Amber Proctor
Zephyrhills
Summary
I am seeking employment with a company where I can use my talent and skills to grow and expand the company.
Knowledgeable Medical Biller with robust background in medical billing and coding. Proven track record of accurately processing and managing patient billing information, resulting in improved revenue cycles. Demonstrated proficiency in claim submissions and resolution, leveraging strong attention to detail and organizational skills.
Overview
25
25
years of professional experience
Work History
Medical Billing Specialist
Kaufman Eye Institute
02.2016 - Current
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- 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.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Liaised between patients, insurance companies, and billing office.
- Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Adhered to established standards to safeguard patients' health information.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Audited and corrected billing and posting documents for accuracy.
- Posted and adjusted payments from insurance companies.
Scheduler/Coordinator
Hometown Homecare
08.2014 - 02.2015
- Scheduling & coordinating appointments for 140+ patients with 3 RNs & 9 LPNs
- Attending weekly case conference meetings to ensure quality patient care
- Daily patient census reports
- Monitoring hospital hold lists
- Maintaining evacuation books on a daily basis
- Answering patient phone calls
Claims Resolution Specialist
University of South Florida Health
04.2002 - 08.2014
- Responsible for all follow-up with insurance companies, employers and insured members on facility and professional charges
- Knowledgeable of PCIS
- Responsible for reviewing and routing Explanation of Benefits and other professional medical correspondence
- Experienced in all specialties inside of University of South Florida Physicians Group Revenue Cycle Operations
- Knowledgeable of Tricare, Medicare, Medicaid and other insurance carriers
- Eligibility verification for all insurance carriers
- Obtaining retro-authorizations when necessary
Medical Biller/Office Staff
OB/GYN Solutions
07.2001 - 04.2002
- Responsible for all follow up on claims for 3 ob/gyn doctors
- Scheduling patient appointments
- Insurance Verification
- Obtaining authorizations
Medical biller
NCO Financial Services
07.2000 - 07.2001
- Responsible for all follow up with insurance companies, employers and insured on facility & professional charges for hospitals across Florida
- Reclaimed thousands of dollars in lost revenue for NCO
- Experienced NSURE systems user; tracking & resolving thousands of claims
- Knowledgeable of Tricare, Medicare, Medicaid and other insurance carriers
Education
High School Diploma -
Chamberlain High School
01.1997
Skills
- Denial management
- Claim submission
- Patient billing
- Insurance billing
- Billing and collection procedures
- Account management
Timeline
Medical Billing Specialist
Kaufman Eye Institute
02.2016 - Current
Scheduler/Coordinator
Hometown Homecare
08.2014 - 02.2015
Claims Resolution Specialist
University of South Florida Health
04.2002 - 08.2014
Medical Biller/Office Staff
OB/GYN Solutions
07.2001 - 04.2002
Medical biller
NCO Financial Services
07.2000 - 07.2001
High School Diploma -
Chamberlain High School
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