Amanda Adkins
Greensboro,NC
Summary
Detail-oriented Billing Specialist with extensive knowledge of medical billing requirements, specializing in laboratory, pharmaceutical, medical office, and chronic care management billing. Proven expertise in administrative functions, customer service excellence, and leadership roles contributes to a well-rounded skill set. Highly organized with strong attention to detail, consistently ensuring accuracy and efficiency in all tasks. Prepared to leverage a diverse background to drive success in a dynamic new position.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Medical Billing Specialist
Kestra Medical Technologies
Kirkland, WA
11.2024 - Current
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Ensure patients statements are generating appropriately, reconciling patient balances identified in the revenue cycle management (RCM) system with both the insurance explanation of benefits (EOB) and our statement system.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Precisely evaluated and verified benefits and eligibility.
- Liaised between patients, insurance companies, and billing office.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Contributed to overall office organization by maintaining up-to-date records of all billed services and payments received.
Medical Billing Coordinator
UpStream
04.2023 - 09.2024
- Prepared monthly financial statements detailing revenue generate by practice locations
- Effectively resolved disputes regarding coverage eligibility or claim denials through professional communication with insurance representatives
- Improved billing accuracy by implementing stringent quality control measures and enhancing documentation processes
- Safeguarded sensitive patient data through strict adherence to HIPAA guidelines and implementation of secure record-keeping practices
- Reduced claim denials and rejections by conducting thorough audits and addressing discrepancies prior to submission
- Coordinated with clinical teams to ensure proper documentation was received for accurate coding and claim submissions, reducing delays in reimbursements
- Communicated with insurance providers to resolve denied claims and resubmitted
- Worked closely with clinical staff to ensure timely submission of claims and accurate coding practices
- Developed training programs for new hires and existing staff to improve performance and efficiency
- Identified areas for process improvement within the billing department, leading to increased productivity among team members
- Unblocking our talented billing team to ensure billing targets are attained
- You'll be identifying and owning initiatives that continually increase the focus areas and operational effectiveness of our billing team
- You'll be identifying and flagging patterns in our billing lifecycle to help inform product and engineering solutions
- You have previous experience leading medical billing teams and are viewed as an empowering leader.
- You have strong analytical skills - you have a learning and investigative mindset and value those mindsets in others.
- You approach RCM from a preventive standpoint vs being reactive - you have a mindset of preventing denials/rejections upstream.
- You have a wide range of experience across multiple specialties, multi state billing, and tele-health billing.
- You have a wide range of Revenue Cycle Management experience such as EDI Enrollments, Payment Posting and Reconciliation, Denial Resolution and Management, etc.
- You are capable of rolling up your sleeves but can be flexible / resourceful to adapt to the ever changing needs of the business.
- You are a clear and concise communicator; you enjoy the challenge of explaining complicated ideas in simple
- Assisted in staff training initiatives to develop a knowledgeable team capable of handling complex billing situations effectively
- Contributed to the development of best practices and process standardization for medical billing operations, ensuring consistency across the billing team members
- Leveraged strong organizational skills to maintain comprehensive patient accounts, enabling quick access to relevant information during billing inquiries
- Ensured compliance with all relevant Federal and State laws and regulations.
- Managed a team of 8 employees
Medical Billing Coordinator
UpStream
04.2022 - 04.2023
- Managed multiple facilities' claims and monthly revenue reports, including sending monthly invoices to clients
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes for Chronic Care Management billing
- Communicated with insurance providers to resolve denied claims and resubmitted
- Located errors and promptly refiled rejected claims
- Identified and resolved patient billing and payment issues
- Examined patients' insurance coverage, deductibles, insurance carrier payments, and remaining balances not covered under policies when applicable
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
Medical Billing Representative
Select Lab Partners
01.2020 - 04.2022
- Managed all SNF claims and accompanying reports
- Verified the accuracy of claim data prior to submission to insurance carriers
- Reviewed medical records to ensure accuracy of billing information and patient data
- Verified insurance coverage and identified third-party payers for billing purposes
- Answered customer inquiries regarding billings, payments, account status
- Utilized multiple insurance portals (BCBS, UHC, Medicare/Medicaid) to obtain patient information, assist supervisor in delegating tasks
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria
- Ensured HIPAA compliance by maintaining confidentiality of all patient information.
Lab Assistant
LabCorp of America
04.2016 - 12.2020
- Maintained laboratory equipment and supplies, ensuring proper functioning of instruments.
- Ensured compliance with all safety regulations when performing experiments.
- Performed data entry of patient information into Accessioning software system.
- Utilized computer systems to obtain and update patient insurance information.
- Processed incoming orders from physicians for laboratory tests.
- Provided customer service and support to patients, physicians, and other healthcare staff.
- Completed daily review of pending orders in order to ensure accuracy and completeness of patient information.
- Maintained complete documentation of all accessioning activities in accordance with established procedures.
- Assisted with training new personnel on accessioning processes and protocols.
- Resolved any discrepancies regarding accessioned specimens or test requests promptly and accurately.
- Monitored departmental reports on a regular basis to identify potential errors or issues requiring attention.
- Generated accurate labels for all specimens according to protocol.
- Conducted periodic audits of completed accessioning tasks.
Education
Bachelor of Science - Health Care Consumer - Trends and Marketing, Public and Community Health, Health Care Information Systems, Health Care Quality Management and Outcomes Analysis in Healthcare Management
University of Phoenix
Phoenix, Arizona01.2023
Associate of Arts - Health Information Administrator (RHIA), Healthcare Management in Medical Administration
University of Phoenix
Phoenix, Arizona01.2012
Medical Terminology, Body Systems, Health Information Content, Structure, and Processing, Health Information Management, Analysis, Legal Issues
Ashworth College
Atlanta, Georgia01.2011
Skills
- Staff Training and Development
- Revenue Cycle Management
- Operations Monitoring
- Electronic Medical Record (EMR) software
- HIPAA Compliance Understanding
- Denial Resolution Techniques
- Organizational abilities
- Strong planning skills
- Insurance Verification
- Claims Processing Proficiency
- Clinical documentation auditing
- Teamwork and Collaboration
- Excellent written communication
- Problem-Solving skills
- Customer Service Skills
- CMS guidelines
- CMS platforms
Certification
- Microsoft Excel Fundamentals
- Introduction to Project Management
Accomplishments
- Collaborated with partnering Billing Coordinator in the development of our 36/60/90-day review process for new hires. As a result, we could ensure that we provided the appropriate training for the new employees.
- Collaborated in creating the Chart Review Quality Report. Each month, this report allowed the clinical leadership team to see how their teams were doing.
- Collaborated with Billing Director, Scheduling Manager, and Scheduling Team Lead to create the Life Cycle Audit Report to ensure we were meeting patient expectations and providing quality care.
- Collaborated with partnering Coordinator and Billing Director to create our Month End Close Checklist. This allowed us to ensure that our team was meeting goals and deadlines. This increased our success rate by 90%, our team felt more organized and understood expectations.
- Created all new SOPs and Training Material for the billing department.
- Increased billing accuracy rates by an average of 7%, based on conducting chart review audits.
- Collaborated in creating our Claims Follow-up Database, this allowed us to recoup $50,000 in unpaid claims for contracted practices.
Timeline
Medical Billing Specialist
Kestra Medical Technologies
11.2024 - Current
Medical Billing Coordinator
UpStream
04.2023 - 09.2024
Medical Billing Coordinator
UpStream
04.2022 - 04.2023
Medical Billing Representative
Select Lab Partners
01.2020 - 04.2022
Lab Assistant
LabCorp of America
04.2016 - 12.2020
Associate of Arts - Health Information Administrator (RHIA), Healthcare Management in Medical Administration
University of Phoenix
Medical Terminology, Body Systems, Health Information Content, Structure, and Processing, Health Information Management, Analysis, Legal Issues
Ashworth College
Bachelor of Science - Health Care Consumer - Trends and Marketing, Public and Community Health, Health Care Information Systems, Health Care Quality Management and Outcomes Analysis in Healthcare Management
University of Phoenix