April Middleton
Summary
Dynamic Patient Financial Advocate with extensive medical billing expertise at South Jersey Treatment Management Group. Proven track record in enhancing patient experiences through effective financial counseling and problem-solving. Skilled in claims processing and insurance verification, successfully reducing patient anxiety and increasing revenue collections while fostering trust and collaboration within healthcare teams.
Professional advocate with a strong background in healthcare finance, delivering results-driven solutions. Skilled in navigating insurance claims, patient billing, and financial counseling. Valued team player known for adaptability, effective communication, and problem-solving. Proven ability to support patients through complex financial processes while ensuring compliance and accuracy.
Overview
18
18
years of professional experience
Work History
Patient Financial Advocate
South Jersey Treatment Management Group
08.2024 - 05.2025
- Assisted patients in understanding financial obligations and payment options.
- Collaborated with healthcare providers to resolve billing inquiries and discrepancies.
- Educated patients about insurance coverage and financial assistance programs.
- Maintained accurate records of patient interactions and financial discussions.
- Communicated effectively with patients to address concerns regarding financial processes.
- Reduced patient anxiety surrounding medical expenses by offering compassionate support and financial guidance during difficult times.
- Enhanced patient trust by maintaining confidentiality and ensuring compliance with HIPAA regulations during financial discussions.
- Developed tailored payment plans for individuals facing financial hardships, promoting access to necessary medical care regardless of income level.
- Increased revenue collections by conducting thorough reviews of patient accounts and identifying potential sources of reimbursement.
- Improved patient financial experiences by providing comprehensive guidance on payment options and assistance programs.
- Verified patient insurance eligibility and entered patient information into the system.
- Provided excellent customer service to patients and medical staff.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Followed document protocols to safeguard the confidentiality of patient records.
- Achieved timely resolution of outstanding accounts through diligent follow-ups and negotiations with patients or their representatives.
- Supported the implementation of patient-friendly billing practices to enhance satisfaction.
- Entered payments into QuickBooks.
- Electronic daily deposits into various location bank accounts.
Sr. Account Worker Comp. Specialist
Clearway Pain Solutions Institute
03.2023 - 10.2023
- Oversee PA/NJ workers' comp accounts receivable.
- Provide attorneys with requested information as needed for litigation.
- Follow up on delinquent accounts in litigation.
- Notify physicians when they are scheduled for court hearings, or depositions.
- Hold weekly meetings with the overseas billing team.
- Negotiate and approve settlement agreements with attorneys regarding account balances.
- Notate detailed information on the patient account as the account goes through the court proceedings.
- Bill the responsible party upon settlement of WC case.
Accounts Receivable Coordinator
Robert Half Temp Agency -Oaks Integrated
06.2022 - 10.2022
- Coordinated with internal departments to resolve billing discrepancies and improve cash flow management.
- Responsible for Medicare, Medicaid, EAP, and Aetna accounts receivable.
- Verification of Medicare HMO coverage, correct in the billing system if needed.
- Confirm that the correct Medicaid program is being billed for services.
- Validate hospital or SNF stays don't crossover our billing dates on denied claims.
- Ensure that emergent and program services are billed timely to avoid denial.
- Request and download any missing pre-certifications.
- Sort the daily mail.
Billing Manager
The Mental Mediator
06.2021 - 06.2022
- Managed billing processes to ensure accuracy and timely invoicing for clients.
- Reviewed and reconciled billing discrepancies, enhancing operational efficiency.
- Collaborated with cross-functional teams to streamline billing workflows and improve service delivery.
- Implemented process improvements that reduced billing cycle time and increased customer satisfaction.
- Analyzed customer accounts to identify trends and resolve outstanding payment issues promptly.
- Maintained compliance with industry regulations while overseeing invoicing procedures and audits.
- Reviewed billing problems, researched issues, and resolved concerns.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Worked with customers to develop payment plans and bring accounts current.
- Enhanced client satisfaction levels by ensuring timely delivery of accurate invoices and addressing concerns professionally.
- Developed a strong rapport with key stakeholders by maintaining open lines of communication and promptly addressing any concerns raised.
- Maintained up-to-date knowledge of industry regulations and compliance requirements, ensuring the department remained compliant at all times.
- Enhanced customer service, resolving billing disputes swiftly and maintaining positive relationships with clients.
- Fostered strong relationships with key clients by providing personalized billing support, ensuring their needs were met promptly and efficiently.
- Boosted cash flow with effective billing strategies, closely monitoring aging reports and prioritizing high-value accounts for collection efforts.
- Maintained up-to-date knowledge of industry regulations, ensuring billing department's compliance and protecting company from potential fines.
- Supported financial director with special projects and additional job duties.
Front Desk Coordinator
AtlantiCare Urgent Care
09.2017 - 02.2020
- Managed front desk operations, ensuring a seamless patient check-in and check-out experience.
- Developed positive relationships with patients through effective communication and personalized service initiatives.
- Balanced daily cash drawer reconciliations, ensuring accurate financial recordkeeping.
- Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
- Maintained strict confidentiality when handling sensitive client information in accordance with company policies.
- Successfully managed challenging situations involving patient complaints or issues by employing excellent problem-solving skills.
- Updated patient records accurately and efficiently, ensuring data integrity within the system.
- Facilitated effective communication between patients and internal staff by serving as a central point of contact.
- Maintained a clean, organized reception area, creating a welcoming atmosphere for patients and visitors.
- Kept accounts in balance and ran daily reports to verify totals.
- Read and responded to emails, answered telephone calls on multi-line phone system and transferred callers.
- Handled high volumes of incoming calls, directing callers to appropriate departments for prompt assistance.
- Greeted patient at front desk and engaged in pleasant conversations while managing check-in process.
- Contributed positively to the workplace environment through friendly interactions with colleagues while promoting teamwork.
- Ran end-of-day reports and batches and notified staff of necessary corrections and resolutions.
- Developed strong relationships with clientele, fostering loyalty and repeat business.
- Verified patient demographic information and documentation, and scanned it into the chart
- Answered patient telephone calls promptly and appropriately handled needs.
- Maintained clean and organized front desk areas to uphold polished company image.
- Answered multi-line phone system and enthusiastically greeted callers.
- Oversaw fast-paced front desk operations and patient needs at busy facility.
- Collected copay payments, processed transactions, and updated relevant records.
- Put together the daily deposit and dropped it off at the bank.
DME Billing Coordinator
Persante Health Care
07.2015 - 09.2017
- Managed billing processes to ensure timely and accurate invoicing for clients.
- Coordinated resolution of billing discrepancies, enhancing customer satisfaction and retention.
- Led company audit teams.
- Verified refund requests and processed as needed.
- Maintained a 0-30 DSO.
- Researched and resolved all payment posting discrepancies.
- Presales of DME supply reorders.
- Pre-cert monthly rentals.
- Obtain documentation from physicians as needed for pre-certs.
Team Lead
Virtua Summit Surgery Center
09.2013 - 03.2014
- Located and monitored past due accounts using multiple computer programs.
- Contacted insurance companies to follow up on outstanding claims.
- Submitted missing paperwork, physician studies, etc., to insurance as requested.
- Write and send appeal letters when needed.
DME Medical Biller/Warehouse Manager
The NBN Group
05.2007 - 08.2013
- Managed billing processes, ensuring timely submission of claims to insurance companies.
- Reviewed and verified patient accounts for accuracy and compliance with regulations.
- Collaborated with healthcare providers to resolve discrepancies in billing information.
- Trained new staff on medical billing procedures and software systems.
- Monitored payment trends and identified opportunities for revenue cycle improvement.
- Analyzed reports to track key performance indicators related to billing operations.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Liaised between patients, insurance companies, and billing office.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Maintained up-to-date knowledge of billing software and healthcare regulations, contributing to department's compliance and efficiency.
- Responded to customer concerns and questions on daily basis.
- Used data entry skills to accurately document and input statements.
- Monitored outstanding invoices and performed collections duties.
- Oversaw daily warehouse operations, ensuring efficient inventory management and streamlined workflows.
- Developed operational procedures that enhanced productivity and reduced waste across warehouse activities.
- Maintained a safe work environment by enforcing strict adherence to OSHA guidelines and company policies.
- Kept documentation and records accurate and up-to-date with latest data to prevent errors in processing or delivery.
- Fostered a positive workplace culture that motivated employees to perform their best while maintaining high morale.
- Completed timely and accurate daily logs to keep internal reporting accurate and track materials movements.
- Enhanced employee productivity, implementing effective scheduling and task delegation strategies.
- Improved delivery plans with strong scheduling knowledge, organizational skills, and route development expertise.
- Developed a strong team of warehouse employees with comprehensive training programs and performance evaluations.
- Boosted warehouse operations performance by overseeing dispatching and setting optimal employee schedules.
- Fostered a culture of continuous improvement by encouraging feedback and suggestions from all team members.
- Increased customer satisfaction by ensuring orders were accurately and promptly fulfilled, leading to repeat business and positive reviews.
- Organized records of vehicles, schedules, and completed orders.
- Developed and maintained a knowledgeable and productive team of employees.
Education
No Degree - Technical Business Management And Marketing
DeVry University
Cherry Hill, NJCertificate of Technical Studies - Medical Office Administration
Network Learning Institute
Mount Laurel, NJ02-2015
Associate of Science - Sociology
Burlington County College
Pemberton, NJ08-2006
Skills
- Medical billing expertise
- Verbal and written communication
- Claims processing
- Patient registration
- Insurance verification
- Medical terminology
- Healthcare industry
- Financial counseling
- Cross-cultural sensitivity
- Teamwork and collaboration
- Problem-solving
- Project management
- Billing procedures
Timeline
Patient Financial Advocate
South Jersey Treatment Management Group
08.2024 - 05.2025
Sr. Account Worker Comp. Specialist
Clearway Pain Solutions Institute
03.2023 - 10.2023
Accounts Receivable Coordinator
Robert Half Temp Agency -Oaks Integrated
06.2022 - 10.2022
Billing Manager
The Mental Mediator
06.2021 - 06.2022
Front Desk Coordinator
AtlantiCare Urgent Care
09.2017 - 02.2020
DME Billing Coordinator
Persante Health Care
07.2015 - 09.2017
Team Lead
Virtua Summit Surgery Center
09.2013 - 03.2014
DME Medical Biller/Warehouse Manager
The NBN Group
05.2007 - 08.2013
No Degree - Technical Business Management And Marketing
DeVry University
Certificate of Technical Studies - Medical Office Administration
Network Learning Institute
Associate of Science - Sociology
Burlington County College
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