Amarilys Caraballo
Lawrenceville
Summary
Results-driven medical billing professional with expertise in billing, coding, and accounts receivable. Skills in analytical problem-solving streamline claims processing and optimize collections while ensuring compliance with payer requirements. Focus on accuracy and revenue cycle improvement through strategic workflow management. Bilingual in Spanish, enhancing communication in diverse settings.
Overview
11
11
years of professional experience
Work History
Insurance and collection specialist
Parker
Highland Park
09.2018 - Current
- Manage high-volume billing for Medicare, Medicaid, managed care, hospice, and workers' compensation programs.
- Manage collections for overdue accounts to maintain regulatory compliance.
- Resolve billing discrepancies by liaising with insurance companies.
- Verify patients' eligibility and benefits to enhance billing efficiency.
- Collect and manage patient account payments effectively.
- Conduct monthly triple-check meetings to ensure process accuracy.
- Address billing inquiries from patients and third-party carriers via calls.
- Submit monthly write-offs in accordance with financial policies.
- Process refund requests and reconcile deposit and patient collections.
Business Office Manager
Atrium
Princeton
12.2015 - 09.2018
- Overseen the daily operations of the Business Office to ensure efficient workflow and compliance
- Verified and reconciled daily census reports to ensure accuracy and compliance with regulatory standards
- Prepared and submitted Medicare, Medicaid, and insurance billing in accordance with established deadlines
- Assisted residents and families with Medicaid application completion and submission
- Coordinated with Mercer County to ensure timely Medicaid eligibility determinations and approvals
- Verified resident insurance eligibility and benefits
- Acquired insurance authorizations to ensure coverage for services.
- Participated in resident care conferences to clarify financial responsibilities and business office procedures, enhancing understanding for residents and families
- Managed resident personal needs accounts, including accurate recordkeeping and disbursements
- Performed accurate data entry and maintained resident financial records
- Prepared and processed daily bank deposits
- Generate and distribute monthly private pay statements
- Processed vendor invoices and submitted accounts payable documentation to the corporate office
- Submitted monthly revenue adjustments and write-offs, maintaining accurate financial records and compliance with accounting policies
- Participated in accounts receivable reviews to ensure accurate billing, collections, and regulatory compliance
- Prepared and submitted legal documentation to the corporate legal department
Education
Medical Assistant Certificate -
Sanford Brown Institute
Melville, NY09-2013
Some College (No Degree) - Liberal Arts
Mercer County Community College
West Windsor, NJSome College (No Degree) - Business Administration
Southern New Hampshire University
Hooksett, NHSkills
Medical Billing & Revenue Cycle Management
Insurance claims processing & Appeals
Accounts Receivable & Collections
Medicare, Medicaid & Commercial insurance
Financial reporting
Business Office Operations
Staff Supervision & Training
Organization, Time Management & Problem- solving
Attention to detail & Multitasking
Bilingual
Timeline
Insurance and collection specialist
Parker
09.2018 - Current
Business Office Manager
Atrium
12.2015 - 09.2018
Medical Assistant Certificate -
Sanford Brown Institute
Some College (No Degree) - Liberal Arts
Mercer County Community College
Some College (No Degree) - Business Administration
Southern New Hampshire University