Proven leader in enhancing medical billing efficiency at Heartview Foundation, adept in HIPAA compliance and MMIS expertise. Leveraged analytical thinking and problem-solving abilities to significantly improve revenue generation processes. Demonstrated adaptability by implementing new EMR technologies, ensuring clinical entry ease and accurate claim processing proficiency.
Overview
10
10
years of professional experience
Work History
Medical Billing Specialist
Heartview Foundation - Drug And Alcohol Treatment And Education
08.2021 - Current
Served as subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
Extensive knowledge with MMIS portal.
Contributed to HIPAA compliance efforts by ensuring secure storage, transmission, and handling of sensitive patient information within the EMR system.
Educated colleagues on best practices in medical billing, providing ongoing training sessions as needed.
Developed customized reports for management review, highlighting trends in key performance metrics such as claim denial rates and days outstanding for accounts receivable balances.
Assisted in training new staff members on medical billing procedures and software systems, contributing to a cohesive team environment.
Acted as an Admin on insurance portals to manage profile/facility information and user profiles.
Acted as first point of contact when Director of Revenue is unavailable.
Collaborated with IT department to troubleshoot technical issues, optimizing EMR system performance for medical staff.
Demonstrated adaptability in learning new software systems as needed, ensuring that the organization remained at the forefront of EMR technology advancements.
Acted as EMR and Clearinghouse Admin to manage forms, users, and facility/provider info as needed.Communicated effectively and extensively with other departments to resolve claims issues.
Located errors and promptly refiled rejected claims.
Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
Collected payments and applied to patient accounts.
Communicated with insurance providers to resolve denied claims and resubmitted.
Posted and adjusted payments from insurance companies.
Created user accounts for all portals for new hires.
Assistant Store Manager
Bed Bath and Beyond
05.2017 - 08.2021
Managed cash registers efficiently, ensuring accurate transactions, balancing drawers daily, and minimizing discrepancies.
Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
Enhanced store appearance for increased sales by maintaining cleanliness and implementing strategic merchandise displays.
Rotated merchandise and displays to feature new products and promotions.
Assisted the Store Manager in analyzing sales data to identify trends and make informed decisions for improving overall store performance.
Mentored new employees on company policies, procedures, and best practices to ensure their success within the organization.
Conducted regular performance evaluations of team members while providing constructive feedback resulting in enhanced productivity levels.
Assisted in recruiting, hiring and training of team members.
Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
Provided weekly work schedules to employees to accommodate business demands and vacation requests.
Managed payroll data entry and processing for employees to comply with predetermined company guidelines.
Provided customer service to employees regarding payroll inquiries and issues.
Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.
Observed each employee's individual strengths and initiated mentoring program to improve areas of weakness.
Scheduled employees for shifts, taking into account customer traffic and employee strengths.
Assistant Manager
Rue 21
08.2014 - 05.2017
Supervised day-to-day operations to meet performance, quality and service expectations.
Maintained a clean, safe, and organized store environment to enhance the customer experience.
Developed strong working relationships with staff, fostering a positive work environment.
Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
Completed regular inventory counts to verify stock levels, address discrepancies, and forecast future needs.
Assisted in recruiting, interviewing, hiring, and onboarding of new employees to maintain adequate staffing levels.
Implemented loss prevention strategies, significantly reducing shrinkage.
Monitored sales trends to adjust pricing strategies for optimal profitability.
Education
One Year Completed - Chemistry
North Dakota State University
Fargo, ND
One Year Completed - Chemistry
Austin Community College
Austin, TX
High School Diploma -
Parshall High School
Parshall, ND
05.2011
Skills
HIPAA Compliance
Team Leadership Qualities
Insurance Verification
Medicare and Medicaid process
MMIS Expertise
Claims Processing Proficiency
Adaptability and Flexibility
Problem-solving abilities
Analytical Thinking Capacity
Payment Posting Abilities
Microsoft Excel and Word
Accomplishments
Played an integral part of implementing and modifying a new EMR and Clearinghouse system.
Assisted executive leadership make significant decisions regarding clinical processes and revenue matters.
Created and maintained the entire billing processes and manuals.
Award
In spring of 2024, I was awarded the "Heart of Heartview," an award and appreciation that is "Given for outstanding performance, and dedication to Heartview Foundation's Mission."
Languages
English
Native or Bilingual
Timeline
Medical Billing Specialist
Heartview Foundation - Drug And Alcohol Treatment And Education
08.2021 - Current
Assistant Store Manager
Bed Bath and Beyond
05.2017 - 08.2021
Assistant Manager
Rue 21
08.2014 - 05.2017
One Year Completed - Chemistry
North Dakota State University
One Year Completed - Chemistry
Austin Community College
High School Diploma -
Parshall High School
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