Brian Avery
Dayton,OH
Summary
Competent medical professional with 10 years of experience in handling wide variety of medical coding, billing and purchasing tasks. Sophisticated and hardworking with excellent analytical and multitasking abilities. Proficient understanding of procedure and diagnosis codes(CPT & ICD-10). Proven capability to explain ledger information to patients and insurance companies. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
6
6
years of professional experience
Work History
Medical Billing Specialist
PE GI Solutions
01.2023 - Current
- Communicate with insurance providers to resolve denied claims and resubmit for reprocessing.
- Verifying and managing refunds in Waystar, ensuring proper authorization and documentation is followed.
- Managed over 60 customer calls per day and kept dropped calls under 1%.
- Examine patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Identify and resolved patient billing and payment issues.
- Provide expertise of explanation of benefits (EOBs), electronic payment Remittance (EPR), electronic funds transfer (EFT).
- Enter data (insurance, CPT codes, charges) from company requisitions to Advantx.
Customer Service Representative III
ERBE - USA
06.2021 - 01.2023
- Answered over 60 calls per shift to meet fast-paced call center demands.
- Implemented forward-thinking strategies focused on addressing customer needs concerns.
- Maintained company standard for service and wait times.
- Managed ordering process: from placing orders to reconciling and processing payments.
- Processed daily critical back-order reports and update orders accordingly.
- Managed key projects with business partners in Member Operations, IT, Product, Account Management to improve client experience.
- Prepared cost analysis for project-specific goods and services using vendor network.
- Established customer relationships and follow up with customers, as needed.
Buyer I
Piedmont Healthcare
06.2017 - 06.2021
- Studied past purchases and projects to estimate future requirements and makes cost effective recommendations.
- Communicated professionally and courteously directly with suppliers in relation to order processing as required to resolve issues and receive order acknowledgements.
- Maintained accurate entry, proofing, maintenance and submission of purchase orders based on customer demand, stock replenishment and management direction.
- Coordinated order status report submissions from suppliers. Resolve changes and discrepancies, and update purchase order information accordingly.
- Designed and implemented routine purchase order review, tracking and expediting of orders.
- Managed customer accounts and supplier price list to ensure needs were being met.
Education
Bachelor of Science - Business Administration And Management
Herzing University
Atlanta, GA05.2023
Skills
- Diagnostic Codes
- Accounts Payable and Accounts Receivable
- Coding Appeals
- Medical Terminology
- Proficient knowledge of CPT Codes and ICD-10 codes
- Authorize Payments
- Vendor Negotiations
- Pricing Knowledge
- Account Management
- Critical Thinking
- POS Systems Expertise
Timeline
Medical Billing Specialist
PE GI Solutions
01.2023 - Current
Customer Service Representative III
ERBE - USA
06.2021 - 01.2023
Buyer I
Piedmont Healthcare
06.2017 - 06.2021
Bachelor of Science - Business Administration And Management
Herzing University
Similar Profiles
Christine DalessioChristine Dalessio
Project Manager at PE GI Solutions/SCA HealthProject Manager at PE GI Solutions/SCA Health
LAURA COOKLAURA COOK
Accounts Receivable Denials Specialist at PE GI SolutionsAccounts Receivable Denials Specialist at PE GI Solutions
Miguel "Brooklyn" NievesMiguel "Brooklyn" Nieves
Project Manager at Sun Valley Solar Solutions / PE Solar / SuncertaProject Manager at Sun Valley Solar Solutions / PE Solar / Suncerta