Angela Casto
Interlochen,MI
Summary
Top-notch administrative team member with in-depth understanding of medical standards, compliance requirements and operational procedures. Practiced problem-solver with friendly and caring mentality and excellent communication skills. Adept at working unsupervised and quickly mastering new skills, who also works great with colleagues and maintains strong patient and professional relations. Excels at following procedures and independently handling common questions and concerns.
Overview
3
3
years of professional experience
Work History
Medical Business Specialist
Munson Advanced Wound Center
Traverse City, MI
05.2023 - Current
- Oversee the daily operations of the clinic including front desk and clinical support staff as well as other patient flow functions
- Oversee and provide clerical support to include: answering incoming phone calls, check-in, check-out, registration and appointment scheduling, insurance verification, transactions and charge entry.
- Work side by side with leaders that mentor and teach new skills for growth and promotional opportunities.
- Submit patient wound care supply orders and work directly with the suppliers to insure orders fall within insurance allowables.
- Point person for all things DME related including insurance, coding, and obtaining prior authorizations.
Intake Specialist
Munson Home Medical Equipment
Traverse City, MI
08.2021 - 05.2023
- Verified insurance eligibility, benefits and patient liabilities for defined services.
- Worked dailywith Pati ent Care Managers and other hospital staff to secure patient equipment for pending patient discharge from hospital.
- Routinely consulted CMS and LCD's to determine if documentation met criteria needed for billing.
- Issued, gathered and inspected intake forms to confirm correct signatures and information.
- Made outbound calls to providers to obtain information necessary to create or update authorization.
- Obtained prior authorizations from all major insurance carriers.
- Updated patient information on computer system to maintain billing accuracy.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
Education
High School Diploma -
Central High School
Traverse City, MI06-1996
Some College (No Degree) - General Studies
Northwestern Michigan College
Traverse City, MISome College (No Degree) - General Studies
Southwest Texas Junior College
Del Rio, TXSkills
- Medical Terminology
- Obtaining prior authorizations and communicating with all parties whether approved or denied and resubmitting for appeals
- Insurance payer requirements
- DME knowledge
- ICD-10 and HCPC/CPT knowledge in order to verify for accuracy and that items are reimburseable
- Microsoft Word, Excel, a various other computer program knowledge
- Knowledge of HIPAA and other medical insurance regulatory standards and protocols
- Excellent ability to communicate with all levels of clinical staff and insurance companies to obtain needed documentation or verification as required
- Able to multi-task and prioritize duties and tasks
- Exceptional math and accounting skills
Timeline
Medical Business Specialist
Munson Advanced Wound Center
05.2023 - Current
Intake Specialist
Munson Home Medical Equipment
08.2021 - 05.2023
High School Diploma -
Central High School
Some College (No Degree) - General Studies
Northwestern Michigan College
Some College (No Degree) - General Studies
Southwest Texas Junior College