Angelica Henriquez
Nashua,NH
Summary
Dynamic and motivated medical billing and coding professional with over 17 years of extensive experience in health operations, revenue cycle management, and clinical. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding, with a proven ability to analyze and validate patient information, diagnoses, and billing data. Highly skilled in medical billing and coding, Medicare, Medicaid, and Commercial Insurance, and handling medical insurance appeals, authorizations, denials, and rejections. I seek a position to leverage my skills and experience in a dynamic organization.
Seasoned Medical Billing, Insurance, and Coding Instructor known for high productivity and efficient task completion. Possess specialized skills in medical billing software, compliance regulations, and coding standards which ensure accurate and effective teaching. Excel in communication, problem-solving, and adaptability, contributing to successful training outcomes.
Highly knowledgeable in medical billing, insurance and coding with background as an instructor. Have facilitated student understanding of complex concepts through innovative teaching methods. Strengths lie in strong communication skills, patience, and ability to simplify complex topics for better comprehension. Previous work has led to improved student performance and increased interest in the field.
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Passionate about continuous learning and professional development.
Experienced professional with a strong background in technology-related roles. Proficient in software development, system administration, and technical support. Skilled in problem-solving and optimizing performance. Capable of managing projects and collaborating effectively with teams. Committed to continuous learning and staying current with industry trends to contribute to organizational success.
Proactive and versatile professional with a dedication to quickly adapting to new challenges. Strong problem-solving abilities and a proven track record of fostering strong relationships with clients and team members. Focused on supporting team success and achieving positive results.
Results-oriented individual with a passion for continuous learning and innovation. Known for leveraging analytical thinking and creativity to solve problems and deliver high-impact solutions in fast-paced environments.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Account Receivables Specialist
Granite Recovery Centers
Salem, NH
05.2019 - 09.2019
- Designed and implemented a daily revenue financial tracking system, reporting directly to the CEO and CFO, which optimized reimbursement processes.
- Established comprehensive coding and billing guidelines for the billing providers and Accounts Receivable Department, enhancing accuracy and compliance.
- Authored detailed policy, procedure, and training manuals to streamline departmental operations.
- Coordinated with front office staff to ensure accurate information for claims processing, reducing errors and delays.
- Managed and maintained all files, including insurance, diagnosis, procedures, and fees, ensuring meticulous record-keeping.
- Conducted charge entry, claim edits, EOB reviews, and unpaid claim follow-ups, significantly improving billing and coding efficiency.
- Processed and verified bimonthly patient statements across multiple facilities, ensuring accuracy and timeliness.
- Investigated, audited, and resolved payment discrepancies, enhancing the integrity of the accounts receivable process.
- Audited and created reports using BI tools to spot trends, improve work processes, and maximize reimbursements.
- Reviewed and verified accuracy of invoices and account balances.
- Processed payments, refunds and adjustments to customer accounts.
- Analyzed customer payment trends and credit worthiness.
- Prepared monthly statements for customers.
- Researched past due accounts and initiated collection efforts in a timely manner.
- Maintained organized records of all customer accounts receivable activity.
- Reconciled discrepancies between customer payments and invoices due.
- Created reports on Accounts Receivable performance for management review.
- Assisted in month-end closing process including preparation of journal entries related to Accounts Receivable activities.
- Responded promptly to customer inquiries regarding their account status or payment history.
- Generated weekly aging reports used to identify delinquent accounts requiring follow-up action.
- Provided excellent customer service while resolving disputes with customers concerning their accounts receivable balance.
- Performed daily cash application functions accurately and efficiently.
- Recommended process improvements that increased efficiency in Accounts Receivable operations.
- Developed strong working relationships with internal stakeholders such as Sales, Credit and Collections, Treasury, Tax Departments.
- Monitored unapplied cash balances and identified potential write-offs or bad debt expense accruals.
- Utilized specialized software systems for tracking customer accounts receivables activity.
- Assisted in developing policies and procedures associated with Accounts Receivable activities.
- Monitored customer account details to minimize or rectify non-payments, delayed payments and other irregularities.
- Kept accounts receivable tracking database current with relevant client information, collection, and billing progress and program changes.
- Generated, mailed and monitored invoices.
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Evaluated open accounts to look for past-due balances and pursue collection strategies.
- Performed various accounts receivable functions, handled cash receipts posting, updated cash flow reports and researched chargebacks and write-offs.
- Processed new customer forms to set up accounts in system.
- Posted and verified entries to logs, spreadsheets or reports to update department records and accounting systems.
- Prepared and submitted accounting documents and reports for review, authorization and processing.
- Verified, classified, computed, posted and recorded accounts payable data and reconciled daily totals to confirm proper accounting.
- Utilized accounting software for efficient management of receivables.
- Communicated effectively with clients to ensure timely collections.
- Reconciled customer accounts and resolved discrepancies.
- Assisted in developing and updating accounts receivable procedures.
- Processed credit memos and adjustments according to company policy.
- Ensured compliance with financial policies and regulations.
- Maintained detailed records of all accounts receivable transactions.
- Participated in financial audits related to accounts receivable.
- Negotiated payment plans with delinquent accounts.
- Provided detailed reports and analyses to management regarding receivables status.
- Enhanced customer satisfaction through prompt and courteous handling of all inquiries and complaints.
- Assisted with month-end and year-end closing processes.
- Managed timely invoicing of clients and ensured accurate billing details.
- Prepared aging reports to identify past due accounts.
- Issued monthly statements to clients and followed up on outstanding payments.
- Implemented payment reminder system to decrease outstanding receivables.
- Received and recorded cash, checks and transfers.
- Checked postings and documents for correctness, accuracy and proper coding.
- Recorded debit, credit and account transactions in computer spreadsheets and databases.
- Reconciled or entered report discrepancies found in financial records.
- Reconciled computer reports with manually maintained ledgers.
- Conducted audits of medical records to identify missing or incorrect documentation that could affect accurate coding and billing.
- Submitted claims electronically to insurance companies in accordance with regulations.
- Generated reports from software systems to track claim status and denials.
- Verified patient information, including medical history and insurance coverage, to ensure accuracy of coding and billing.
- Analyzed trends in denials in order to recommend process improvements which would reduce the number of denials received.
- Researched denied claims to determine the cause of denial and corrected errors as needed.
- Reviewed physician orders, laboratory results, diagnostic images, clinical statements and other health care provider services for completeness and accuracy.
- Maintained detailed accounts receivable aging reports on a daily basis to ensure timely payments from patients and insurance companies.
- Assigned appropriate codes using ICD-10-CM for diagnosis, CPT for procedures, HCPCS for supplies and modifiers as required by payers.
- Facilitated payment arrangements with patients and guarantors who were unable to make full payment at time of service.
- Provided customer service support via phone or email regarding account balances or other inquiries related to billing issues.
- Performed data entry into electronic health record system for all relevant patient information including diagnoses, procedures performed, medications prescribed .
- Participated in meetings with physicians and other healthcare providers regarding coding compliance standards.
- Developed policies and procedures related to medical coding processes.
- Attended seminars or webinars related to changes in medical coding guidelines.
- Trained new employees on medical coding practices.
- Assisted with preparation of financial statements such as balance sheets and income statements.
- Worked closely with department managers on budgeting activities.
- Provided administrative support including filing documents, preparing correspondence .
- Monitored regulatory updates from Medicare and Medicaid programs as well as private insurers.
- Updated patient demographics information within practice management system.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Maintained high accuracy rate on daily production of completed reviews.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- Advised on the impact of coding decisions on reimbursement and compliance.
- Collaborated with healthcare providers to verify necessary documentation for coding accuracy.
- Performed quality assurance checks on coded data.
- Conducted audits to ensure compliance with federal and state regulations.
- Updated coding skills and knowledge through continuous education and training.
- Resolved coding discrepancies and denials to maximize reimbursement.
- Participated in coding team meetings to discuss challenges and best practices.
- Analyzed patient charts and records to extract relevant coding information.
- Educated healthcare staff on coding standards and changes in coding guidelines.
- Reviewed patient records and assigned accurate codes for diagnoses and procedures.
- Monitored and analyzed coding error trends to improve coding accuracy.
- Supported external audits by providing coded data and documentation as requested.
- Entered coded data into electronic health record (EHR) systems.
- Utilized coding software and tools efficiently to expedite the coding process.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
- Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing.
- Kept abreast of updates and changes in coding guidelines and reporting requirements.
- Coordinated with billing department to clarify billing issues related to coding.
- Assisted with the development of coding policies and procedures.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Pulled patient records and transferred information to appropriate parties.
- Set up patient charts and documented information in various company software.
- Safeguarded medical records to maintain patient confidentiality.
- Maintained positive working relationship with fellow staff and management.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Handled incoming calls and directed callers to appropriate department or employee.
- Transmitted information or documents to customers through email, mailings or facsimile machine.
- Purged inactive files and destroyed obsolete files following procedures.
- Ordered and restocked supplies in line with budget limits and office needs.
- Verified record copies before handing each over to check for and remove unnecessary details.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Determined and implemented techniques to improve medical records retrieval process.
- Compiled and coded patient data using standard classification systems.
- Mentored junior team members and managed employee relationships.
- Located and retrieved files, assisting public with general information.
- Streamlined day-to-day office processes to meet long-term goals.
- Assigned patients to diagnosis-related groups using appropriate computer software.
- Analyzed and processed medical insurance claims using ICD-10 codes to ensure accuracy in billing.
- Reviewed patient records for completeness and accuracy of information, including coding and diagnosis.
- Processed adjustments to patient accounts as needed based on insurance payment or denial.
- Resolved discrepancies between providers, payers, and patients regarding billing issues.
- Assisted with the development of internal procedures for accurate medical billing.
- Performed data entry into various systems such as EMR, PMS, and HMS.
- Generated monthly reports related to claim rejections and denials, payments received from insurers.
- Audited medical bills for coding errors and other discrepancies prior to submission.
- Provided customer service support by responding to inquiries from providers, payers, and patients regarding status of claims.
- Investigated denials or underpayments associated with claims submitted electronically or via paper forms.
- Collaborated with clinical staff on proper documentation requirements for successful reimbursement of services rendered.
- Reconciled outstanding accounts receivable balances for timely collection of payments due from insurers or patients.
- Maintained up-to-date knowledge of current federal regulations concerning HIPAA compliance in regards to healthcare privacy laws.
- Adhered to all applicable state laws when processing out-of-state claims.
- Developed strategies to reduce denials and improve overall revenue cycle performance.
- Researched complex billing problems that arise during the course of filing claims.
- Ensured compliance with all Medicare and Medicaid rules and regulations pertaining to health care reimbursement policies.
- Documented processes related to medical billing activities in order to improve efficiency within the department.
- Interpreted Explanation Of Benefits statements issued by insurance companies.
- Implemented corrective action plans when necessary in order to resolve any identified issues affecting claim processing times or accuracy rates.
- Participated in training sessions designed to stay abreast of changes in coding standards, regulations.
- Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Input details into accounts and tracked payments.
- Handled billing, waivers and claims for private and commercial clients.
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Organized information for past-due accounts and transferred to collection agency.
- Maintained billing software by updating rate change, cash spreadsheets and current collection reports.
- Answered customer questions to maintain high satisfaction levels.
- Submitted claims to insurance companies.
- Managed all payments processing, invoicing and collections tasks.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Collected, posted and managed patient account payments.
- Processed invoice payments and recorded information in account database.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Performed insurance verification, pre-certification and pre-authorization.
- Checked claims coding for accuracy with ICD-10 standards.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Input statement information, reconciled accounts and resolved discrepancies.
- Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Executed account updates and noted account information in company data systems.
- Generated and distributed month-end statements for customers and resolved related concerns.
- Maintained accounting ledgers by verifying and posting account transactions.
- Developed strong professional rapport with vendors and clients.
- Gathered information to produce accounts payable reports for review.
- Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
- Reconciled codes against services rendered.
- Prepared and posted weekly payments to vendors and suppliers.
- Expedited payments by verifying accuracy and currency of vendor information.
- Enforced compliance with organizational policies and federal requirements regarding confidentiality.
- Created receiving reports and updated vendor balance sheets to record accounts payable.
- Eliminated inaccuracies in accounts payable payments by verifying information prior to generating checks and electronic payment transfers.
- Reviewed purchase orders, sales tickets and charge slips to compute fees or charges due.
- Maintained historical records by microfilming and filing documents.
- Reviewed legal claims for accuracy and issues.
- Identified professional development opportunities and delivered comprehensive, standardized and hands-on training to new staff.
- Charged expenses to accounts and cost centers by analyzing invoice and expense reports.
- Weighed envelopes containing statements to determine correct postage and affix postage.
- Reviewed engine assigned codes and modifiers to update and verify accuracy.
- Completed efficient drop and bulk filing to maintain well-organized and easily accessed systems
- Computed credit terms, discounts and shipment charges for goods or services to complete billing documents.
- Verified accuracy and integrity of motor vehicle and workers' compensation claims through careful research and analysis.
- Reviewed and verified health insurance benefits for patients prior to their scheduled appointments.
- Identified discrepancies in patient benefit information and resolved them with the insurance provider.
- Collaborated with medical staff to ensure accuracy of patient records and eligibility for services.
- Developed strategies to maximize available coverage for clients.
- Interpreted complex policy language from insurance providers to determine benefits coverage.
- Conducted research on new products offered by insurance companies and provided recommendations based on findings.
- Maintained accurate records of all verifications, including date of service, procedure codes, diagnosis codes.
- Resolved customer inquiries regarding benefit eligibility in a timely manner.
- Assisted customers in understanding their benefits package and how it relates to their individual needs.
- Provided assistance with claims processing when needed, including filing appeals as necessary.
- Monitored changes in regulations related to healthcare benefits verification processes and procedures.
- Created reports for management on trends in benefit utilization and identified areas for improvement.
- Processed requests from physicians' offices for pre-authorization of tests or treatments.
- Managed correspondence between patients, providers, and payers regarding authorization status.
- Explained the requirements for obtaining pre-authorization from insurers.
- Facilitated communication between providers and payers when there were disputes over claim payments.
- Conducted data entry into relevant systems regarding benefit verifications.
- Advised customers about different types of coverage options available through their insurer.
- Educated customers on the importance of staying up-to-date on their premiums and other costs associated with their policies.
- Worked closely with internal teams to ensure compliance with state and federal regulations governing healthcare benefits verification processes.
- Coordinated benefits processing, including enrollments, terminations and claims.
- Provided assistance to plan participants by explaining benefits information to ensure educated selections.
- Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.
- Reviewed employee enrollments to verify accuracy, inputting information into company database.
- Checked accuracy and completeness of benefits applications and documents.
- Oversaw enrollment of new employees and company-wide yearly enrollment period.
- Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
- Assisted with audits by preparing accounts and providing information.
- Produced detailed reports and data models to help clients pick optimal plans.
- Managed and maintained employee benefits programs including health insurance, retirement plans, and wellness programs.
- Negotiated with benefits vendors to secure cost-effective services for the organization.
- Assisted employees with benefits enrollment and changes, providing guidance on plan options and implications.
- Ensured compliance with federal, state, and local regulations affecting benefits programs, including ACA and ERISA.
- Conducted benefits orientation sessions for new hires, ensuring understanding of benefits offerings.
- Participated in benefits renewal process, analyzing proposals and making recommendations.
- Developed and maintained benefits policies and procedures manuals.
- Coordinated annual open enrollment process, including preparation of materials, presentations, and employee support.
- Analyzed benefits usage and cost trends to advise on plan adjustments and negotiations with vendors.
- Implemented wellness initiatives aimed at improving employee health and reducing healthcare costs.
- Collaborated with HRIS team to ensure benefits data integrity and streamline enrollment processes.
- Developed and distributed communications materials to educate employees about their benefits and any changes.
- Administered leave programs such as FMLA, PTO, and disability leave, ensuring compliance and proper tracking.
- Stayed current with benefits trends and legislation through continuous education and professional development.
- Provided training and support to HR team members on benefits administration best practices.
- Processed benefits invoices for payment, verifying accuracy and resolving discrepancies with vendors.
- Conducted surveys and focus groups to assess employee satisfaction with benefits offerings and identify improvement areas.
- Maintained detailed records of employee benefits enrollments and changes for auditing and reporting purposes.
- Resolved employee issues related to benefits, serving as a liaison between employees and insurance providers.
- Assisted with the preparation of reports and presentations on benefits programs for senior management.
- Administered employee insurance, pension and savings plans, working with insurance brokers and plan carriers.
- Researched employee benefit and health and safety practices, recommending changes or modifications to existing policies.
- Offered subject matter expertise on employment regulations, compensation policies and personnel management procedures to optimize internal structures.
- Evaluated job positions to determine classification, exempt or non-exempt status and salary.
- Developed and evaluated methods and techniques for selecting, promoting and training workers.
- Prepared flow charts and career path reports to summarize job analysis and evaluation and compensation analysis information.
- Negotiated collective agreements on behalf of employers or workers and mediated labor disputes and grievances.
- Surveyed employees and conducted focus group meetings to collect job, organizational, and occupational information.
- Prepared occupational classifications, job descriptions and salary scales.
- Reviewed occupational data on alien employment certification applications to determine occupational titles and codes.
- Analyzed health data to identify trends, patterns and relationships.
- Developed reports and presentations based on findings from health data analysis.
- Utilized a variety of software tools to manipulate, analyze and interpret health data.
- Created databases for storing and managing health information.
- Performed gap analyses to identify areas of improvement in patient care processes.
- Designed statistical models to predict outcomes related to healthcare services.
- Developed algorithms to automate the process of analyzing large volumes of health data.
- Provided technical support in the implementation of new systems for collecting and reporting healthcare data.
- Collaborated with other healthcare professionals to develop strategies for improving patient care quality and outcomes.
- Maintained accurate documentation of all activities related to the collection and analysis of health data.
- Conducted research studies using various sources of health-related information such as surveys, medical records.
- Prepared detailed reports summarizing the results from various studies conducted on healthcare services.
- Assisted in the development of policies and procedures related to the use of health information technology.
- Identified opportunities for cost savings through improved utilization of existing resources.
- Presented findings at conferences or meetings regarding current trends in healthcare information management.
- Audited existing systems for accuracy, completeness and compliance with regulations governing healthcare information security.
- Implemented new technologies designed to improve efficiency when collecting, organizing and analyzing healthcare data.
- Consulted with stakeholders on best practices for utilizing available resources when working with health information technology solutions.
- Provided training sessions on proper methods for collecting, documenting, analyzing and interpreting healthcare data.
- Gathered data from multiple sources to assimilate meaningful inputs for databases.
- Protected medical information against unauthorized access, loss, or corruption by consistently following security protocols.
- Met needs of physicians and other treating team members with timely retrievals of patient medical records.
- Enhanced electronic records management systems to meet new needs and forecasted demands.
- Improved integrity and completeness of medical records by consulting with clinical staff to resolve coding and diagnostic mistakes.
- Supported healthcare applications by monitoring security, performance and reliability.
- Evaluated and recommended upgrades to improve existing computerized healthcare systems.
- Generated periodic and ad hoc reports outlining statistics, narrative findings or graphical representations of health information.
- Drafted statistical reports related to diseases treated, surgeries performed and hospital bed occupancy
Claims Administrator
Ametros
Wilmington, MA
11.2018 - 01.2019
- Classified diagnoses and services for member treatment, enhancing case management and analytics accuracy.
- Assessed service relevance to members' accidents or injuries, ensuring proper case handling.
- Recorded, tracked, and followed up on all correspondences, maintaining thorough documentation.
- Identified and swiftly resolved claim issues, improving overall process efficiency.
- Coordinated benefits transitions for claims outside CareGuard coverage, ensuring seamless service continuity.
- Managed bill payments, performing detailed claim reviews and analyses to ensure accurate fund allocation.
- Audited incoming claims and bill review processes, resolving technical issues with IT and Management for optimal operations.
- Collaborated with vendors to correct billing errors, acting as a key resource for Customer Service reps, and claims associates needing assistance.
- Reviewed customer claims for accuracy and completeness.
- Processed incoming claims, including data entry into the system.
- Researched and analyzed claim information to determine validity of coverage.
- Provided excellent customer service by responding to inquiries in a timely manner.
- Assisted customers with setting up online accounts and navigating the website.
Accounts Receivable Supervisor
Advantedge Healthcare Solutions
Salem, NH
10.2015 - 09.2017
- Supervised accounts receivable operations for over 17 clients across multiple locations, ensuring accuracy and timeliness in medical billing.
- Led a team of 6, providing daily direction, monitoring A/R, and managing work queues to meet performance targets.
- Streamlined time and attendance tracking for the team, ensuring compliance and efficiency.
- Interviewed, hired, and onboarded new team members, enhancing team capability and cohesion.
- Resolved escalated calls and complex billing issues, maintaining high levels of client satisfaction.
- Fostered strong communication channels with internal and external stakeholders through high-volume email and phone interactions.
- Evaluated and improved processes and procedures, implementing suggestions to boost client satisfaction and operational efficiency.
- Trained and mentored team members, enhancing skills, and fostering professional development.
- Conducted performance reviews and managed disciplinary actions, ensuring company policy adherence and high morale.
- Managed billing transactions for multiple third-party insurances, ensuring compliance with payer requirements and successfully resolving audits and denied claims.
- Audited and created reports using BI tools to spot trends, improve work processes, and maximize reimbursements.
- Utilized proficiently EPIC, VM, Salesforce, PowerBI, Tableau, EMR, 3M Encoder, Excel, and any system required by our client.
- (Physicians, Office, Facility, Diagnostic) Utilized work queues to generate our work.
- Supervised and monitored the daily operations of the Accounts Receivable department to ensure accuracy, completeness, and timeliness of payments.
- Analyzed financial data and generated reports for management review.
- Developed and implemented effective strategies to reduce delinquency rates within Accounts Receivable accounts.
- Maintained accurate records of customer account activity including invoices, payments, credits, adjustments.
- Created monthly aging report for review by management team.
- Resolved customer queries related to billing issues or payment discrepancies in a timely manner.
- Ensured compliance with accounting policies and procedures as well as government regulations.
- Evaluated existing processes and proposed improvements to streamline workflow efficiency.
- Conducted regular reconciliation activities on customer accounts to verify accuracy of balances.
- Tracked all incoming payments received via check, ACH and wire transfer or other methods.
- Managed collection process for past due receivables while maintaining good relationships with customers.
- Investigated disputes regarding unpaid invoices and worked with clients to resolve them in an amicable manner.
- Provided training sessions for new employees on Accounts Receivable procedures and policies.
- Performed periodic reviews of unapplied cash items on the general ledger accounts.
- Prepared month-end closing entries related to Accounts Receivable transactions.
- Monitored online banking systems for electronic payments made by customers.
- Negotiated payment plans and arrangements.
- Identified past due accounts and contacted account holders to arrange payment.
- Received and input receivables payments in compliance with internal financial procedures.
Billing Manager
Horizon Healthcare Services
Chipley, FL
07.2014 - 10.2015
- Led and mentored a team of 2-3 support billers, enhancing productivity and efficiency
- Streamlined billing transactions across multiple third-party insurance providers, ensuring timely processing
- Conducted comprehensive AR aging reviews to expedite billing claims within payer deadlines, improving cash flow
- Spearheaded insurance and patient collections, reducing aged accounts and optimizing revenue recovery
- Successfully handled claim resubmissions and appeals, significantly increasing the rate of overturned denials
- Resolved claim denials through effective collaboration with patients and third-party billers, achieving a high-resolution rate
- Audited and submitted medical documents for authorization, ensuring compliance and timely billing submissions
- Researched and applied payer requirements, including HCPCS and ICD-10 codes, to ensure accurate billing
- Verified insurance before equipment delivery, reducing non-payment risks
- Maintained strict HIPAA compliance in all billing activities, safeguarding patient information
- Kept abreast of payer regulations and policies, ensuring compliance and minimizing claim rejections
- Implemented AR adjustments and reapplications of payments/credits, maintaining accurate financial records
- Assisted in transitioning to a new billing system, facilitating a smooth and efficient changeover.
- Developed and implemented billing procedures to ensure accurate data entry and timely payment collection.
- Analyzed customer accounts and identified discrepancies in invoices, payments, credits, and deductions.
- Reviewed customer contracts for accuracy of pricing, terms of payment, discounts.
- Prepared monthly reports on accounts receivable status and aging analysis.
- Worked with customers to resolve billing disputes in a timely manner.
- Performed credit checks on all new customers prior to extending credit terms.
- Collaborated with sales team to ensure proper billing of orders.
- Researched complex billing issues using internal resources and external sources as needed.
- Established policies and procedures for the entire order-to-cash cycle.
- Managed daily cash postings from lockbox or other electronic methods of payment processing.
- Assisted auditors with required documentation related to accounts receivable audits.
- Maintained customer records in accounting systems ensuring accuracy of information entered into system.
- Created manual invoices when necessary for special circumstances such as rush orders or incorrect pricing on original invoice.
- Processed customer refunds promptly upon request.
- Monitored delinquent accounts and worked with collections department if necessary.
- Reconciled bank statements each month ensuring accuracy of deposits made by customers.
- Generated monthly aged trial balances for review by management team.
- Investigated unapplied payments or credits to determine appropriate application method.
- Provided support to Accounts Payable department when needed regarding vendor inquiries or dispute resolution.
- Participated in process improvement initiatives to increase efficiency within the department.
- Resolved billing issues by applying knowledge and completing in-depth research.
- Managed billing calendar and scheduled claims for payments.
- Developed improved standard operating procedures to increase billing accuracy and cash flow.
- Helped customers to bring accounts into good standing by implementing payment plans.
- Conducted insurance verification and pre-authorization, coded medical procedures and managed patient charts.
- Developed performance improvement plans based on deep reviews of current work.
- Negotiated with software providers to enhance billing system functionalities according to company needs.
- Implemented new billing system software, resulting in an increase in productivity.
- Developed and maintained a comprehensive billing system database for accurate record-keeping and reporting.
- Streamlined billing processes through the introduction of automated systems, reducing manual errors.
- Collaborated with IT department to troubleshoot and resolve billing system issues promptly.
- Oversaw the preparation of monthly billing reports and analysis to track billing efficiency and accuracy.
- Analyzed billing processes and recommended improvements to minimize cycle time and enhance customer satisfaction.
- Facilitated monthly training sessions for billing department staff on new billing procedures and technologies.
- Managed the setup and billing of complex client accounts, ensuring compliance with contractual agreements.
- Established clear billing policies and procedures, ensuring consistent application across all client accounts.
- Managed and supervised billing department staff, including training, evaluation, and workflow distribution.
- Developed and implemented efficient billing procedures to ensure timely and accurate invoice generation.
- Prepared detailed financial statements related to billing for executive review and decision-making.
- Led the transition to electronic billing systems, significantly reducing paper use and contributing to sustainability goals.
- Coordinated interdepartmental efforts to improve integration between billing and customer service functions.
- Provided expert advice on billing optimization strategies, leading to a reduction in outstanding accounts receivables.
- Conducted regular audits of billing activities to ensure compliance with company policies and regulatory standards.
- Coordinated with sales, client services, and finance departments to resolve billing discrepancies and disputes.
- Conducted benchmark studies of competitive billing operations to identify areas for improvement and innovation.
- Created and updated financial reports on frequent basis to present information to leadership teams.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Developed invoicing systems and internal controls to boost billing efficiencies.
- Checked payroll, vendor payments and other accounting disbursements for accuracy and compliance.
- Coordinated preparation of external audit materials and external financial reporting.
- Developed or analyzed information to assess current or future financial status of firms.
- Analyzed actual financial results to budget, preparing variance reporting to functional groups.
- Maintained regular performance appraisals for subordinates through verbal, written and on-going review programs.
- Created financial management mechanisms to minimize financial risk to business.
- Managed relationships with tax authorities, bankers and auditors.
- Conducted reviews and evaluations for cost-reduction opportunities.
- Analyzed competitors and market trends to facilitate business growth.
- Built financial models to allocate resources, forecast cash and investment needs and make capital budgeting decisions.
Department Secretary / Executive Assistant
Bay Medical Sacred Heart Health System
FL
09.2009 - 07.2014
- Achieved a 94% recovery rate for old claims and a 98% collection rate for billed charges by spearheading targeted revenue recovery initiatives.
- Resolved complex revenue recovery claims from Medicare and commercial insurance, optimizing the reimbursement process.
- Enhanced billing efficiency by implementing four innovative management techniques and continuous process improvements.
- Revitalized office procedures within three months, ensuring audit compliance and significantly boosting productivity.
- Led the scheduling, coding, and billing of all surgeries, successfully resolving unpaid charges and insurance denials.
- Directed the creation and maintenance of personnel schedules, ensuring accurate tracking of hours and enhancing workforce management.
- Supervised a team of 34, effectively controlling office expenditures and maintaining an optimal supply inventory.
- Prepared and edited high-impact correspondence, reports, and presentations, enhancing communication and decision-making processes.
- Facilitated staff recruitment, appraisals, and performance management, fostering a high-performance culture.
- Contract Negotiations organized key community events such as Healthy Start, Kid Fest, and The Walk to Remember, strengthening community relations.
- Answered and directed incoming calls to appropriate personnel.
- Prepared and maintained filing systems, ensuring accuracy of records.
- Organized meetings and events, including scheduling conference rooms and ordering catering services.
- Assisted in the preparation of reports, documents, presentations and correspondence.
- Monitored departmental inventory levels and ordered office supplies as needed.
- Greeted visitors, ascertained their needs and directed them to the appropriate staff member.
- Compiled data for special projects or reports as requested by management team.
- Maintained an efficient workflow by prioritizing tasks based on urgency.
- Provided administrative support for department staff members with daily activities such as photocopying and scanning documents.
- Collaborated with other departments to coordinate inter-office functions.
- Processed incoming mail according to established procedures.
- Updated departmental databases with current information on a timely basis.
- Created spreadsheets using Microsoft Excel to track financial data.
- Coordinated travel arrangements for business trips including flights, hotels, car rentals.
- Ensured compliance with company policies and procedures through regular audits.
- Provided customer service assistance to clients visiting the office or calling in.
- Developed standard operating procedures for new processes within the department.
- Transcribed notes from meetings into minutes for distribution among attendees.
- Performed basic bookkeeping duties such as processing invoices and payments.
- Handled confidential information in a professional manner at all times.
- Performed accounting functions such as payroll and expense tracking.
- Opened and distributed correspondence to staff members.
- Managed computer database and physical department records.
- Directed clients and guests to correct departments, rooms, and staff members.
- Oversaw office inventory by restocking supplies and submitting purchase orders.
- Produced and reviewed documentation, spreadsheets and presentations for department use.
- Oversaw reception area, greeted and directed visitors, answered telephone calls and received packages.
- Reduced financial discrepancies by accurately analyzing and managing customer orders and invoices for various Fortune 500 companies.
- Organized files, developed spreadsheets, faxed reports and scanned documents, maintaining front desk and reception area in neat and organized fashion.
- Pleasantly welcomed visitors, answered phone calls, and maintained front reception desk.
- Created spreadsheets in Microsoft Excel for record-keeping and reporting.
- Kept office equipment functional and supplies well-stocked to promote efficient operations.
- Handled incoming calls and directed callers to appropriate department or employee.
- Responded to customer issues to provide immediate resolution and improve retention.
- Sorted and distributed incoming faxes, letters and emails for office distribution.
- Updated system to organize office documentation, maximizing efficiency and increasing productivity.
- Composed, edited and typed complex memos and reports with job-related software.
- Set up workshops, conferences and meetings by scheduling and reserving rooms and preparing supplies.
- Oversaw staff correspondence, record tracking and data communications, resulting in improved automation of office operations.
- Coordinated travel arrangements and completed expense reports for travel reimbursement.
- Conducted research, compiled and typed statistical reports, synthesized information and provided excellent communication to disseminate information throughout organization.
- Coordinated catering services for various functions, including sales trainings and department meetings.
- Drove customer feedback to deliver information to management for corrective action.
- Provided product shipment logistical support and quality control by coordinating with vendors, resulting in increased revenue.
- Executed on-time, under-budget projects by solving complex issues for senior leadership.
- Used voice recorder or notepad to compose and transcribe meeting minutes.
- Raised funds by organizing multiple events and diligently managed details to meet deadlines.
- Organized and managed complex calendar of appointments, meetings, and travel arrangements for executive team.
- Maintained confidential records and files related to executive operations.
- Coordinated with internal departments on a regular basis to ensure efficient functioning of day-to-day operations.
- Prepared reports, presentations, agendas, minutes, and other documents as needed by the executive staff.
- Provided administrative support in preparing contracts, invoices, purchase orders, and other documentation required for daily business activities.
- Developed effective filing systems for easy retrieval of information when needed.
- Monitored incoming emails and responded accordingly in a timely manner.
- Acted as a liaison between the executives and internal and external stakeholders to facilitate communication flow.
- Assisted in developing policies and procedures pertaining to office administration matters.
- Responded promptly to inquiries from customers or clients regarding products or services offered by the company.
- Conducted research on various topics as requested by executives or senior management personnel.
- Performed data entry tasks into various software programs including MS Excel spreadsheets.
- Assisted in organizing conferences, seminars and other events as directed by the executives.
- Greeted visitors warmly upon arrival at the office premises.
- Managed all aspects of catering needs for special events hosted by the organization.
- Oversaw inventory control processes ensuring availability of supplies at all times.
- Answered telephone calls from customers or clients providing assistance where necessary.
- Created and maintained up-to-date records related to customer accounts or financial transactions.
- Scheduled appointments for executives with external parties such as vendors or suppliers.
- Ensured that all relevant paperwork was completed accurately prior to submission for approval.
- Maintained company confidence and protected business operations by keeping sensitive information confidential.
- Opened, read and replied to e-mails, letters and correspondence on behalf of executives.
- Coordinated meeting and work schedules for staff teams and executives.
- Scheduled and arranged travel and hotel reservations for meetings, conferences and seminars.
- Set up meeting and event logistics for senior management and updated calendars.
- Made travel arrangements to provide executives seamless and travel policy-approved business trips.
- Managed daily invoices, reports and proposals.
- Managed and tracked expenses to meet company budget requirements.
- Tackled and addressed top-level, high-priority issues with professional administrative discretion.
- Screened phone calls for executives to instantly identify priority clients and filter out spam calls.
- Conducted research and collected and analyzed data to prepare reports and documents.
- Facilitated board meeting agendas and distributed support materials in advance for successful sessions.
- Entered customer information and updates in database system to track leads, interactions, relationships and propel sales opportunities.
- Followed proper accounting and bookkeeping procedures to support audits.
- Leveraged word processing software to create proposals, letters and memos.
- Handled confidential information with discretion and integrity.
- Created and maintained computer- and paper-based filing and organization systems for records, reports and documents.
- Participated in frequent communication with other administrative team members, human resources and finance department on special projects and events.
- Facilitated communications by forwarding emails, transferring calls and filing documents.
- Took detailed notes in meetings and disseminated information afterward.
- Coordinated multiple schedules using online calendaring system.
- Compiled meeting agendas and supportive materials ahead of meetings.
- Supervised executive and management calendars while allocating tasks to administrative support team for smooth operational flow.
- Delivered optimal administrative, customer service and case management support.
- Provided accurate, up-to-date information to external parties through emails, phone calls and in-person interactions.
- Ordered catering or restaurant delivery to offer food and beverages to meeting and conference attendees.
- Relayed messages, retrieved reports and printed documents for co-workers to assist with office workflow.
- Executed special objectives and projects in response to executive team and board member requests.
- Researched and prepared information for presentations to high-level executives.
- Wrote and distributed executive meeting agendas and minutes to department heads and executive team members.
- Designed PowerPoint presentations for monthly divisional meetings with top-level executives.
- Coordinated executive and senior management vacation, day-to-day meeting and travel schedules.
- Prepared invoices and drafted memos for executives.
- Updated and implemented administrative and executive support policy changes and monitored effects.
- Filtered important calls and spam calls to help executives prioritize specific clients and expedite daily operations.
- Reviewed incoming reports, applications and memos to determine workplace priorities.
CNA/Health Unit Coordinator
Bay Medical Sacred Heart Health System
Panama City, FL
09.2009 - 07.2014
- Diagnosed substantial changes in accounts receivable aging accounts, enhancing insurance carrier accountability.
- Conducted research and reconciliation transactions, improving financial accuracy.
- Coordinated insurance verifications and pre-certifications, streamlining patient processing.
- Directed billing operations, providing high-level executive and administrative support for daily business operations.
- Executed clerical and administrative tasks, maintaining efficient unit functioning.
- Received and recorded patient payments, ensuring accurate database management, and issuing receipts.
- Provided assistance with activities of daily living, including bathing, dressing and grooming.
- Assisted patients in ambulation and transfers using proper body mechanics.
- Performed vital sign assessments, such as taking blood pressure and temperature.
- Documented patient care services by charting in designated areas.
- Reported changes in patient conditions to registered nurse or physician.
- Answered patient call lights promptly and responded to requests appropriately.
- Observed patients for any physical or emotional changes, reported findings to medical staff immediately.
- Collaborated with interdisciplinary team members to ensure quality patient care was delivered at all times.
- Assisted with range of motion exercises and other rehabilitative activities per physician orders.
- Utilized appropriate safety measures when handling hazardous materials or waste products.
- Maintained a clean, safe environment for the patient by adhering to infection control policies and procedures.
- Monitored food intake and output as directed by nursing staff.
- Demonstrated excellent customer service skills when interacting with patients, families and guests.
- Participated in educational programs designed to improve knowledge of health care practices.
- Provided emotional support to family members during difficult times.
- Educated patients on self-care techniques that would help them maintain their independence.
- Assisted in preparing meals according to prescribed diets while monitoring food consumption levels.
- Ensured compliance with HIPAA regulations regarding confidentiality of information.
- Administered medications under supervision of a licensed nurse.
- Transported residents within the facility as needed.
- Recognized signs, symptoms of abuse, neglect and reported them per policy.
- Facilitated communication between patients, family members, and healthcare professionals.
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation.
- Answered signal lights, bells or intercom systems to determine resident needs.
- Observed and reported unusual symptoms and changes to charge nurse.
- Conducted routine checks on patient vitals, blood pressure, blood sugar and heart rate.
- Turned and repositioned residents using proper body mechanics to prevent pressure ulcers.
- Assisted patients with shaving, bathing and oral hygiene to promote healthy habits and overall wellness.
- Assisted residents with bathing and dressing to promote personal hygiene.
- Used mobility devices to transport patients.
- Helped residents walk with or without self-help devices.
- Distributed drinking water and nourishment to residents.
- Maintained accurate, timely flow of information by completing thorough patient records and updating healthcare team on patient status.
- Assisted residents in preparing for activities and social programs.
- Exhibited compassionate care and communication regarding issues surrounding death and dying.
- Managed and maintained patient rooms, shared-living areas and nursing stations.
- Fostered relationships with patients, caregivers and healthcare teams to achieve individual care plan targets.
- Rendered hands-on nursing care under direct RN supervision, adhering to medical center policies and procedures.
- Looked for physical, emotional, and symptomatic changes in patient condition and obtained necessary care for medical concerns.
- Supported non-ambulatory residents in range of motion exercises.
- Collected specimens, monitored vitals and maximized patient comfort to maintain optimal environment.
- Documented activities and recorded information in EMR system.
- Examined and treated patient lacerations, contusions, and physical symptoms and referred patients to other medical professionals.
- Conducted patient education on health maintenance and disease prevention.
- Assisted patients with daily living activities, including bathing, dressing, and grooming.
- Communicated with patients to determine feelings, need for assistance or social and emotional support.
- Documented information in patient charts and communicated status updates to interdisciplinary care team.
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
- Answered patient call signals and signal lights to determine patients' needs.
- Provided physical support to assist patients with bathing, dressing and toileting.
- Turned and repositioned bedridden patients to prevent bedsores.
- Measured and recorded food and liquid intake and output, reporting changes to medical or nursing staff.
- Assisted nurses with wound care for pressure ulcers, bed sores and surgical site wounds.
- Kept medical supply room and patient rooms stocked with necessary supplies, equipment and instruments.
- Planned and served meals and snacks to patients according to prescribed diets.
- Assisted with lifting patients to move on or off beds, examination tables and surgical tables.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Supplied, collected and emptied patient bedpans on frequent basis.
- Collected specimens from patients for laboratory testing purposes.
- Administered medications and educated patients and families on correct at-home administration.
- Transported specimens, laboratory items or pharmacy items, verifying proper documentation and delivery to authorized personnel.
- Reminded patients to take prescribed medications or nutritional supplements.
- Shaved and draped patients to prepare for surgery, treatment or examination.
- Exercised comatose and paralyzed patients to reduce delirium and improve physical function.
- Answered incoming calls and routed them to the appropriate departments or staff members.
- Organized patient records, charts, and other documents in an orderly manner.
- Assisted with scheduling appointments for patients and doctors.
- Prepared new patient files by entering demographic information into a computer system.
- Greeted visitors and directed them to the proper area of the office.
- Verified insurance coverage prior to patient visits.
- Maintained inventory of medical supplies and equipment in health unit.
- Provided administrative support to nursing staff as needed.
- Created spreadsheets and reports from data gathered from patient files.
- Processed paperwork related to hospital admissions, discharges, and transfers.
- Managed daily operations of the health unit including filing, faxing, photocopying.
- Conducted quality assurance checks on all patient records for accuracy and completeness.
- Entered medication orders into the pharmacy system accurately and timely.
- Monitored expiration dates of medications stored in the health unit.
- Assisted with orienting new employees to departmental procedures.
- Received requests for medical records from outside agencies or individuals.
- Updated patient information in electronic systems according to established policies and procedures.
- Performed clerical tasks such as typing letters, memos, reports., as requested by management.
- Coordinated communication between various departments within the facility regarding patient care needs.
- Provided customer service assistance to patients who had questions or concerns about their care plans.
- Participated in team meetings regarding policy changes or improvements within the health unit.
- Communicated with patients and medical staff to convey important information and facilitate smooth unit operations.
- Maintained unit supplies and equipment for medical staff and patient care needs.
- Responded to patient call lights quickly and expedited appropriate follow-through.
- Scheduled medical appointments and coordinated transportation to medical facilities for patients.
- Transcribed physicians' orders to aid in medical care and minimize medical errors.
- Conducted unit greetings and orientations for newly admitted and transferred patients.
- Backed up floor staff by keeping patients' rooms clean and orderly.
- Oversaw patient unit, providing daily functions such as grooming, bathing, feeding, and turning in bed.
- Completed insurance forms and other patient documentation, ensuring accuracy and compliance with policies.
- Scheduled appointments, tests, and procedures in alignment with healthcare provider recommendations and patient needs.
- Provided administrative support to healthcare teams, including data entry, filing, and preparing reports.
- Assisted in the preparation and maintenance of patient charts, ensuring all pertinent information was up-to-date.
- Assisted with patient care activities under the direction of nursing staff to support patient needs.
- Maintained inventory of medical supplies and equipment, placing orders as necessary to ensure availability.
- Facilitated communication between medical staff, departments, and external entities to ensure efficient patient care.
- Processed physician orders, including medication, laboratory tests, and diagnostic procedures, accurately and promptly.
- Participated in quality assurance activities to improve patient care and comply with healthcare regulations.
- Compiled and submitted daily reports on patient admissions, discharges, and transfers for administrative use.
- Participated in staff meetings and training sessions to stay informed of hospital policies and best practices.
- Coordinated patient admissions, transfers, and discharges to ensure seamless workflow and patient satisfaction.
- Managed and updated patient records with attention to confidentiality and accuracy in a fast-paced environment.
- Ensured the cleanliness and organization of the nursing station and patient areas to maintain a safe environment.
- Utilized healthcare software systems for patient scheduling, billing, and record management efficiently.
- Conducted patient and family education on hospital policies, procedures, and health management strategies.
- Responded to emergency situations by following hospital protocols and assisting medical staff as needed.
- Collaborated with interdisciplinary teams in the development and implementation of patient care plans.
- Answered and directed incoming calls, providing information or taking messages as appropriate for efficient communication.
- Monitored patient flow to optimize scheduling and minimize wait times for procedures or consultations.
- Communicated with patients with compassion while keeping medical information private.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Maintained records management system to process personnel information and produce reports.
- Monitored inpatient bed use, facilities and staff to provide optimal use of resources.
- Explained policies, procedures and services to patients.
- Managed changes in integrated health care delivery systems and technological innovations while keeping focus on quality of care.
- Maintained awareness of government regulations, health insurance changes and financing options.
- Maintained communication and transparency with governing boards, department heads and medical staff.
- Coordinated work activities and scheduling of medical, nursing and physical plant staff.
- Built work schedules and staff assignments, taking workload, space and equipment availability into consideration.
- Updated procedures necessary for compounding, mixing, packaging, and labeling medications.
- Recruited, hired and trained new medical and facility staff.
- Established solid relations with leadership and staff by attending board meetings and coordinating interdepartmental information exchanges.
- Developed medical programs that promoted community health and research.
Medical Assistant
Emerald Medical
Panama City, FL
02.2009 - 08.2009
- Provided comprehensive support to doctors by consulting with patients, taking vital signs, and assisting with office procedures and exams.
- Efficiently scheduled appointments handled data entry, and managed patient billing, including taking payments and verifying insurance information.
- Prepared and organized patient charts and samples, ensuring accurate record-keeping and smooth workflow.
- Administered treatments and injections and performed tests.
- (Vaccines, GI Cocktails, EKG, etc.) Checked and evaluated patients for the weight loss program and other patient care initiatives.
- Managed high-volume inbound calls, ensuring timely and accurate responses to patient and doctor messages.
- Coordinated patient check-out processes, scheduling follow-up appointments, procedures, and testing with specialists.
- Phlebotomy: Proper urine collection techniques, along with urinalysis. Patient positioning and draping techniques. Examination room sterilization and preparation skills. Performed the preliminary intake check and verified medications, patient history, and any test requested by a physician, and completed any consent forms needed.
- Assisted physicians with patient care by taking vital signs, patient histories and preparing patients for examinations.
- Administered injections, medications and treatments as directed by the physician.
- Provided assistance to medical staff in performing minor surgical procedures.
- Prepared laboratory specimens for analysis and organized lab results for review by the physician.
- Maintained accurate medical records through filing, charting, transcription and data entry into electronic health record system.
- Answered phones, scheduled appointments and managed patient flow while greeting visitors in a professional manner.
- Performed basic laboratory tests such as urinalysis and blood glucose levels under direct supervision of a physician or registered nurse.
- Educated patients on healthcare topics such as nutrition and disease prevention methods.
- Ordered medical supplies, maintained inventory logs and restocked exam rooms when needed.
- Conducted EKGs, spirometry testing, audiograms and other diagnostic tests as requested by the physician.
- Inspected equipment to ensure proper working order prior to use on patients.
- Organized patient charts before each day's clinic sessions began.
- Assisted with pre-operative preparation of patients including providing instruction about post-operative care plans.
- Collected samples from patients for laboratory testing purposes.
- Ensured that all instruments used during exams were cleaned properly after each use according to established protocols.
- Monitored vital signs of hospitalized patients throughout their stay at the hospital or clinic setting.
- Kept examination rooms clean, stocked with necessary supplies and prepared for incoming patients.
- Registered new patients into practice management software program accurately entering demographic information.
- Filed insurance claims forms in accordance with applicable regulations.
- Adhered to HIPAA regulations regarding safeguarding confidential patient information at all times.
- Scheduled appointments for patients via phone and in person.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Measured vital signs and took medical histories to prepare patients for examination.
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Organized charts, documents and supplies to maintain team productivity.
- Cleaned and maintained medical equipment following procedures and standards.
- Documented notes during patient visits.
- Responded to patient callbacks and phone-in prescription refill requests.
- Educated patients about medications, procedures and physician's instructions.
- Secured patient information and maintained patient confidence by completing and safeguarding medical records.
- Contacted pharmacies to submit and refill patients' prescriptions.
- Participated in team meetings to improve workflows and contribute to improving patient population outcomes.
- Incorporated outside records into charts and EHR.
- Answered phones, scheduled appointments, greeted patients and ordered supplies.
- Conducted patient interviews to gather health history, vital signs and information about current medical issues.
- Prepared treatment rooms for patient examinations.
- Verified appointment times with patients, preparing charts, pre-admission and consent forms.
- Kept facility stocked with necessary supplies, equipment and instruments.
- Explained treatment procedures and physicians' instructions.
- Oversaw patient registration, insurance verification, form completion and appointment scheduling to maintain operational efficiency.
- Handled general office duties to support administrative staff during peak hours.
- Positioned patients properly during examination or treatment for comfort and safety.
- Collected, labeled and stored laboratory specimens properly prior to testing.
- Assisted back office patient processes to reduce office wait times.
- Supported administrative staff by processing payments.
- Administered medications under physician's supervision.
- Processed orders for medical supplies and lab equipment.
- Communicated with pharmacies for prescription refills on behalf of supervising physician.
- Changed dressings on wounds to prevent infection and check for healing.
- Conducted routine laboratory tests and sample analyses to monitor diseases.
- Contacted medical facilities to schedule patients for admission.
- Operated x-ray and electrocardiogram (EKG) to administer diagnostic tests.
Front Desk / CNA
South County Nursing Home and Rehabilitation Center
Kingston, RI
05.2008 - 02.2009
- Greeted and escorted patients to exam rooms,
- Scheduled patients for appointments.
- Placed reminder calls to patients regarding appointments.
- Answered patient and family inquiries, performed urinalysis and blood testing, and inventoried exam room supplies, and stocked.
- Patient assessment and education capabilities gained through education and clinical experience.
- Provided assistance with activities of daily living, including bathing, dressing and grooming.
- Assisted patients in ambulation and transfers using proper body mechanics.
- Performed vital sign assessments, such as taking blood pressure and temperature.
- Documented patient care services by charting in designated areas.
- Reported changes in patient conditions to registered nurse or physician.
- Answered patient call lights promptly and responded to requests appropriately.
- Observed patients for any physical or emotional changes, reported findings to medical staff immediately.
- Collaborated with interdisciplinary team members to ensure quality patient care was delivered at all times.
- Assisted with range of motion exercises and other rehabilitative activities per physician orders.
- Maintained a clean, safe environment for the patient by adhering to infection control policies and procedures.
- Utilized appropriate safety measures when handling hazardous materials or waste products.
- Monitored food intake and output as directed by nursing staff.
- Demonstrated excellent customer service skills when interacting with patients, families and guests.
- Participated in educational programs designed to improve knowledge of health care practices.
- Provided emotional support to family members during difficult times.
- Educated patients on self-care techniques that would help them maintain their independence.
- Assisted in preparing meals according to prescribed diets while monitoring food consumption levels.
- Ensured compliance with HIPAA regulations regarding confidentiality of information.
- Administered medications under supervision of a licensed nurse.
- Transported residents within the facility as needed.
- Recognized signs, symptoms of abuse, neglect and reported them per policy.
- Facilitated communication between patients, family members, and healthcare professionals.
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation.
- Answered signal lights, bells or intercom systems to determine resident needs.
- Observed and reported unusual symptoms and changes to charge nurse.
- Conducted routine checks on patient vitals, blood pressure, blood sugar and heart rate.
- Turned and repositioned residents using proper body mechanics to prevent pressure ulcers.
- Assisted patients with shaving, bathing and oral hygiene to promote healthy habits and overall wellness.
- Assisted residents with bathing and dressing to promote personal hygiene.
- Used mobility devices to transport patients.
- Helped residents walk with or without self-help devices.
- Distributed drinking water and nourishment to residents.
- Maintained accurate, timely flow of information by completing thorough patient records and updating healthcare team on patient status.
- Assisted residents in preparing for activities and social programs.
- Exhibited compassionate care and communication regarding issues surrounding death and dying.
- Managed and maintained patient rooms, shared-living areas and nursing stations.
- Fostered relationships with patients, caregivers and healthcare teams to achieve individual care plan targets.
- Rendered hands-on nursing care under direct RN supervision, adhering to medical center policies and procedures.
- Looked for physical, emotional, and symptomatic changes in patient condition and obtained necessary care for medical concerns.
- Supported non-ambulatory residents in range of motion exercises.
- Collected specimens, monitored vitals and maximized patient comfort to maintain optimal environment.
- Documented activities and recorded information in EMR system.
- Examined and treated patient lacerations, contusions, and physical symptoms and referred patients to other medical professionals.
- Assisted patients with daily living activities, including bathing, dressing, and grooming.
- Conducted patient education on health maintenance and disease prevention.
- Communicated with patients to determine feelings, need for assistance or social and emotional support.
- Documented information in patient charts and communicated status updates to interdisciplinary care team.
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
- Answered patient call signals and signal lights to determine patients' needs.
- Provided physical support to assist patients with bathing, dressing and toileting.
- Turned and repositioned bedridden patients to prevent bedsores.
- Measured and recorded food and liquid intake and output, reporting changes to medical or nursing staff.
- Assisted nurses with wound care for pressure ulcers, bed sores and surgical site wounds.
- Kept medical supply room and patient rooms stocked with necessary supplies, equipment and instruments.
- Planned and served meals and snacks to patients according to prescribed diets.
- Assisted with lifting patients to move on or off beds, examination tables and surgical tables.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Supplied, collected and emptied patient bedpans on frequent basis.
- Collected specimens from patients for laboratory testing purposes.
- Administered medications and educated patients and families on correct at-home administration.
- Transported specimens, laboratory items or pharmacy items, verifying proper documentation and delivery to authorized personnel.
- Reminded patients to take prescribed medications or nutritional supplements.
- Shaved and draped patients to prepare for surgery, treatment or examination.
- Exercised comatose and paralyzed patients to reduce delirium and improve physical function.
CNA
Hope Nursing Home Healthcare
Cranston, RI
07.2007 - 05.2008
- Provided assistance with activities of daily living, including bathing, dressing and grooming.
- Assisted patients in ambulation and transfers using proper body mechanics.
- Performed vital sign assessments, such as taking blood pressure and temperature.
- Documented patient care services by charting in designated areas.
- Reported changes in patient conditions to registered nurse or physician.
- Answered patient call lights promptly and responded to requests appropriately.
- Observed patients for any physical or emotional changes, reported findings to medical staff immediately.
- Collaborated with interdisciplinary team members to ensure quality patient care was delivered at all times.
- Assisted with range of motion exercises and other rehabilitative activities per physician orders.
- Maintained a clean, safe environment for the patient by adhering to infection control policies and procedures.
- Utilized appropriate safety measures when handling hazardous materials or waste products.
- Monitored food intake and output as directed by nursing staff.
- Demonstrated excellent customer service skills when interacting with patients, families and guests.
- Participated in educational programs designed to improve knowledge of health care practices.
- Provided emotional support to family members during difficult times.
- Educated patients on self-care techniques that would help them maintain their independence.
- Assisted in preparing meals according to prescribed diets while monitoring food consumption levels.
- Ensured compliance with HIPAA regulations regarding confidentiality of information.
- Administered medications under supervision of a licensed nurse.
- Transported residents within the facility as needed.
- Recognized signs, symptoms of abuse, neglect and reported them per policy.
- Facilitated communication between patients, family members, and healthcare professionals.
- Facilitated activities of daily living, personal hygiene management, feeding and ambulation.
- Answered signal lights, bells or intercom systems to determine resident needs.
- Observed and reported unusual symptoms and changes to charge nurse.
- Conducted routine checks on patient vitals, blood pressure, blood sugar and heart rate.
- Turned and repositioned residents using proper body mechanics to prevent pressure ulcers.
- Assisted patients with shaving, bathing and oral hygiene to promote healthy habits and overall wellness.
- Assisted residents with bathing and dressing to promote personal hygiene.
- Used mobility devices to transport patients.
- Helped residents walk with or without self-help devices.
- Distributed drinking water and nourishment to residents.
- Maintained accurate, timely flow of information by completing thorough patient records and updating healthcare team on patient status.
- Assisted residents in preparing for activities and social programs.
- Exhibited compassionate care and communication regarding issues surrounding death and dying.
- Managed and maintained patient rooms, shared-living areas and nursing stations.
- Fostered relationships with patients, caregivers and healthcare teams to achieve individual care plan targets.
- Rendered hands-on nursing care under direct RN supervision, adhering to medical center policies and procedures.
- Looked for physical, emotional, and symptomatic changes in patient condition and obtained necessary care for medical concerns.
- Supported non-ambulatory residents in range of motion exercises.
- Collected specimens, monitored vitals and maximized patient comfort to maintain optimal environment.
- Documented activities and recorded information in EMR system.
- Examined and treated patient lacerations, contusions, and physical symptoms and referred patients to other medical professionals.
- Assisted patients with daily living activities, including bathing, dressing, and grooming.
- Conducted patient education on health maintenance and disease prevention.
- Communicated with patients to determine feelings, need for assistance or social and emotional support.
- Documented information in patient charts and communicated status updates to interdisciplinary care team.
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
- Answered patient call signals and signal lights to determine patients' needs.
- Provided physical support to assist patients with bathing, dressing and toileting.
- Turned and repositioned bedridden patients to prevent bedsores.
- Measured and recorded food and liquid intake and output, reporting changes to medical or nursing staff.
- Assisted nurses with wound care for pressure ulcers, bed sores and surgical site wounds.
- Kept medical supply room and patient rooms stocked with necessary supplies, equipment and instruments.
- Planned and served meals and snacks to patients according to prescribed diets.
- Assisted with lifting patients to move on or off beds, examination tables and surgical tables.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Supplied, collected and emptied patient bedpans on frequent basis.
- Collected specimens from patients for laboratory testing purposes.
- Administered medications and educated patients and families on correct at-home administration.
- Transported specimens, laboratory items or pharmacy items, verifying proper documentation and delivery to authorized personnel.
- Reminded patients to take prescribed medications or nutritional supplements.
- Shaved and draped patients to prepare for surgery, treatment or examination.
- Exercised comatose and paralyzed patients to reduce delirium and improve physical function.
Front Desk /Medical Billing Intern
Dr. Aracelia Bernier and Dr. Maria Paris
FL
06.2003 - 08.2003
- Completed externship experience, which applied learned skills to a real work medical environment.
- Greeted and escorted patients to exam rooms, scheduled patients for appointments, placed reminder calls to patients regarding appointments, answered patient and family inquiries, performed urinalysis and blood testing, and inventoried exam room supplies and stocked.
- Assisted in the preparation of patient bills by verifying insurance coverage and calculating charges.
- Organized and maintained patient accounts, including billing records and payment histories.
- Processed incoming payments accurately and promptly.
- Resolved discrepancies between provider contracts and actual payments received.
- Created invoices for medical services rendered to patients.
- Entered data into electronic health record systems for accurate billing purposes.
- Generated reports on account receivables, collections, adjustments, denials.
- Assisted with filing claims electronically and via mail to insurance companies.
- Reviewed claim rejections from payers to ensure accuracy of information provided.
- Provided customer service support to patients regarding their billing inquiries.
- Addressed coding issues that arose during the course of each claim submission process.
- Followed up on denied or unpaid claims to ensure timely resolution of payment issues.
- Maintained knowledge of current CPT and HCPCS codes used for reimbursement purposes.
- Utilized various software programs such as Microsoft Office Suite.
- Performed research activities related to reimbursement policies and procedures.
- Scanned documents into electronic document management system for archiving purposes.
- Collaborated with healthcare providers to resolve patient billing disputes quickly.
- Attended training sessions related to ICD-10 coding guidelines and updates.
- Answered phone calls from patients regarding billing questions or concerns.
- Participated in departmental meetings designed to improve operational efficiency.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Input details into accounts and tracked payments.
- Handled billing, waivers and claims for private and commercial clients.
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Organized information for past-due accounts and transferred to collection agency.
- Maintained billing software by updating rate change, cash spreadsheets and current collection reports.
- Answered customer questions to maintain high satisfaction levels.
- Submitted claims to insurance companies.
- Managed all payments processing, invoicing and collections tasks.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Collected, posted and managed patient account payments.
- Processed invoice payments and recorded information in account database.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Performed insurance verification, pre-certification and pre-authorization.
- Checked claims coding for accuracy with ICD-10 standards.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Input statement information, reconciled accounts and resolved discrepancies.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Generated and distributed month-end statements for customers and resolved related concerns.
- Executed account updates and noted account information in company data systems.
- Maintained accounting ledgers by verifying and posting account transactions.
- Developed strong professional rapport with vendors and clients.
- Gathered information to produce accounts payable reports for review.
- Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
Education
Liberal Arts Associates Degree -
Manchester Community College NH
05.2025
Phlebotomy Certificate
01.2011
HOPE NURSING HOME CARE CNA
10.2007
High School Diploma
06.2004
CNA
FLCNA
RICHUC – Certified Health Unit Coordinator
Skills
- Medical Billing and Coding
- Professional & Institutional Billing
- Pulmonary
- Anesthesia
- Cardiology
- Hospital
- Gastroenterology
- Pain Management
- Radiology
- Sleep Study
- DME
- Behavioral Health and Substance Abuse
- Women & Children
- Medicare
- Medicaid
- Commercial Insurance
- ICD 9 & 10
- Power BI
- 3M Encoder
- SharePoint
- Customer Service
- Analyst
- Strong peer leadership
- Organizational skills
- EPIC
- Negotiation
- Insurance Verification
- VM Virtual Manual Software
- Intuit QuickBooks
- Active Staffer
- EClinical
- Brightree
- AdvanceMD
- Remote deposit capture software
- Sage 50 Accounting
- Check processing software
- Check imaging software
- Athenahealth
- EZClaim
- Optum Coding
- Medical Coding
- Visio
- Excel
- PowerBI
- Tableu
- Credit and collections
- Investigative research
- Billing dispute resolution
- Payment management
- Policy Development
- Adjustment posting
- Bill processing
- Audit Procedures
- Statement issuing
- Finance
- Collections
- Bookkeeping
- Generally Accepted Accounting Principles
- Financial Management
- Fiscal reporting
- Department Oversight
- Contract reviewing
- Accounts Receivable
- Cross-Functional Team Collaboration
- Dispute Resolution
- Claims Processing
- Accounts receivable expertise
- Payment posting
- General Ledger
- Microsoft Excel
- Invoice Processing
- Statement preparation
- Relationship Building
- Account Reconciliation
- Coding proficiency
- Credit management
- Research and due diligence
- Invoice Preparation
- Process Improvements
- Invoicing proficiency
- Financial Reporting
- Collections experience
- Analytical Problem Solving
- Continuous Process Improvement
- Electronic Health Records Management
- Chart Auditing
- Multitasking and Organization
- Medical Transcription
- Billing and Collection Procedures
- Clerical Support
- Commercial and Private Insurance
- Records Management
- Teamwork and Collaboration
- Claims review
- Insurance Billing
- Claim review
- Electronic Health Record Software
- Medics
- Database systems
- Medical Billing
- Payer Contracts
- Patient Collections
- Operations Support
- Patient Billing
- Medicaid and Medicare Knowledge
- ICD-9
- Data Analysis
- Billing codes
- Insurance collections
- Insurance Claims
- CMS-1500 Billing Forms
- Work Prioritization
- ICD-10 Coding
- CPT code modifiers
- Collections Management
- Records Maintenance
- Electronic Claims
- Invoice Coding
- Data Entry
- HIPAA Compliance
- Submission of medical claims
- ICD-10
- Reimbursements
- Insurance claims processing
- Regulatory Compliance
- Medical coding understanding
- Worker's Compensation Knowledge
- Account follow-up
- Medical record security
- Account Management
- Data security procedures
- Information inputting
- Medical Terminology
- Critical Thinking
- Identity Verification
- Document Verification
- Background Checks
- Insurance terminology
- Eligibility Determination
- Documentation and Correspondence
- Medicaid knowledge
- Attention to Detail
- Insurance plan verification
- Customer Relationship Management
- Communication and Interpersonal Skills
- Analytical Thinking
- Data Security and Confidentiality
- Electronic Medical Records
- Insurance Coverage Verification
- Secure data practices
- Database Management
- Patient Rapport
- Patient Communication
- Fraud Detection
- Meditech
- Insurance knowledge
- Data Verification
- Referral Coordination
- Workflow Development
- Data Integrity
- Account Maintenance
- Data review
- Customer Database Systems
- Process evaluation
- Accuracy and Precision
- Financial Counseling
- Centricity
- Policy Interpretation
- Radiology Knowledge
- Allscripts
- Work Monitoring
- Document Management
- Organizational abilities
- Medical billing software
- Medical software applications
- Medical terminology expertise
- Revenue Cycle Management
- Ethical standards
- Documentation oversight
- Qualified pain management coder
- Patient data identification
- Healthcare claim coding
- Coding Error Resolution
- Clinical Documentation
- Performance Improvement
- Training and mentoring
- Workflow Management
- Regulatory guidelines
- Staff Training and Development
- Effective communication abilities
- Program Improvements
- Report Preparation
- Project Management
- Collections understanding
- Procedure optimization
- HIPAA knowledge
- Audit Support
- Staff Training
- Project Leadership
- Team direction
- Operations Monitoring
- Workflow Planning
- Personnel Oversight
- Team leadership and supervision
- HIPAA Compliance Certification
Careerchronology
- Family Sabbatical, 09/2017, Present, Put my Career on hold for my family and to care for my Elderly grandparents full-time. During this time, even if I was not employed earning a paycheck, I continued using my professional skills as a CNA/MA, assisting them in all their daily needs beyond any employment requirements. I also intermittently took courses online and will graduate with my Associate in May 2025. I am currently in my 2nd to last semester. I attempted to also work part-time during this time, but the places I worked in were not the right fit for me.
- Account Receivables Specialist (Contract), Salem, NH, 05/2019, 09/2019, Designed and implemented a daily revenue financial tracking system, reporting directly to the CEO and CFO, which optimized reimbursement processes. Established comprehensive coding and billing guidelines for the billing providers and Accounts Receivable Department, enhancing accuracy and compliance. Authored detailed policy, procedure, and training manuals to streamline departmental operations. Coordinated with front office staff to ensure accurate information for claims processing, reducing errors and delays. Managed and maintained all files, including insurance, diagnosis, procedures, and fees, ensuring meticulous record-keeping. Conducted charge entry, claim edits, EOB reviews, and unpaid claim follow-ups, significantly improving billing and coding efficiency. Processed and verified bi-monthly patient statements across multiple facilities, ensuring accuracy and timeliness. Investigated, audited, and resolved payment discrepancies, enhancing the integrity of the accounts receivable process. Audited and created reports using BI tools to spot trends, improve work processes, and maximize reimbursements.
- Claims Administrator (Contract), Wilmington, MA, 11/2018, 01/2019, Classified diagnoses and services for member treatment, enhancing case management and analytics accuracy. Assessed service relevance to members' accidents or injuries, ensuring proper case handling. Recorded, tracked, and followed up on all correspondences, maintaining thorough documentation. Identified and swiftly resolved claim issues, improving overall process efficiency. Coordinated benefits transitions for claims outside CareGuard coverage, ensuring seamless service continuity. Managed bill payments, performing detailed claim reviews and analyses to ensure accurate fund allocation. Audited incoming claims and bill review processes, resolving technical issues with IT and Management for optimal operations. Collaborated with vendors to correct billing errors, acting as a key resource for Customer Service reps and claims associates needing assistance.
- Accounts Receivable Supervisor, Salem, NH, 10/2015, 09/2017, Supervised accounts receivable operations for over 17 clients across multiple locations, ensuring accuracy and timeliness in medical billing. Led a team of 6, providing daily direction, monitoring A/R, and managing work queues to meet performance targets. Streamlined time and attendance tracking for the team, ensuring compliance and efficiency. Interviewed, hired, and onboarded new team members, enhancing team capability and cohesion. Resolved escalated calls and complex billing issues, maintaining high levels of client satisfaction. Fostered strong communication channels with internal and external stakeholders through high-volume email and phone interactions. Evaluated and improved processes and procedures, implementing suggestions to boost client satisfaction and operational efficiency. Trained and mentored team members, enhancing skills and fostering professional development. Conducted performance reviews and managed disciplinary actions, ensuring company policy adherence and high morale. Managed billing transactions for multiple third-party insurances, ensuring compliance with payer requirements and successfully resolving audit and denied claims. Audited and created reports using BI tools to spot trends, improve work processes, and maximize reimbursements. Utilized proficiently EPIC, VM, Salesforce, PowerBI, Tableau, EMR, 3MEncoder, Excel, and any system required by our client. (Physicians, Office, Facility, Diagnostic) Utilized work ques to generate our work and
- Billing Manager, Chipley, FL, 07/2014, 10/2015, Led and mentored a team of 2-3 support billers, enhancing productivity and efficiency. Streamlined billing transactions across multiple third-party insurance providers, ensuring timely processing. Conducted comprehensive AR aging reviews to expedite billing claims within payer deadlines, improving cash flow. Spearheaded insurance and patient collections, reducing aged accounts and optimizing revenue recovery. Successfully handled claim resubmissions and appeals, significantly increasing the rate of overturned denials. Resolved claim denials through effective collaboration with patients and third-party billers, achieving a high-resolution rate. Audited and submitted medical documents for authorization, ensuring compliance and timely billing submissions. Researched and applied payer requirements, including HCPCS and ICD-10 codes, to ensure accurate billing. Verified insurance before equipment delivery, reducing non-payment risks. Maintained strict HIPAA compliance in all billing activities, safeguarding patient information. Kept abreast of payer regulations and policies, ensuring compliance and minimizing claim rejections. Implemented AR adjustments and reapplications of payments/credits, maintaining accurate financial records. Assisted in transitioning to a new billing system, facilitating a smooth and efficient changeover.
- Department Secretary / Executive Assistant, FL, 09/2009, 07/2014, Achieved a 94% recovery rate for old claims and a 98% collection rate for billed charges by spearheading targeted revenue recovery initiatives. Resolved complex revenue recovery claims from Medicare and commercial insurance, optimizing the reimbursement process. Enhanced billing efficiency by implementing four innovative management techniques and continuous process improvements. Revitalized office procedures within three months, ensuring audit compliance and significantly boosting productivity. Led the scheduling, coding, and billing of all surgeries, successfully resolving unpaid charges and insurance denials. Directed the creation and maintenance of personnel schedules, ensuring accurate tracking of hours and enhancing workforce management. Supervised a team of 34, effectively controlling office expenditures and maintaining an optimal supply inventory. Prepared and edited high-impact correspondence, reports, and presentations, enhancing communication and decision-making processes. Facilitated staff recruitment, appraisals, and performance management, fostering a high-performance culture. Contract Negotiations Organized key community events such as Healthy Start, Kid Fest, and The Walk to Remember, strengthening community relations.
- CNA/Health Unit Coordinator, Panama City, FL, 09/2009, 07/2014, Diagnosed substantial changes in accounts receivable aging accounts, enhancing insurance carrier accountability. Conducted research and reconciliation transactions, improving financial accuracy. Coordinated insurance verifications and pre-certifications, streamlining patient processing. Directed billing operations, providing high-level executive and administrative support for daily business operations. Executed clerical and administrative tasks, maintaining efficient unit functioning. Received and recorded patient payments, ensuring accurate database management and issuing receipts.
- Medical Assistant, Panama City, FL, 02/2009, 08/2009, Provided comprehensive support to doctors by consulting with patients, taking vital signs, and assisting with office procedures and exams. Efficiently scheduled appointments, handled data entry, and managed patient billing, including taking payments and verifying insurance information. Prepared and organized patient charts and samples, ensuring accurate record-keeping and smooth workflow. Administered treatments and injections and performed tests. (Vaccines, GI Cocktails, EKG ext.) Checked and evaluated patients to the weight loss program and other patient care initiatives. Managed high-volume inbound calls, ensuring timely and accurate responses to patient and doctor messages. Coordinated patient check-out processes, scheduling follow-up appointments, procedures, and testing with specialists. Phlebotomy Proper urine collection techniques along with urinalysis Patient positioning and draping techniques Examination room sterilization and preparation skills Performed the preliminary intake check and verified medications, patient history, and any test requested by a physician and completed any consent forms needed.
- Front Desk / CNA, Kingston, RI, 05/2008, 02/2009
- CNA, Cranston, RI, 07/2007, 05/2008
- Front Desk /Medical Billing Intern, FL, 06/2003, 08/2003, Completed externship experience, which applied learned skills to a real work medical environment. Greeted and escorted patients to exam rooms scheduled patients for appointments placed reminder calls to patients regarding appointments answered patient and family inquiries performed urinalysis and blood testing and inventoried exam room supplies and stocked Accurate monitoring of blood pressure, temperature, and heart rate Patient assessment and education capabilities gained through education and clinical experience
Languages
- English
- Spanish
Careerfocus
Dynamic and motivated medical billing and coding professional with over 17 years of extensive experience in health operations, revenue cycle management, and clinical. Expertise in ICD-9 and ICD-10, CPT, and HCPCS coding, with a proven ability to analyze and validate patient information, diagnoses, and billing data. Highly skilled in medical billing and coding, Medicare, Medicaid, and Commercial Insurance, and handling medical insurance appeals, authorizations, denials, and rejections. I seek a position to leverage my skills and experience in a dynamic organization.
Professional Highlights
- Accuracy Champion: Maintained a reporting system with an impressive accuracy rate for tracking and auditing.
- Revenue Booster: Drove a 68% increase in revenue growth by skillfully negotiating higher rates on insurance contracts.
- Bilingual and Research: Fluent in English and Spanish with over a decade of medical expertise. Proficient in computer and Microsoft Office applications and an expert in internet research, committed to delivering top-tier customer service.
- Tech-Savvy Specialist: Extensive experience with McKesson, Report Express, Active Staffer, EMR, PMM, Brightree, QuickBooks, VM, EPIC, AdvanceMD, Salesforce, eClinical, Emdeon. Adept at troubleshooting and resolving software issues.
- Insurance and Coding Expert: In-depth knowledge of Medical Billing & Coding, Medicare, Medicaid, Commercial Insurance, ICD 9 & 10, CPT, HCPCS, Medical Records, and handling Medical Insurance Appeals, Utilization, Denials, and Rejections.
Languages
English
Full Professional
Spanish
Native/ Bilingual
Certification
CNA - CNA184409 License Expiration Date 5/31/2015 License Original Issue Date 03/25/2009 for FL – My Original license is from RI - NA37480
Issue Date:
11/27/2007
Phlebotomy Certificate - 2011
CHUC– Certified Health Unit Coordinator – Certification # 86765 Expiration Date: 05/31/2017
HOPE NURSING HOME CARE CNA- Graduated:10/4/2007
Timeline
Account Receivables Specialist
Granite Recovery Centers
05.2019 - 09.2019
Claims Administrator
Ametros
11.2018 - 01.2019
Accounts Receivable Supervisor
Advantedge Healthcare Solutions
10.2015 - 09.2017
Billing Manager
Horizon Healthcare Services
07.2014 - 10.2015
Department Secretary / Executive Assistant
Bay Medical Sacred Heart Health System
09.2009 - 07.2014
CNA/Health Unit Coordinator
Bay Medical Sacred Heart Health System
09.2009 - 07.2014
Medical Assistant
Emerald Medical
02.2009 - 08.2009
Front Desk / CNA
South County Nursing Home and Rehabilitation Center
05.2008 - 02.2009
CNA
Hope Nursing Home Healthcare
07.2007 - 05.2008
Front Desk /Medical Billing Intern
Dr. Aracelia Bernier and Dr. Maria Paris
06.2003 - 08.2003
Liberal Arts Associates Degree -
Manchester Community College NH
Phlebotomy Certificate
HOPE NURSING HOME CARE CNA
High School Diploma
CNA
CNA
CHUC – Certified Health Unit Coordinator
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