Andrea Skiles
Casper,WY
Summary
Accomplished Billing Specialist with expertise in medical billing and coding at Axis Billing and Family Advocacy. Proficient in ICD-10 and EMR systems, enhancing claim accuracy and efficiency. Developed strong relationships with insurance representatives, reducing claim denials by implementing improved documentation practices. Demonstrated exceptional communication skills and commitment to HIPAA compliance.
Overview
22
22
years of professional experience
Work History
Billing Specialist/Insurance advocate
Axis Billing and Family Advocacy
10.2018 - 04.2024
- Reviewed billing data to identify discrepancies or errors, resolving issues promptly to minimize delays in payment processing
- Processed and submitted medical claims to insurance companies, ensuring accuracy and adherence to billing guidelines
- Verified patient information, including demographics and insurance coverage, to ensure proper billing procedures
- Reviewed medical documentation and coding to identify any discrepancies or errors that could impact reimbursement
- Followed up on unpaid or denied claims, working with insurance companies to resolve issues and secure payment
- Maintained updated knowledge of medical coding systems (e.g., ICD-10, CPT) and insurance regulations
- Collaborated with healthcare providers to obtain necessary documentation for claim submission
- Responded promptly to inquiries from patients, insurance companies, and other stakeholders regarding billing matters
- Performed regular audits of billing records to identify potential compliance issues or inaccuracies
- Utilized electronic health record (EHR) systems and specialized software for accurate data entry and claim processing
- Assisted in the development of standardized billing procedures for improved efficiency and accuracy
- Implemented strategies for reducing claim denials through improved documentation practices and error prevention measures
- Collaborated with coding specialists to ensure proper code assignment based on medical records
- Participated in training programs or workshops related to medical billing updates or changes in regulations
- Maintained confidentiality of patient information in accordance with HIPAA regulations
- Developed strong relationships with insurance company representatives for efficient claims processing
- Identified opportunities for process improvement within the billing department
- Provided guidance to colleagues regarding complex billing scenarios or coding questions
- Coded diagnoses accurately using appropriate codes such as ICD-10-CM
- Collaborated with medical coders to ensure accurate coding and billing practices
- Researched and resolved billing discrepancies or issues in a timely manner
- Implemented electronic claim submission processes, reducing manual paperwork and improving efficiency
Medical Billing Clerk/preauth coordinator
Mountain View Regional Hospital
Casper, WY
01.2009 - 01.2017
- Reviewed and processed pre-authorization requests for medical procedures, ensuring compliance with insurance guidelines
- Verified patient eligibility and benefits coverage to determine if pre-authorization was required
- Collaborated with healthcare providers to obtain necessary documentation and clinical information for pre-authorization requests
- Maintained accurate records of all pre-authorization activities in the electronic database
- Communicated with insurance companies to follow up on pending or denied pre-authorization requests
- Resolved issues related to incomplete or inaccurate documentation by coordinating with healthcare providers and insurance companies
- Developed strong knowledge of different insurance plans, policies, and procedures related to pre-authorizations
- Assisted patients in understanding their insurance coverage and explained the process of obtaining a pre-authorization
- Ensured timely submission of complete and accurate pre-authorization requests to minimize delays in patient care
- Managed a high volume of incoming calls from patients, healthcare providers, and insurance representatives regarding pre-authorizations
- Collaborated with the billing department to ensure proper coding and billing practices for authorized procedures
- Identified opportunities for process improvement in the pre-authorization workflow and implemented effective solutions
- Provided training and guidance to new team members on the processes involved in handling pre-authorizations
- Maintained confidentiality of patient information according to HIPAA regulations at all times
Medical Receptionist
The Family Clinic
Casper, WY
01.2002 - 01.2007
- Managed front desk operations, including greeting patients, scheduling appointments, and answering phone calls
- Maintained accurate electronic medical records (EMR) by updating patient demographics and medical history
- Scheduled laboratory tests, radiology exams, and specialist appointments as per physician's orders
- Effectively communicated with healthcare providers to ensure timely delivery of test results and reports to patients
- Assisted in the coordination of patient referrals to other healthcare facilities or specialists when necessary
- Implemented efficient appointment reminder system resulting in a XX% reduction in no-shows
- Responded promptly to patient inquiries regarding appointment availability, clinic hours, and general inquiries about services provided
- Ensured waiting area cleanliness by organizing magazines, sanitizing surfaces regularly, and restocking supplies as needed
- Managed confidential patient information according to HIPAA regulations while maintaining utmost professionalism at all times
- Provided administrative support such as filing documents, scanning records into EMR system, and managing incoming/outgoing mail
Education
High school diploma -
Midwest High School
Midwest, WY01.1995
Skills
- Medical records management
- EMR systems expertise
- Clerical support
- Medical billing and coding
- Scheduling coordination
- Documentation compliance
- ICD-10 and CPT coding
- Medical receptionist skills
- HIPAA compliance
- Insurance verification
Timeline
Billing Specialist/Insurance advocate
Axis Billing and Family Advocacy
10.2018 - 04.2024
Medical Billing Clerk/preauth coordinator
Mountain View Regional Hospital
01.2009 - 01.2017
Medical Receptionist
The Family Clinic
01.2002 - 01.2007
High school diploma -
Midwest High School
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