Anna Borst
Bakersfield,CA
Summary
Insurance Claims Specialist with proven success in claims processing and customer service at Embark Behavioral Health. Achieved significant reductions in processing time while enhancing client satisfaction through effective communication and negotiation. Expertise in claims analysis and relationship building, with strong attention to detail and problem-solving skills.
Overview
10
10
years of professional experience
Work History
Insurance Claims Specialist
Embark Behavioral Health
04.2024 - Current
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Enhanced customer satisfaction by efficiently managing insurance claims processes and providing timely resolutions.
- Maintained compliance with industry regulations and standards by staying current on relevant laws, policies, and best practices for handling insurance claims.
- Evaluated and settled complex insurance claims in strict timeframes.
- Maximized client retention by addressing concerns promptly and professionally, consistently demonstrating empathy and understanding during difficult situations.
- Expedited claim resolutions through effective negotiation with clients, adjusters, and other stakeholders involved in the process.
- Upheld a high level of accuracy by consistently double-checking figures, data entries, calculations, before finalizing any settlement documents or payments.
- Increased productivity by streamlining claim processing procedures and implementing time-saving technologies.
- Achieved significant reductions in processing time, implementing streamlined procedures for claim documentation and verification.
- Posted payments to accounts and maintained records.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Calculated adjustments, premiums and refunds.
- Collected premiums and issued accurate receipts.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Medical Office Assistant
Accelerated Urgent Care
01.2022 - 04.2024
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Updated patient information and insurance details for accurate electronic medical records.
- Ensured compliance with HIPAA regulations through meticulous handling of sensitive patient information.
- Fostered strong relationships with patients and their families by providing compassionate support and answering questions about medical care.
- Assisted physicians with medical procedures, ensuring high-quality patient care and safety.
- Prepared examination rooms for patients, maintaining a clean and organized environment for optimal care delivery.
- Helped with phlebotomy work by drawing blood for tests and giving common injections for immunization and treatment.
- Helped nurses and doctors with patient procedures such as sterilized/non-sterilized suture set ups, injections, Electrocardiograms/nebulizer treatments, Ear Lavage, crutches, covid, Flu, papsmear examinations etc.
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Obtained client medical history, medication information, symptoms, and allergies.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Collected and documented patient medical information such as blood pressure and weight.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
- Measured patient spirometry.
- Measured patient pulse oximetry.
Medical Scribe
Premier Medical Group
02.2018 - 01.2022
- Documented complete information about examinations, treatment plans, lab results, and other details directly into charts.
- Charted patient encounters by recording information such as diagnosis, treatments, and prescriptions.
- Increased overall productivity of clinical staff by providing real-time scribing support during high-volume shifts, enabling better focus on direct patient care.
- Ensured compliance with HIPAA regulations by consistently maintaining patient confidentiality and protecting sensitive information during documentation processes.
- Demonstrated exceptional multitasking abilities by effectively balancing competing priorities in a fast-paced clinical environment while maintaining a high level of accuracy in all documentation efforts.
- Reduced physician workload by taking on additional administrative tasks as needed, such as retrieving laboratory results and organizing patient files.
- Enhanced patient care by diligently transcribing physician-patient interactions during medical examinations.
- Facilitated effective communication between healthcare providers by accurately recording diagnostic test results and treatment plans.
- Collected required documents to prepare discharge and release summaries of patients.
- Streamlined workflow for attending physicians by organizing notes according to specified templates, enabling quicker review of pertinent information before finalizing documentation.
- Processed patient referrals and authorizations to enable smooth patient consultations.
- Improved patient education by documenting discharge instructions and follow-up care recommendations.
- Verified medical terminology and codes to deliver accurate and up-to-date information.
Medical Biller and Coder
Macman Management Healthcare Services
10.2015 - 02.2018
- Correctly coded and billed medical claims for the providers office.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Contributed to team efficiency by maintaining organized records of patient accounts, billing statements, and payment statuses.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Provided support to administrative staff by ensuring proper handling of sensitive patient data according to HIPAA regulations.
- Streamlined billing processes by implementing efficient coding practices, resulting in reduced errors and improved revenue generation.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Collaborated with other billing professionals during team meetings to exchange best practices and strategies for overcoming common challenges in the industry.
- Enhanced compliance with industry regulations by staying up-to-date on changes to medical billing and coding guidelines.
- Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
- Developed effective communication channels with insurance companies to facilitate prompt resolution of claim inquiries and disputes.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Transcribed and entered patient medical information into electronic medical records systems.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Education
San Fernando High
San Fernando, CASkills
- Claims investigation
- Claims analysis
- Policy interpretation
- Teamwork and collaboration
- Attention to detail
- Customer service
- Claims processing
- Data entry
- Organizing and prioritizing work
- Insurance coverage verification
- Claim amount calculations
- Claims adjustment
- Documentation skills
- Recordkeeping organization
- Billing software
- Decision-making
- Eligibility determination
- Coverage determination
- Denied claims identification
- Insurance claim forms review
- Medical terminology
- New policies processing
- Microsoft office
- Patient contact
- Great mathematical skills
- Prior authorization processing
- Records management
- Critical thinking
- Information verification
- Account management
- Teamwork
- Problem-solving
- Time management
- Problem-solving abilities
- Multitasking Abilities
- Reliability
- Excellent communication
- Organizational skills
- Adaptability and flexibility
- Relationship building
- Computer proficiency
- Self motivation
- Interpersonal skills
- Analytical thinking
- Goal setting
- Professionalism
Languages
Spanish
Limited Working
Timeline
Insurance Claims Specialist
Embark Behavioral Health
04.2024 - Current
Medical Office Assistant
Accelerated Urgent Care
01.2022 - 04.2024
Medical Scribe
Premier Medical Group
02.2018 - 01.2022
Medical Biller and Coder
Macman Management Healthcare Services
10.2015 - 02.2018
San Fernando High
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