APRIL GULLSTRAND
Kent,WA
Summary
Seasoned Medical Billing specialist with over 15 years experience in healthcare revenue cycle management. Proven track record of optimizing billing processes, Increasing collection ratesand ensuring compliance with healthcare regulations. Adept at leading teams implementing new billing systems, and resolving complex reimbursement issues
Overview
21
21
years of professional experience
Work History
Customer Service Representative
Express Staffing Professionals
03.2025 - Current
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Collaborated with team members to develop best practices for consistent customer service delivery.
Independent Contractor
Rover.com
05.2022 - Current
- Contact potential new clients and schedule Meet & Greets with the pet owner so that I can find out the pets temperament, and if there are any medical conditions that I need to be aware of while the pet is in my care
- Find out how the pet will respond to my own pet and my son while in my care
- Manage a household, and services calendar so that I don’t over book client on top of client
- Set industry rates for my services
- Make sure to have pet necessities, such as dog & cat food, chew toys, cat & dog treats, beds, food ect
Private Nanny
Katie Schaumleffel
02.2023 - 03.2023
- Developed strong relationships with parents, maintaining open communication about each child''s progress and
- Played games, worked on puzzles, and read books to young children.
- Prepared healthy, age-appropriate snacks and meals.
- Built positive and nurturing environments to support child social and emotional growth.
- Organized and cleaned home after activities by picking up toys and straightening up play room.
- Established clear expectations for behavior, setting boundaries to create a respectful atmosphere within the home.
- Established lasting, professional connections with families and children by encouraging open communication and delivering positive feedback.
- Led indoor and outdoor activities to entertain and occupy children.
- Enhanced children''s emotional well-being by providing consistent and nurturing care.
- Communicated with children at age-appropriate levels to encourage understanding and foster relationships.
- Implemented daily routines for optimal child development and created a structured environment.
- Conducted regular safety checks and maintained a clean, hazard-free environment for the children at all times.
- Organized engaging activities that incorporated age-appropriate educational components for cognitive development.
- Adapted caregiving approaches based on individual needs of each child to provide personalized support.
- Taught children everyday skills and language.
- Facilitated relationships with children and parents by developing caring and structured home environments.
Social Worker/Assisted Living
Demorest House
02.2009 - 12.2019
- Advocated for residents’ rights and needs, connecting them with necessary community resources
- Coordinated patient care and treatments with healthcare team
- Review chart notes and treatments with healthcare team to maintain compliance and obtain any prior authorizations needed for treatments, medications and durable medical equipment
- Act as a liaison between the patient, provider, pharmacy and insurance company to resolve any billing discrepancies
Medical Billing
Artek
05.2019 - 11.2019
- Obtain, verify and update insurance on patient accounts
- Create, correct and submit and/resubmit insurance claims for reimbursement
- Follow up with insurance companies on the status of submitted claims
- Track and locate payments received from the insurance companies, and based on the Explanation of Benefits make the appropriate adjustments
- Compare the Explanation of Benefits for possible short payment, denials and contracting issues
- If there was a discrepancy between the EOB and the fee schedule loaded on EPIC contract the provider representative to see if the discrepancy lies in the contract loaded into our system or if it was a processing error
- If it was contracting issue create a spreadsheet to submit to the provider representative for expedited reprocessing of short paid or denied claims
- Coordinate with the authorization/Referral department to cover outstanding open claims for reimbursement
- If there is an issue with obtaining the prior authorization, place services on to avoid adjustments
Office Manager
Allcare Dental
05.2010 - 11.2012
- Manage , and oversee operations for an expanding dental team of 15 , that included 4 separate offices located in 2 states
- Hire and train new staff members
- Post insurance payments , adjustments , account audits , and account reconciliation
- Abstract patient chart notes/records to bill for services
- Coordinate care between facilities , caregivers , transportation and insurance companies
- Submit chart notes , patient records , and any other needed documentation to insurance companies to obtain prior authorization for services
- Resolution of insurance denials for prior authorization of services and payment for services rendered
- Provider , insurance , and union credentialing
- Patient scheduling and verification of insurance benefits
Sr. Billing Representative/ Suspended Billing
Apria Healthcare
08.2004 - 03.2008
- Train new highers on Apria Billing Software (ACIS ), company billing policies and procedures
- Account billing, denial follow up/resolution, account compliance evaluation for a requisition company Apria purchased but allowed them to operate under their previous name
- I was the only billing representative in the billing center to work on the DBA company of Preferred Medical accounts and with doing so I was billing over insurance that was contracted with Apria Healthcare/ Preferred Medical
- With being in this unique position I ended up with access, contracts, and working knowledge of a vast number of both government and commercial insurance companies
- Due to this knowledge I was able to not only bill my DBA accounts, but also any open caseloads, account reconciliations/audits on accounts needing review for various reasons
- Follow up with insurance, companies, provider physicians, and patients with any questions or concerns
- Large insurance audits to identify fee discrepancies within ACIS and contract fee schedules
- Track mis-posted insurance and patient co-pays
- Submit requests to the cash posting department to rectify any mis-posted funds, and adjust accordingly
- Submit patient & insurance companies fund requests to the cash posting department Process patient insurance change requests, schedule equipment pick-ups, and equipment deliveries
- In addition to working any open case loads in the billing center
- I also oversaw weekly reports tracking every billing representatives open accounts receivables, aging and denials
- Submitted these reports to each billing representative and management
- Create large scale cash posted/ monthly goals to track progress
- When moving into the Sr
- Billing Representative role for Preferred Medical caseload I started my que with over 600 individual account denials, within 3 months I had resolved all but 4 denied claims
- Suspended Billing: obtain patient medical records, prescriptions, Letter of Medical Necessity from the prescribing physician and/or Apria customer service for equipment readouts for compliance
- Determine with the physician and patient if the DME is still needed submit required proof of medical necessity records with a prior authorization request for rental or purchase of DME and supplies
- Work on denial of services appeals with billing representatives by obtaining any additional needed documentation for the biller
- Create spreadsheets for Group Health/ Kaiser of expired / expiring authentications for recertification
- With in 2 months of taking this position I was also working multiple caseloads in addition to creating cash posting/ cash goal boards for the billing representatives
Education
Medical administration/Billing Diploma - undefined
Bryman Technical College
Renton, WA02.2003
High School diploma - undefined
Kentwood High School
Covington, WA06.2001
Skills
- Organizational Skills
- Communication Skills
- Time Management
- Attention to Detail
- Problem-Solving
- Customer Service
- Data Entry
- Project Management
- Multitasking
- Proficiency in Microsoft Office
- ICD-10
- HCPCS
- CPT
- Insurance Repots
- Data collection & Management
- Coding patient information
- Submitting insurance claims
Timeline
Customer Service Representative
Express Staffing Professionals
03.2025 - Current
Private Nanny
Katie Schaumleffel
02.2023 - 03.2023
Independent Contractor
Rover.com
05.2022 - Current
Medical Billing
Artek
05.2019 - 11.2019
Office Manager
Allcare Dental
05.2010 - 11.2012
Social Worker/Assisted Living
Demorest House
02.2009 - 12.2019
Sr. Billing Representative/ Suspended Billing
Apria Healthcare
08.2004 - 03.2008
Medical administration/Billing Diploma - undefined
Bryman Technical College
High School diploma - undefined
Kentwood High School
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