Epic
Amanda Blake
Billing
Shelby,NC
Summary
Competent and reliable Medical Biller with 15+ years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities, great decision maker. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Overview
19
19
years of professional experience
Work History
Rheumatology Infusion Consultant (temporary)
Eastside Rheumatology
Bellevue, WA
11.2023 - Current
- Providing advice on operational processes for a Rheumatology clinic focusing on Infusion Treatments
- Training current manager on administrative duties (obtaining benefits, authorizations) to ensure clinic is coding correctly, following up with insurance on claim status, claim denials and applying techniques to analyze trends
- Training on reports to run in their EMR system to show denials, reimbursement amounts
- Advising on coding errors, working with team to correct and resubmit claims to insurance
- Assisting in developing and implementing workflows and communication processing
- Will participate in training and managing new hires to bring new team members up to speed
- Preparing accurate and concise reports, conveying progress, issues and solutions
Medical Coder and Biller
Tryon Medical Partners
Charlotte, NC
09.2020 - 09.2023
- Assisted with the development of new processes for billing, coding, collections, and reimbursements
- Trained clinic staff on the following tasks: obtain infusion benefits and prior authorization, calculate patient financial responsibility, obtain patient assistance from various programs, send in for the reimbursement from the co-pay programs after insurance pays their portion, track and document the payments and valid authorizations on a spreadsheet before patients' next infusion
- Implemented several procedures to organize infusion administration processes
- Ran reports to TRACK denials and claim rejections in Athena
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials
- Communicated with insurance companies to research and RESOLVE coding discrepancies
- Worked with team to correct and resubmit claims or appeals
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation
- Monitored aging accounts receivable reports to identify unpaid balances due
- Correctly coded and billed medical claims for various outpatient physician offices including Rheumatology and Internal Medicine; specializing in Infusion Treatments
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures
- Submitted claims to insurance companies electronically or by mail
- Communicated with healthcare personnel, including practitioners to promote and ensure accuracy
Practice Manager
CaroMont Medical Group
Gastonia, NC
01.2009 - 09.2020
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions
- Oversaw accounting, budgeting, and financial reporting
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties
- Performed all Coding and Billing for Rheumatology Providers, including Infusion Treatments, in office procedures and office visits
- Track denials in both EPIC and Athena EMR systems, insurance follow up for denied claims; Analyzed claims data to identify trends in denials and rejections
- Reconciled accounts receivable to ensure accuracy of payments received
- Performed daily audits on all bills submitted for accuracy and completeness
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation
- Assisted with the development of department policies related to charge capture processes and coding practices
- Provided customer service support to patients regarding billing inquiries
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers; Acted as liaison between business department, billers and third-party payers in resolving billing and reimbursement accuracy
- Prepared financial statements that summarize account activity over a period of time
- Oversaw staff to complete infusion benefit, authorization and patient assistance process
- Implemented organized system to track all steps and results needed to get patients infused and practice reimbursed
- Stepped in to help when staff was overwhelmed (especially during beginning of the year benefits re-verification)
- Successfully negotiated client contract renewals to create increased revenue
Infusion Coordinator
CaroMont Medical Group
Gastonia, NC
09.2004 - 12.2008
- Ensured all required documentation was completed accurately prior to administering an infusion therapy
- Responsible for obtaining infusion benefits, authorizations, communicated with patients' financial responsibility of insurance and self-pay for Infusion Services
- Set up patients on various Patient Assistance Programs to help with financial obligations
- Successfully maintained Excel Spreadsheet for patient benefits, authorizations and patient assistance programs (expiration dates and financial amounts)
- This is where I developed the organizational skills and refined my processes to ensure ALL steps are taken and tracked to confirm patient is eligible for the infusion and we were reimbursed correctly and from all resources (insurance and co-pay programs)
Education
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Shelby High School
Skills
- Employee Management
- Management Coaching
- Operations Analysis
- Reports and Documentation
- Process Optimization
- Work Planning and Prioritization
- Multitasking and Organization
- Billing and Collection Procedures
- Claims Processing
- Insurance Billing
- Data Analysis
- Billing Codes
- Account Follow-Up
- Insurance Collections
- Reimbursements
- Financial Reporting
- Verbal and Written Communication
- Financial Management
References
REFERENCES
References available upon request.
Additional Information
- -157f-49e5-b8ed-5aa08ae92cac
Work Preference
Work Type
Full TimeContract WorkWork Location
RemoteImportant To Me
Healthcare benefitsWork from home optionWork Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Software
Athena
Excel
Timeline
Rheumatology Infusion Consultant (temporary)
Eastside Rheumatology
11.2023 - Current
Medical Coder and Biller
Tryon Medical Partners
09.2020 - 09.2023
Practice Manager
CaroMont Medical Group
01.2009 - 09.2020
Infusion Coordinator
CaroMont Medical Group
09.2004 - 12.2008
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Shelby High School
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