Amber Cacioppo
Mooresville,NC
Summary
Professional Diverse Experience Required to Manage Personnel and Complex Operations & Projects. 10+ years of proven experience in corporate and private medical sector sector
Possess a comprehensive background in Cross-Functional Leadership / Teambuilding, Project & Logistics Management,
Possess extensive knowledge in Corporate medical insurance benefits verifications, authorizations, resolution specialist, insurance procedures, and guidelines, Client advocacy, Workflow Planning, and Personnel Management.
Overview
20
20
years of professional experience
Work History
Patient Care Coordinator
Hand Rehabilitation Specialists
06.2014 - Current
- Communicated with insurance companies such as Aetna, Blue Shield, Blue Cross, Cigna, Healthnet, Tricare, Workers Comp, HMOs, Medicare, and Medicaid to verify coverage and obtain authorizations for medical treatments and procedures. Successfully obtained authorizations for OT,PT, and DME allowing for proper claim submission and payment.
- Ensured regulatory health insurance compliance by staying up-to-date on industry standards and best practices related to insurance. Utilized CMS website to pull up current Medicare and Medicaid rules and regulations to ensure proper claim submission, essentially decreasing mandatory Medicare audits by 50%.
- Expert in ICD-10/CPT coding and able to effectively utilize coding manuals to retrieve proper coding for the best reimbursement. Knowledge of EOBs and payment posting. Processed over 60 payments per day. Contacted patients with outstanding balances and decreased amounts by 70% within 4 months.
- Developed efficient insurance verification processes that significantly reduced processing time and decreased retro authorizations by 50% per year.
- Managed over 30 workers comp cases per month. Communicated with adjusters to obtain authorizations and successfully negotiated prices for DME, ensuring the highest reimbursement.
- Conducted daily audits of patient charts to ensure therapists were following proper procedures and guidelines for medical documentation, which in return decreased claims errors by 40%. Utilized WebPT practice management software to address discrepancies promptly. Was able to pull up unfinalized chart notes to have the therapist complete and bring all notes up to 100% completion. Ran lost patient logs to schedule patients who did not have any follow-up appointments to fill empty appointment slots.
- Worked as a Patient advocate by helping patients navigate the complexities of the healthcare system, ensuring a great patient experience. Provided insurance and financial counseling by explaining their insurance benefits in detail and created financial estimate forms so the patient knows what their financial responsibility are. Provided patients with necessary materials needed for aftercare such as home exercise programs, post-op care, and business cards for other specialists they would need to follow up with.
- Expert resolution specialist. Helped address patient complaints and concerns. Contacted insurance companies on the patient's behalf to investigate why a claim was denied. Professionally handled complaints about care through timely corrective actions and appropriate referrals.
- Acted as the main point of contact for patients, therapists, and referring physicians by closely reviewing medical charts and maintaining high levels of communication.
- Assisted over 10 patients per week with completing necessary paperwork and forms to provide healthcare facilities with essential information to bill for services. Ensured patients were aware of possible uncovered services by having them sign ABN forms which helped reduce patient medical insurance claims disputes by 50%.
- · Gained strong leadership skills by managing projects from start to finish. Organized and edited training manuals twice a year which helped to promote a growth mindset in new employees. Trained new staff members on office procedures and protocols, ensuring consistency in patient care delivery using the training manuals I created. Essentially, decreasing office turnover by 30%. Implemented a more efficient system for managing medical records which helped facilitate easy retrieval of crucial patient information needed for claim processing and referring physicians.
ER Admitting Clerk
Ojai Valley Community Hospital
06.2014 - 06.2017
- Provided patient service efficiently coordinating admission processing and release paperwork for more than 50 patients daily in the emergency department.
- Verified insurance benefits for emergency room visits and surgeries. Obtained authorizations when necessary.
- Scheduled inpatient and outpatient procedures with the operating room and surgical center. Provided patients with pre-op and post-op instructions.
- Maintained records and reports. Provided clerical support for assigned areas.
- Performed regular chart audits to ensure that all treating Physician signatures were included in the charting, essentially decreasing the amount of Doctor hospital suspensions by 50%.
- Communicated with patients via phone or in-person to obtain payments on outstanding accounts or copays that were missed in the Emergency department.
Assistant Manager
Panera Bread
08.2004 - 04.2011
- Managed, hired, scheduled trained, and coached over 60 employees on customer service skills, and food/beverage knowledge.
- Managed Daily operations including openings and closings.
- Assisted with training for 3 new store openings.
- Increased profits by 10% by training employees on upselling techniques
- Maintained an employee retention rate 15% higher than the industry standard through management training programs, periodic performance reviews, and motivational coaching tactics.
- Implemented a revised inventory system focused on storage conditions, and ordering techniques resulting in a 6% decrease in losses created by food waste.
- Prepared weekly sales reports and processed weekly payroll, and marketing.
- Reduced annual labor and food costs by 12% through proper scheduling, inventory management and budgeting
Education
Bachelor of Science - Business Administration & Human Resources
Western Governors University
Salt Lake City, UT07.2024
Associate of Science - Business Administration
Moorpark College
Moorpark, CA04.2021
Associate of Science - Health Information Technology
Charter College
Oxnard, CASkills
- Rapid and Adaptive
- Solution Oriented Professional
- Skilled Collaborator
- Committed High Achiever
- Self-Management
- Effective Cross-Functional Communicator
- Leadership
- Relationship management
- Self-awareness
Timeline
Patient Care Coordinator
Hand Rehabilitation Specialists
06.2014 - Current
ER Admitting Clerk
Ojai Valley Community Hospital
06.2014 - 06.2017
Assistant Manager
Panera Bread
08.2004 - 04.2011
Bachelor of Science - Business Administration & Human Resources
Western Governors University
Associate of Science - Business Administration
Moorpark College
Associate of Science - Health Information Technology
Charter College
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