Summary
Overview
Work History
Education
Skills
Timeline
Generic

Andria Margiasso

Summary

Seasoned Medical Insurance/Claims Billing Specialist with excellent planning and problem-solving abilities Offering 25+ years of experience and a willingness to take on any challenge. Strong Knowledge of Accounts receivable and finance. Organized, driven, and adaptable professional with successful history managing high caseloads in fast-paced environments. I am Looking to tackle new challenges with a company that values dynamic skills and a strong work ethic.

Overview

32
32
years of professional experience

Work History

Insurance Specialist/Accounts Receivable

US Oncology
04.2023 - Current
  • Audit patient accounts and claims
  • Review patient accounts to confirm accuracy
  • Ensure payor and patient payments are received in a timely manner
  • Investigate and determine root causes of aging claims
  • Prepare and present findings based on researched data
  • Communicate between several agencies simultaneously to resolve claims and disputes
  • Communicate effectively and concisely with management regarding status of claims
  • Input and archive data related to patient accounts
  • Schedule and attend employee meetings

Account Receivables/Medical Billing Specialist

Hope House Inc.
11.2019 - Current
  • Time Management
  • Customer Contact
  • Account Posting
  • Insurance Claims Review
  • Claims Investigation
  • Coverage Determination
  • Credit and Collections
  • Adjustment Posting
  • Customer Relations
  • Claims Processing
  • Accounts Receivable Expertise
  • Kept accounts receivable tracking database current with relevant client information, collection and billing progress and program changes.
  • Processed new customer forms to set up accounts in system.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Checked postings and documents for correctness, accuracy and proper coding.
  • Received and recorded cash, checks and transfers.
  • Recorded debit, credit and account transactions in computer spreadsheets and databases.
  • Completed and submitted appeals for denied claims.
  • Coordinated communications between patients, billing personnel and insurance carriers.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Leveraged EMR software to post payments received for medical services.
  • Answered customer questions to maintain high satisfaction levels.
  • Submitted claims to insurance companies.

Patient Account Representative/MRI Authorization

Ortho NY
11.2009 - 05.2016
  • Contacted insurance companies to check status of claim payments.
  • Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
  • Submitted electronic bills following facility and legal compliance standards.
  • Answered customer questions regarding account discrepancies or problems.
  • Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.

Claims/Billing Representative

Capital Region Orthopedics
05.2005 - 06.2008
  • Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
  • Verified patient insurance coverage, created financial plan according to treatment schedules for collections and communicated between patient and billing company regarding health insurance.
  • Managed numerous client accounts to track and collect money owed.
  • Managed account receivables to maintain payments within net terms.
  • Researched and resolved billing inconsistencies and errors through individual and collaborative analysis.

Office Manager

Center For Human Growth
07.2000 - 08.2001
  • Maintained impeccable office organization to support efficiency, professionalism and performance objectives.
  • Administered payroll and maintained proper documentation of employee personnel.
  • Handled scheduling and managed timely and effective allocation of resources and calendars.

Medical Claims/Claims/Billing Specialist

St. Peter's Hospital
07.1993 - 04.1999
  • Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
  • Assisted claimants, providers and clients with problems or questions regarding claims.
  • Collaborated with fellow team members to manage large volume of claims.
  • Prepared and reviewed insurance-claim forms and related documents for completeness.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.

Education

High School Diploma -

Ravena Coeymans Selkirk
Ravena, NY
06.1989

Skills

  • Eligibility evaluation
  • Client support
  • Insurance Claims Management
  • Appointment Scheduling
  • Coverage Determination
  • Credit and Collections
  • Adjustment Posting
  • Claims Processing
  • Accounts Receivable Expertise
  • Policy analysis
  • Documentation skills
  • Account management
  • Claims management
  • Customer service
  • Insurance eligibility
  • Billing procedures
  • Policy Knowledge
  • Insurance coverage verification

Timeline

Insurance Specialist/Accounts Receivable

US Oncology
04.2023 - Current

Account Receivables/Medical Billing Specialist

Hope House Inc.
11.2019 - Current

Patient Account Representative/MRI Authorization

Ortho NY
11.2009 - 05.2016

Claims/Billing Representative

Capital Region Orthopedics
05.2005 - 06.2008

Office Manager

Center For Human Growth
07.2000 - 08.2001

Medical Claims/Claims/Billing Specialist

St. Peter's Hospital
07.1993 - 04.1999

High School Diploma -

Ravena Coeymans Selkirk

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