CAROLYN ISIBUE
Coon Rapids,MN
Summary
Patient Services Representative with experience supporting twelve physicians in a busy medical office. Highly efficient and analytical minded Medical Biller with experience in family practice, internal medicine, and hospital billing. Excellent multi-tasker and demonstrated team player with positive attitude. Skills with EPIC ,PWPM (vital works) and
Excellian. An organized individual that boasts 20 years of experience multitasking including difficult situations and claims-processing tasks. Works quickly with insurance companies to resolve problematic disputes and handle patient inquiries an brings a can-do attitude to collaborating with medical professionals, insurance providers and clients.
Overview
28
28
years of professional experience
Work History
Problem Solver
Amazon
12.2018 - Current
- Exceeded team goals and collaborated with staff to implement customer service initiatives.
- Worked under strict deadlines and responded to service requests and emergency call-outs.
- Maintained high-volume workload within fast-paced environment and consistently met performance benchmarks.
- Provided advice and front-line expertise to internal committees in order to improve team, service and procedural standards.
Medical Billing Specialist
Noran Neurologial Clinic
05.2022 - 12.2024
- Processed and submitted medical claims efficiently, ensuring compliance with insurance regulations.
- Resolved billing discrepancies promptly, enhancing accuracy of patient accounts.
- Maintained up-to-date knowledge of healthcare policies and coding standards to support billing operations.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Collected payments and applied to patient accounts.
- Filed and updated patient information and medical records.
Medical Billing Specialist
Cerner/R1
05.2016 - 03.2021
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Posted charges, payments and adjustments.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Completed appeals and filed and submitted claims.
- Posted and adjusted payments from insurance companies.
- Reviewed and verified benefits and eligibility with speed and precision.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Applied payments, adjustments and denials into medical manager system.
- Collaborated closely with other departments to resolve claims issues.
- Entered procedure codes, diagnosis codes and patient information into EPIC, PWPM, and Excellian.
- Remained up-to-date details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Posted surgeries, hospital visits and payments for assigned carriers within 72 hours.
Patient Services Representative
Allina Health System
06.1997 - 12.2014
- Acquired insurance authorizations for procedures and tests ordered by the attending physician.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Scheduled patient appointments.
- Completed registration quickly and cordially for all new patients.
- Accurately entered procedure codes, diagnosis codes and patient information into billing software.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy.
- Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
- Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Confirmed patient information, collected copays and verified insurance.
- Completed appeals and filed and submitted claims.
- Posted charges, payments and adjustments.
- Submitted refund requests for claims paid in error.
- Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
- Performed quality control of the data entry system to verify that claims and payments were posted correctly.
- Efficiently performed insurance verification and pre-certification and pre-authorization functions.
Education
Certificate - Business Management
Elgin Community College
05.1990
Skills
- Bill payment
- Submission of medical claims
- Medical coding understanding
- Account follow-up
- Insurance claims
- CPT code modifiers
- Billing codes
- Account management
- Claim review
- ICD-10 coding
- Data entry
- Quality-oriented team player
Flexible schedule
Prior authorization process
Medical terminology knowledge
Languages
English
Timeline
Medical Billing Specialist
Noran Neurologial Clinic
05.2022 - 12.2024
Problem Solver
Amazon
12.2018 - Current
Medical Billing Specialist
Cerner/R1
05.2016 - 03.2021
Patient Services Representative
Allina Health System
06.1997 - 12.2014
Certificate - Business Management
Elgin Community College
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