Andrea Skelly
Prescott Valley,AZ
Summary
Dedicated medical coding, billing and quality metric professional with a robust background in managing healthcare claims and ensuring compliance with industry standards. Recognized for effective collaboration and adaptability, consistently achieving organizational goals while responding to evolving demands. Self-motivated with a strong sense of personal responsibility and integrity, thriving in both independent and dynamic team environments.
Overview
31
31
years of professional experience
5
5
Certification
Work History
Medical Coding and Billing Specialist
Community Health Center of Yavapai, an FQHC
Prescott, AZ
05.2023 - Current
- Analyzed daily charges from providers for compliance of billing, coding and quality regulations; billed charges daily.
- Processed and verified medical claims for accuracy and compliance with industry regulations.
- Implemented billing processes that improved accuracy and reduced claims denials
- Trained and mentored junior staff on coding standards and billing procedures
- Reduced errors in medical billings, effectively addressing discrepancies and rectifying financial issues promptly.
- Analyzed claim data to identify trends, enhancing revenue cycle management.
- Verified signatures and checked medical charts for accuracy and timely completion.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Performed on-site coding audits to determine accuracy and compliance with coding and quality guidelines.
- Worked closely with Medical Director on quality measures and compliance.
- Resolved coding discrepancies through in-depth auditing, analysis and collaboration with physicians, ensuring appropriate reimbursement.
- Maximized productivity through effective time management, prioritizing tasks based on urgency and importance.
- Analyzed medical records for Risk Adjustment and HCC Coding opportunities.
- Provided exceptional customer service to patients, addressing their concerns regarding insurance claims or billing issues with empathy and professionalism.
Revenue Cycle Manager
Marin Community Clinics, an FQHC
Marin County, CA
03.2017 - 05.2023
- Managed and supervised 17 staff – including scheduling, annual evaluations, approving time-records and maintaining schedules.
- Record payment management for various insurance payers including Medi-Cal, Partnership and Medicare.
- Designed and maintained financial models to identify and measure risks, including internal audits to validate and improve accuracy of financial reporting.
- Supported financial director with special projects, reports and additional job duties.
- Developed and implemented training programs for new hires, leading to more competent and effective billing team.
- Conducted detailed audits of billing and coding practices, identifying and rectifying compliance issues.
- Improved team morale and reduced turnover by implementing comprehensive staff development and recognition program.
- Established continuous improvement culture within revenue cycle department, fostering innovation and efficiency.
- Monitored industry trends to anticipate changes that may impact the organization's revenue cycle performance.
- Coordinated with the COO and finance team to produce accurate monthly financial reports on collection metrics and trends.
- Led cross-functional teams in identifying and implementing strategic improvements in billing operations.
- Streamlined revenue cycle processes to enhance efficiency and reduce claim denials.
Medical Coding Specialist
Northern California Medical Associates
Santa Rosa, CA
02.2009 - 01.2016
- Manage medical records requests, distribution, scanning, storage, and destruction.
- Front and back medical office support – including answering phones, scheduling appointments, obtaining eligibility, and working closely with patients.
- Billing and coding diverse types of providers, including specialists.
- Collaborated with healthcare providers to clarify ambiguous or incomplete documentation, resulting in more precise medical codes and better reimbursement.
- Working with elderly patients regarding their billing statements and Medicare.
- Attained up-to-date knowledge of coding requirements through continuing education courses and certification renewal.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Analyzed medical documentation for accurate coding and compliance with regulatory standards.
Executive Assistant / Certified Corporate Trainer
Cisco Systems, Inc. and Cerent
San Jose, CA And Petaluma, CA
02.1995 - 05.2002
- Worked as an Executive Assistant to the CEO, COO, CMO and CFO.
- Managed executive calendars, ensuring efficient scheduling and prioritization of meetings.
- Trained junior administrative staff on best practices, fostering a collaborative work environment.
- Coordinated travel arrangements, optimizing itineraries for time and cost efficiency; completed expense reports for each itinerary.
- Streamlined office processes, enhancing communication across departments.
- Handled confidential and sensitive information with discretion and tact.
- Collaborated with cross-functional teams to identify training needs and create targeted content.
- Prepared comprehensive reports and presentations for executive review, ensuring clarity and professionalism.
- Evaluated training effectiveness through assessments, feedback, and performance metrics.
- Facilitated workshops and seminars that promoted organizational values and best practices.
- Implemented innovative learning technologies to improve training accessibility and engagement.
- Designed comprehensive onboarding programs that accelerated new hire integration into the company culture.
- Developed and delivered engaging training programs to enhance employee skills and knowledge.
- Promoted into Marketing Bid Manager – putting together a proposal team.
- Managed the entire proposal process; deadlines, team production, completed government requests for proposals and requests for bids.
- Corporate trainer for the sales team on the entire proposal process that I created.
- Managed complex calendars and scheduled meetings for executives, ensuring optimal time management.
- Prepared high-level correspondence and reports, ensuring clarity and professionalism in communication.
- Assisted in project management tasks, tracking progress and deadlines to support team objectives.
- Implemented process improvements that enhanced workflow efficiency across administrative functions.
- Collaborated with cross-functional teams to support strategic initiatives and enhance operational effectiveness.
- Handled administrative tasks such as expense report processing or invoice reconciliation efficiently; allowing executives to focus on high-priority responsibilities without distraction.
Education
Certificate of Technical Studies - Medical Billing and Coding
Empire College
Santa Rosa, CACertificate of Technical Studies - Animal Physical And Massage Therapy
Northwest School of Animal Massage
Certificate - End of Life Coach
IAP Career College
CanadaSkills
- Highly organized
- Proficient in prioritizing tasks
- Analytical problem solver
- Collaborative team leader
- Versatile in dynamic environments
- Clinical record auditing and analysis
- Proficient in medical terminology
- Claims management
- Revenue cycle optimization
- Accurate payment posting
CV
Curriculum Vitae
Certification
- CPC - Certified Professional Coder
- CRC - Certified Risk Adjustment Coder
- Certified BHC - Behavioral Health Coder
- Licensed Animal Massage Therapist
- Certified End-of-Life Coach
Timeline
Medical Coding and Billing Specialist
Community Health Center of Yavapai, an FQHC
05.2023 - Current
Revenue Cycle Manager
Marin Community Clinics, an FQHC
03.2017 - 05.2023
Medical Coding Specialist
Northern California Medical Associates
02.2009 - 01.2016
Executive Assistant / Certified Corporate Trainer
Cisco Systems, Inc. and Cerent
02.1995 - 05.2002
Certificate of Technical Studies - Medical Billing and Coding
Empire College
Certificate of Technical Studies - Animal Physical And Massage Therapy
Northwest School of Animal Massage
Certificate - End of Life Coach
IAP Career College