Carmella Houston
Antioch,USA
Summary
Billing Supervisor with proven track record in managing billing operations and leading teams to success. Expertise in optimizing workflows and financial reporting, ensuring compliance with regulations, and driving operational efficiency. Adept at resolving critical issues in dynamic environments while fostering high-performance teams. Focused on continuous improvement and motivating staff to meet organizational objectives.
Overview
17
17
years of professional experience
Work History
Billing and Cashiering Supervisor
Uc Berkeley
Berkeley, California
03.2024 - Current
- Supervised four billing staff, achieving timely processing of insurance claims and improving revenue cycle efficiency.
- Managed billing and accounts receivable, ensuring accurate processing of various insurance claims and student health fees.
- Oversaw daily cash management operations, reconciling cash, checks, and electronic payments while adhering to internal controls.
- Resolved complex billing inquiries for students and third-party payers, showcasing strong problem-solving capabilities.
- Maintained current knowledge of medical billing regulations and insurance requirements, minimizing claim denials.
- Conducted annual employee evaluations according to union and HR guidelines.
- Participated in successful implementation of Epic Systems within the health center's billing module.
- Developed financial reports that provided management with insights for effective cash flow strategies.
Medical Billing Supervisor
pMD soft
04.2021 - 06.2023
- Overseen preparation of medical bills, calculation of provider charges, and verification of patient services.
- Reviewed EDI reports and claim submissions to ensure successful clearinghouse transactions.
- Maintained lockbox and daily reconciliation of ERA payments for accurate financial tracking.
- Conducted month-end calls with RCM clients to analyze financial data and emerging trends.
- Created edits to enhance clean claims submission and monitored key performance metrics.
- Guided and trained new medical billers on effective coding practices for optimal compliance.
- Analyzed payer reimbursement data to provide actionable recommendations for improvement.
- Developed strategies that improved collection rates while reducing bad debt write-offs.
Patient Account Representative III
Northbay Hospital- Baycare Health Systems
Fairfield, USA
03.2018 - 03.2021
- Monitored collection and organization of analytical data on revenue, sales, and financial activities.
- Submitted appeals for patients based on research conducted into denied claims.
- Fostered customer service relations with patients regarding billing inquiries and account details.
- Collaborated with insurance companies to secure authorizations for services rendered.
Recovery Coordinator/Lead
Stanford Healthcare
Oakland, USA
10.2016 - 03.2018
- Monitored and recovered various claims overpayments efficiently.
- Collaborated with Claims, Member Services, Provider Network Operations, and Participating Provider Groups.
- Created and maintained a database to facilitate timely reimbursement on overpaid claims.
- Coordinated with Capitation Analyst to ensure completion of retro transactions and documentation.
- Ensured provider reimbursements were processed within 30 days of request submission.
- Processed all received provider payments promptly.
- Issued statements for outstanding balances to maintain transparency.
Medical Biller
UCSF Medical Center
San Francisco, USA
12.2015 - 09.2016
- Completing daily revenue cycle functions for the healthcare enterprise, including system billing, reporting and followup.
- Ensuring that account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services.
- Streamlined charge-capture processes, leading to noticeable gains in billing accuracy and reduced delays in payment processing.
Medical Biller
Bay Area Surgical Specialists
Walnut Creek, USA
06.2015 - 12.2015
- Performing the day-to-day billing and follow-up activities within the revenue operations.
- Worked all aging claims from work queue or aging reports.
- Responsible for presenting trends or issues to direct supervisor, and collaborating together to make improvements.
- Resolved denials or correspondences from patients and insurance carriers based on productivity standards.
- Completed daily insurance and patient payment posting on processed claims.
- Completed first-level and second-level appeals as needed.
Medical Biller
Marin General Hospital
Greenbrae, USA
05.2008 - 08.2014
- Managed billing, follow-up, and collections for improved cash flow.
- Conducted claim status checks, identifying discrepancies and facilitating timely resolutions to enhance overall billing accuracy.
- Documented collection activities with precision and accuracy.
- Reviewed accounts to determine next steps in billing processes.
Education
High School Diploma -
Guajome Park Academy
Sacramento, CA06-2004
Bachelor of Science - Health Administration
Western Governors University
Salt Lake City, UTSkills
- Financial reporting
- Regulatory compliance
- Data analysis
- Team leadership
- Staff training and development
- Customer service
- Claims analysis
- Workflow optimization
- Problem resolution
- Quality assurance
- Revenue cycle management
- Electronic health records
- Performance evaluation
- Epic, HB, PB, Tapestry expertise
- Process improvement and monitoring
- Policy development
- Medical terminology proficiency
- Critical and analytical thinking
- Clearinghouse and payer management
- Time management skills
- Decision making capabilities
- Claim denial management
- Staff management
- Payroll processing
- Performance metrics
Timeline
Billing and Cashiering Supervisor
Uc Berkeley
03.2024 - Current
Medical Billing Supervisor
pMD soft
04.2021 - 06.2023
Patient Account Representative III
Northbay Hospital- Baycare Health Systems
03.2018 - 03.2021
Recovery Coordinator/Lead
Stanford Healthcare
10.2016 - 03.2018
Medical Biller
UCSF Medical Center
12.2015 - 09.2016
Medical Biller
Bay Area Surgical Specialists
06.2015 - 12.2015
Medical Biller
Marin General Hospital
05.2008 - 08.2014
High School Diploma -
Guajome Park Academy
Bachelor of Science - Health Administration
Western Governors University