry
- Medical Billing and Collection Procedures
- Commercial and Private Insurance
- Claims Review/ Processing
- Medicaid and Medicare knowledge
- Staff education and training
- EMR / EHR
- Medical information release
- Microsoft Products; Windows, Word: Excel, Powerpoint, Centricity
Timeline
Medical Records Specialist
Advanced Radiology
05.2024 - Current
Medical Billing Specialist
Optum 360/ United Healthcare
10.2018 - 08.2023
Medical Billing Specialist
Ameripath Diagnostic
01.2006 - 01.2018
Medical Billing Specialist
Neurological Specialist, p.c
01.2004 - 01.2006
Third Party Medical Rep.
Billing
01.2003 - 01.2004
Third Party Medical Rep
Diann Systems
01.2000 - 01.2003
Customer Services Rep.
Milford Surgical/ Phils Pharmacy
01.1996 - 01.2000
High School -
Bass's High School
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