Experienced administrative professional with 10+ years in provider billing and credentialing services. Works productively with facilities, provider groups and individual professionals. Knowledgeable about application requirements for government and private insurance plans.
Hi, I’m
Amber Miller
Billing and Credentialing Coordinator
Kansas City,MO
Summary
Overview
22
years of professional experience
1
Certification
1
HIPPA
1
Notary
Work History
Synergy Services Inc
Billing and Credentialing Coordinator
2020.02 - Current (4 years & 7 months)
Job overview
- Insurance Verifications of all clients 'Commercial and State Medicaid'
- Monthly Billing and Rebilling through different platforms - Office Ally/EMOMED
- Posting funds into EMR system CCL - sending reports Finance Department breaking down counties as well as Group Home's - Sending SBIS invoices for every payment posted
- Credentialing of all Licensed Therapists - Creating CAQH account while keeping it up to date with State and Federal Compliance - Creating NPI for new therapists - Creating Mo Medicaid Provider number as well as Credentialing commercial plans if applicable
- Improved turnaround times for processing credentials by diligently reviewing and verifying provider eligibility.
- Strengthened relationships with external agencies by responding promptly to verification requests and inquiries regarding providers'' credentials.
- Contributed to risk management initiatives by monitoring expiring licenses, certifications, and insurances, notifying providers of renewal requirements in a timely manner.
- Minimized potential legal complications by ensuring adherence to federal and state regulations governing healthcare practitioners'' licensure and certification requirements.
- Upheld strict confidentiality standards, safeguarding sensitive provider information from unauthorized access or disclosure.
- Enrolled providers and Medicaid, Medicare and private insurance plans.
High Risk Pregnancy Center
Billing Specialist
2017.03 - 2019.10 (2 years & 7 months)
Job overview
- Improved billing accuracy by implementing a streamlined invoicing process.
- Enhanced customer satisfaction with timely and accurate invoice generation.
- Reduced errors in financial records by conducting regular audits of billed accounts.
- Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
- Increased efficiency within the department by automating routine processes using specialized software tools.
- Strengthened client relationships through effective communication regarding billing issues and concerns.
- Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
- Researched and resolved billing discrepancies to enable accurate billing.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
University of Kansas Hospital Authority
Pre-Certification Specialist of Orthopedic Surgeries
2014.04 - 2017.03 (2 years & 11 months)
Job overview
- Ability to Verify Various Insurance benefits and Obtain Medical/Clinical Pre-certification in a Timely Fashion - through various avenues of websites or direct insurance company contact
- Patient and Provider Driven to have Pre-Admissions Approved
- Thrives in High Functioning, Fast pace, High Volume Environment
- Liaison Role Between Physician Office/Staff and Insurance Companies
- Positive and Friendly Collections and Payment Arrangements with Patients when self pay
- Person of Contact between KU Orthopedics and Tri-West (VA)
- Streamlined precertification processes by implementing efficient tracking systems and prioritizing urgent cases.
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
Gold Cross EMS Ambulance Billing Provider
NAAC (National Academy of Ambulance Coding) Certified
2011.04 - 2014.01 (2 years & 9 months)
Job overview
- Timely Ins Filing Guidelines and Reimbursements
- Multi-tasking Between Multiple Accounts-with Accurate and Detail Oriented Notes
- Filing Timely Appeals with Insurance Companies with Timely Follow up for Payment
- Understanding of Contracted Rates and Positive Report with Hospital and Medical Agencies
- Skilled at working independently and collaboratively in a team environment.
- Managed time efficiently in order to complete all tasks within deadlines.
- Excellent communication skills, both verbal and written.
- Paid attention to detail while completing assignments.
Grand County EMS Ambulance Billing Provider
Posting and balancing of all payment and reimbursements
2009.01 - 2011.01 (2 years)
Job overview
- Review and research all ambulance calls for proper processing for reimbursement
- Certified Ambulance Coder/ Medicare and Medicaid compliant
- Certified PIO for disaster communication
- Certified Emergency Medical Technician - IV Certified
- Administrative Assistance to EMS Education/Billing Captain
Embrace Richmond
Office Manager
2002.01 - 2007.01 (5 years)
Job overview
- Organizing Warehouse - drop off/delivery times and items
- Handled Client Intake, Managed Confidential Client Files
- Disseminated Client information into proper Spreadsheets for Board Review
- Lead Community Drives for Donations of Household Items and Funding
Education
Argosy University Atlanta, GA
Associate of Arts from Psychology Drug and Alcohol Abuse
10.2015
University Overview
Allied Medical College Saint Louis, MO
Associate of Arts from Business/Massage Therapy
01.2003
University Overview
Skills
- Background Checks
- Records and File Management
- Data Entry Proficiency
- Effective Written and Verbal Communication
- Professional Networking
- HIPAA Compliance
- Customer Service
- Medical Terminology
- Multitasking Abilities
- Organizational Skills
- Time Management
- Effective Communication
References
References
Professional/Personal References Provided Upon RequestCertification
- Certified Notary in the State of Missouri, - Exp 01/2028
Timeline
Billing and Credentialing Coordinator
Synergy Services Inc
2020.02 - Current (4 years & 7 months)
Billing Specialist
High Risk Pregnancy Center
2017.03 - 2019.10 (2 years & 7 months)
Pre-Certification Specialist of Orthopedic Surgeries
University of Kansas Hospital Authority
2014.04 - 2017.03 (2 years & 11 months)
NAAC (National Academy of Ambulance Coding) Certified
Gold Cross EMS Ambulance Billing Provider
2011.04 - 2014.01 (2 years & 9 months)
Posting and balancing of all payment and reimbursements
Grand County EMS Ambulance Billing Provider
2009.01 - 2011.01 (2 years)
Office Manager
Embrace Richmond
2002.01 - 2007.01 (5 years)
Argosy University
Associate of Arts from Psychology Drug and Alcohol Abuse
Allied Medical College
Associate of Arts from Business/Massage Therapy
- Certified Notary in the State of Missouri, - Exp 01/2028
Quote
Whether you think you can or whether you think you can’t, you’re right!
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