Adrianne Ferrer
Orlando,FL
Summary
Credentialing specialist with solid background in credentialing processes and compliance management. Successfully managed credentialing for diverse healthcare providers, ensuring adherence to regulatory standards. Demonstrated expertise in meticulous documentation and effective communication with credentialing entities. Also previously experienced in medical payment posting, accounts receivables, medical insurance verification, and medical billing and coding.
Overview
10
10
years of professional experience
Work History
Credentialing Specialist
Florida Retina Institute
08.2023 - Current
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Conducted primary source verifications such as background checks and board certifications.
- Safeguarded confidential provider information by adhering to strict data privacy regulations and company policies.
- Facilitated communication between departments, resulting in improved collaboration during the credentialing process.
- Received and evaluated applications to look for missing and inaccurate information.
- Prepared records for site visits and file audits.
- Updated and maintained accurate records in credentialing databases, ensuring timely renewals and verifications.
Payment Poster
Florida Retina Institute
10.2021 - 07.2023
- Ran daily bank EFT, check, and credit card deposits
- Supported audits by providing detailed records of all posted payments and adjustments upon request
- Balancing payments to match with deposited amount
- Accurately posted payments and adjustments both electronically and manually
- Identified overpayments and processed refunds for insurance carriers and patients
- Contributed to the reduction of aged accounts receivable by prioritizing oldest outstanding balances for follow-up action
- Maintained 24-48 hour turn around time for posting all received payments-any outstanding payment unable to be resolved were communicated with billing and or management
- Proactively identified potential underpayments from insurers and took appropriate actions to rectify discrepancies swiftly
- Manually entered insurance and patient checks using desktop banking device
AR Specialist
Orlando Internal Medicine
10.2017 - 07.2021
- Analyzed trends in payment patterns and customer behavior, identifying opportunities for process enhancements that would improve overall AR performance.
- Coordinated with external collections agencies when necessary, ensuring seamless handoff of delinquent accounts while protecting company interests at all times.
- Increased customer satisfaction levels by promptly addressing inquiries regarding billing issues or adjustments needed on their accounts.
- Analyzed, prepared, and issued chargeback notices for payment to prevent third-party collection agency involvement.
- Improved accounts receivable efficiency by streamlining payment processing and invoice management.
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
- Maintained accurate financial records by reconciling AR accounts, resolving discrepancies, and updating system data regularly.
- Crossed trained in medical payment posting and front desk patient check in for associated practice clinics.
Medical Biller and Coder
Internal Medicine Connection
03.2015 - 09.2017
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Cross trained in insurance payment posting and patient check out
Education
Certificate of Technical Studies - Medical Billing And Coding
Florida Technical College
Orlando, FL02-2015
Skills
- Provider enrollment
- Data management
- Insurance/Facility application coordination
- Credentialing oversight
- Employee onboarding
- Payment posting
- Overpayment identification
- Batch balances and reports
- Insurance verification
- Aging reports analysis
- Medical billing and coding
Timeline
Credentialing Specialist
Florida Retina Institute
08.2023 - Current
Payment Poster
Florida Retina Institute
10.2021 - 07.2023
AR Specialist
Orlando Internal Medicine
10.2017 - 07.2021
Medical Biller and Coder
Internal Medicine Connection
03.2015 - 09.2017
Certificate of Technical Studies - Medical Billing And Coding
Florida Technical College
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