Carolina Christensen
West Islip,NY
Summary
Medical Billing Manager with 10 + years of experience. Adept in claims processing and enhancing revenue cycle management. Demonstrated expertise in Medicare and commercial insurance, alongside a strong ability to communicate effectively. Bilingual and proficient in HIPAA compliance. Significantly reduced denied claims, ensuring high levels of patient satisfaction and operational efficiency.
Professional with strong background in managing medical office operations, ensuring seamless workflow and effective patient care. Skilled in administrative management, scheduling, billing, and compliance, coupled with focus on team collaboration and achieving consistent results. Known for adaptability, reliability, and fostering supportive environment for staff and patients. Prepared to contribute to success and efficiency of any healthcare setting.
Overview
22
22
years of professional experience
Work History
Medical Billing Manager
South Shore Infectious Diseases
08.2010 - Current
- Verified patients benefits and eligibility and applicable coverage, deductibles, coinsurance, patient responsibility.
- Enhanced revenue cycle management by overseeing timely and accurate claims submissions resulting in prompt payment for services rendered.
- Reduced denied claims through diligent review, correction, and refiled rejected claims.
- Posted and adjusted payments from insurance companies.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Assisted patients with understanding their medical bills and provided clarification on insurance issues. Developed payment plans to bring accounts current.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Posted payments and collections on regular basis.
- Liaised between patients, insurance companies, and billing office.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Pre-certified medical and radiology procedures as well as authorizations for medications
- Trained new employees on billing programs and data entry software
Medical Office Manager
South Shore Infectious Diseases
08.2010 - Current
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations.
- Managed daily administrative tasks to ensure smooth operations within the medical office environment.
- Maintained strict confidentiality of sensitive patient information, adhering to HIPAA guidelines and safeguarding against potential data breaches.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Addressed and remedied all patient or team member issues.
- Assisted physicians with clinical documentation to ensure complete and accurate records for each patient visit.
- Communicated effectively with staff members, physicians, and patients, employing active listening and interpersonal skills.
- Increased revenue by optimizing billing processes and ensuring timely collection of payments from both patients and insurance companies.
- Coordinated regular staff meetings to address challenges, discuss solutions, and share best practices within the team.
- Provided proper scheduling of patients, ensuring timely, and effective allocation of resources and calendars.
- Managed 15 employees with various personalities and from different cultures for large 7-physician practice.
- Developed close working relationships with front office and back office staff.
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties.
- Oversaw accounting, budgeting, and financial reporting.
- Negotiated with suppliers to secure cost-effective purchasing agreements for office supplies and medical equipment.
- Streamlined billing processes for quicker reimbursement, improving cash flow.
- Optimized organizational systems for payment collections, AP/AR, deposits, and recordkeeping.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
Medical Assistant
South Shore Infectious Diseases
08.2010 - 07.2015
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Performed medical records management, including filing, organizing and scanning documents.
- Facilitated seamless patient care with thorough and accurate documentation of medical histories, vital signs, and medications.
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.
- Performed phlebotomy tasks efficiently while ensuring minimal discomfort for patients during blood collection procedures.
- Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
- Assisted in the development of clinic policies and procedures to ensure compliance with industry standards and regulations.
EMT-B
Emergency Ambulance Service- EAS
09.2008 - 10.2010
- Improved patient outcomes by efficiently assessing, treating, and stabilizing medical conditions in emergency situations.
- Ensured timely decision-making under pressure during challenging rescue operations.
- Maintained optimal ambulance readiness by regularly inspecting vehicles for cleanliness, functionality, and proper stock levels.
- Boosted patient satisfaction through compassionate communication and empathetic care during crises.
- Evaluated patient histories to assess and prioritize levels of care.
- Trained EMTs in basic life support skills, oxygen therapy, and wound care.
Cashier
BJ's Wholesale
01.2003 - 01.2006
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
- Maintained a balanced cash drawer, ensuring accurate accounting at the end of each shift.
- Helped customers complete purchases, locate items, and join reward programs.
- Assisted customers with returns, refunds and resolving transaction issues.
Education
Associate of Science - Business Management
Suffolk County Community College
Brentwood05-2025
Phlebotomist
Bohemia06-2007
Skills
- Claims processing proficiency- Claims Submission, Payment Posting, Denials, Error correction
- Medicare, Commercial Insurance, Workers Compensation process
- HIPAA compliance
- Effective communication
- Patient confidentiality practices
- Insurance verification
- Bilingual (Spanish)
- Payroll administration (ADP)
- Multitasking Abilities
Languages
Spanish
Native or Bilingual
Proficient in Microsoft Word and Excel
Proficient
Timeline
Medical Billing Manager
South Shore Infectious Diseases
08.2010 - Current
Medical Office Manager
South Shore Infectious Diseases
08.2010 - Current
Medical Assistant
South Shore Infectious Diseases
08.2010 - 07.2015
EMT-B
Emergency Ambulance Service- EAS
09.2008 - 10.2010
Cashier
BJ's Wholesale
01.2003 - 01.2006
Associate of Science - Business Management
Suffolk County Community College
Phlebotomist
Similar Profiles
Tara HatchieTara Hatchie
Project Director at The Division of Allergy and Infectious Diseases: Chu Lab, University of WashingtonProject Director at The Division of Allergy and Infectious Diseases: Chu Lab, University of Washington
Jennifer YaneyJennifer Yaney
Department Administrator II at Institute for Infectious and Inflammatory Diseases (i3D)Department Administrator II at Institute for Infectious and Inflammatory Diseases (i3D)
Stefani ButtsStefani Butts
Program Manager at University of Miami – Miller School of Medicine - Division of Infectious DiseasesProgram Manager at University of Miami – Miller School of Medicine - Division of Infectious Diseases