Casey Glotz
Warren,PA
Summary
Competent Certified Medical Billing Specialist with 5 years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Adds value to any organization in need of great collaboration, interpersonal and multitasking abilities. Meets tight deadlines. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Billing and Revenue Specialist
Concert Health
San Diego, CA
10.2022 - 03.2023
- Coordinated monthly billing cycle for assigned partner practices.
- Prepared, reviewed, and entered over 200 claims per day via electronic claim processing.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Utilized various software programs to enter procedure codes, diagnosis codes and patient information.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations..
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Reviewed and validated accuracy of charges including dates of service, services provided, location and provider signature.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Audited and corrected billing and posting documents for accuracy.
- Precisely evaluated and verified benefits and eligibility.
- Liaised between patients, insurance companies, and billing team.
- Identified and resolved patient billing and payment issues.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Managed time efficiently in order to complete all tasks within deadlines.
Licensed Practical Nurse, Triage
Community Surgery and Laser Center
Warren, PA
10.2016 - 10.2022
- Managed over 30 patients per day.
- Verified, updated and communicated patient history prior to clinic appointments and procedures with providers.
- Performed additional clinic and non-triage nurse duties such as instructing patients in general and specific medical care and health issues and administering or dispensing medication and injections.
- Documented accurate and complete patient information to address patient problems and expected outcomes.
- Suggested appropriate disposition to acting physicians based on assessment.
- Gathered lab specimens, ordered testing, and interpreted results to diagnose patients.
- Delivered orientation and training of less experienced staff in specific operations and procedures.
- Verified patient insurance eligibility and identified primary care physician, contacting office to obtain patient file.
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Advised patients on pre- and post-operative instructions, medication administration and symptoms indicating emergency care.
- Administered controlled narcotics and inserted IVs
- Counseled patients via telephone according to established guidelines and protocols, advising on provider-established plans of care.
- Answered incoming phone calls from patients to provide basic assistance and triage medical concerns.
Ambulatory Surgical Coordinator
Community Surgery and Laser Center
Warren, PA
10.2016 - 10.2022
- Scheduled surgeries according to physician volume and maintained prompt turnaround times.
- Resolved scheduling conflicts to maintain high-quality patient services.
- Located scheduling barriers and implemented appropriate solutions.
- Updated daily operating room calendars with accurate appointment schedules.
- Completed administrative patient intakes with case histories, insurance information and mandated forms.
- Arranged and scheduled post-operative visits during appropriate timeframe after surgery.
- Educated patients on at-home surgery preparation requirements and post-operative care process.
- Obtained signatures and collected completed pre-operative consent and HIPAA forms from patients.
- Informed patients of payment policies, collected insurance information and verified benefits.
- Coordinated with 6 facilities to schedule surgeries for 2 Ophthalmologists
- Received and routed laboratory results to correct clinical staff members.
- Verified insurance coverage
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Transcribed medical information dictated by physician to document patient care and health updates.
- Obtained pre-authorizations and pre-certifications ahead of scheduled surgeries.
- Arranged pre-operative and post-operative appointments for surgical patients.
Education
Certified Professional Biller - Medical Insurance Billing
AAPC
Remote08.2022
Licensed Practical Nurse - Nursing
Venango Technology
Warren, PA06.2014
No Degree - Forensic Psychology
Kaplan University
Davenport, IA09.2006
Certified Nursing Assistant - Nursing Assistance
The Warren Manor
Warren, PA07.2000
GED - AP And CP Courses
Warren Area High School
Warren, PA01.2000
Skills
- In-depth knowledge of Medical Terminology
- Appointment Scheduling
- Data Entry Software
- Epic Systems
- Athena
- Cerner
- Medical Charting
- HIPAA Compliance
- Claim Forms
- Insurance Authorizations
- Patient Billing
- Medical Coding
- CPT Coding
- Computer Proficiency
- Patient Health Information Access
- Referral Verification
- Revenue Operations
- Workflow Processes
- Quarterly Reviews
- Microsoft Office
- Electronic Health Record Software
- Diagnostic Codes
- Insurance Claim Requirements
- Billing Codes
- Medical Records Security
- Regulatory Compliance
- ICD-10
- Obtaining Authorizations
- 10-Key Data Entry
- CMS-1500 Billing Forms
- Medicare and Medicaid Processes
- Benefits Verifications
- Workers' Compensation Knowledge
- Medical Claims Submission
- Cataract Surgery
- Surgical Counts
- Oculoplastic Surgery
- MIPS Standards
- Schedule Coordination
- Administrative Duties
- Behavioral health billing and collections
Certification
- CPB, AAPC - 2022
- LPN, VTC - 2014
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
Know the true value of time; snatch, seize, and enjoy every moment of it. No idleness, no laziness, no procrastination: never put off till to-morrow what you can do to-day.
Philip Dormer Stanhope, Lord Chesterfield
Timeline
Billing and Revenue Specialist
Concert Health
10.2022 - 03.2023
Licensed Practical Nurse, Triage
Community Surgery and Laser Center
10.2016 - 10.2022
Ambulatory Surgical Coordinator
Community Surgery and Laser Center
10.2016 - 10.2022
Certified Professional Biller - Medical Insurance Billing
AAPC
Licensed Practical Nurse - Nursing
Venango Technology
No Degree - Forensic Psychology
Kaplan University
Certified Nursing Assistant - Nursing Assistance
The Warren Manor
GED - AP And CP Courses
Warren Area High School
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