Summary
Overview
Work History
Education
Skills
Timeline
Generic

CASSANDRA MAPLES

Farmington,NM

Summary

.Excellent multi-tasker and demonstrated team player with positive attitude. Skills in HMS and Medisoft billing systems. Organized professional known for always adhering to data confidentiality and HIPAA regulations. Smart Medical Biller capable of performing all office duties with efficiency and undeniable detail. Accurate biller performs all aspects of medical billing, including coding, charge entry, transmission, correction and resubmission. Offering 6 years of experience in working hand-in-hand with front office to validate proper information for claims processing. Detail-oriented and helpful professional with expertise in resolving billing issues and reviewing claim denials. Quality-focused billing professional successful at selling patient and insurance accounts. Multitasking Medical Biller with a career spent submitting claims quickly and efficiently to insurance companies. Individual with a can-do demeanor and a positive attitude. Ready to tackle new challenges in an office-based environment. Results-oriented Medical Biller with excellent organization, communication and relationship-building skills. Bill payment Quality-oriented team player Files and records management Accounts payable Submission of medical claims Data security procedures Database systems Recordkeeping Medical coding understanding Information posting Insurance claims Billing codes Data entry Claim review Customer service Account follow-up Insurance collections. Organized Medical Biller skilled at accurately auditing patient charts and billing corresponding parties. Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills. Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Capable Medical Billing Supervisor with six years overseeing billing and coding, patient charting, insurance claims and appointment scheduling in a busy medical office setting.

Overview

16
16
years of professional experience

Work History

Medical Billing Specialist

Reliance Medical Group LLC
03.2018 - Current
  • Remained up-to-date with all insurance requirements, including details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs
  • Analyzed and interpreted patient medical and surgical records to determine billable services
  • Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims
  • Reviewed and verified benefits and eligibility with speed and precision
  • Determined prior authorizations for medication and outpatient procedures
  • Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information
  • Prepared billing statements for patients, ensuring correct diagnostic coding
  • Maintained current working knowledge of CPT and ICD-10 coding
  • Precisely evaluated and verified benefits and eligibility.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Filed and updated patient information and medical records.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Liaised between patients, insurance companies, and billing office.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Evaluated patients' financial status and established appropriate payment plans.
  • Maintained and updated collections tracking spreadsheet to help organize payment information.
  • Managed collections claims for unpaid bills against estates of debtors.
  • Located errors and promptly refiled rejected claims
  • Communicated with insurance providers to resolve denied claims and resubmitted
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
  • Identified and resolved patient billing and payment issues
  • Collected payments and applied to patient accounts
  • Posted and adjusted payments from insurance companies
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers
  • Precisely evaluated and verified benefits and eligibility
  • Precisely completed appropriate claims paperwork, documentation and system entry
  • Filed and updated patient information and medical records
  • Prepared billing correspondence and maintained database to organize billing information
  • Communicated effectively and extensively with other departments to resolve claims issues
  • Liaised between patients, insurance companies, and billing office
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts
  • Printed and reviewed monthly patient aging report and solicited overdue payments
  • Evaluated patients' financial status and established appropriate payment plans
  • Maintained and updated collections tracking spreadsheet to help organize payment information
  • Managed collections claims for unpaid bills against estates of debtors
  • Pre-certified medical and radiology procedures, surgeries and echocardiograms

Temporary Bartender

Dino's Hideaway
06.2019 - 09.2019
  • Confirmed customers' ages for alcohol service and discontinued service to intoxicated guests
  • Checked identification of customers to verify age requirements needed for purchase of alcohol
  • Stocked bar with beer, wine, liquor and related supplies
  • Made product recommendations to customers based on preference, food pairings and special promotions
  • Balanced daily registers and generated sales reports to support financial and administrative objectives
  • Stayed up-to-date on latest in mixology trends, bar equipment and sanitation standards
  • Upsold customers from shelf to premium brands to help boost sales
  • Monitored patrons to keep alcohol consumption in designated areas
  • Kept close track of bar tabs and transferred open tabs to dining area seamlessly, smoothing process for wait staff
  • Planned and updated menus to capitalize on changing trends in customer preferences.

Lead Daycare Teacher

Children's Discovery Place
12.2014 - 01.2018
  • Established indoor and outdoor safe play environments for toddler-age children
  • Engaged with children on individual basis to build positive relationships and promote learning.
  • Resolved staff and parent disputes through constructive problem-solving techniques.
  • Implemented hands-on, play-based strategies such as games and crafts for experiential learning
  • Organized and led activities to promote physical, mental and social development
  • Taught children foundational skills such as colors, shapes and letters
  • Enhanced sensory abilities by giving children access to numerous textures and shapes
  • Maintained daily records of individual activities, behaviors, meals and naps
  • Controlled classroom environments with clearly outlined rules and positive reinforcement techniques
  • Created and implemented developmentally appropriate curriculum addressing all learning styles
  • Collaborated with parents to develop and maintain strong support networks and build rapport to foster seamless communication
  • Identified children in need of extra support for emotional, health-related or developmental concerns and conceived improvement strategies.
  • Four Years experience with neurodiverse children ages 6 weeks to school aged
  • Introduced groups of 5-7 toddlers to multisensory activities such as music, dance and stories to encourage exploration and spark curiosity
  • Communicated with children's parents and guardians about daily activities, behaviors and problems
  • Supported children's emotional and social development by adapting communication tactics for differing client needs
  • Incorporated music and art activities to encourage creativity and expression
  • Upheld all CPR and New Mexico regulated certifications
  • Encouraged children to be understanding and patient with others
  • Supervised circle time, free play, outside play and learning and developmental activities
  • Made policy decisions in conjunction with daycare board
  • Completed daily paperwork for agencies such as Child Protection
  • Services and Resource and Referral Centers
  • Managed general housekeeping duties, including feeding, diapering,resting, and cleanup
  • Familiarized parents with center's policies, regulations, fees and curriculum
  • Created and implemented developmentally appropriate curriculum
  • Escorted children on outings and trips to local parks and zoos.

Assistant Store Manager

Family Dollar Stores Inc
04.2009 - 12.2012
  • Assisted in overall day-to-day operations of store, including continuous development of effective store associates to achieve desired sales and results
  • Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
  • Maintained positive customer relationships by responding quickly to customer service inquiries.
  • Recruited, interviewed and hired individuals demonstrating passion, dedication and added value to team
  • Collaborated with staff to maximize customer satisfaction, streamline procedures and improve bottom-line profitability
  • Set schedules and delegated assignments based on team member strengths to optimize floor coverage and service levels
  • Replenished merchandise, welcomed customers, responded to questions and maintained overall presentation of store
  • Mentored team on effective upselling and cross-selling techniques
  • Promoted and supported strong relationships with local community organizations in surrounding area
  • Minimized waste through expense tracking and effective cost control strategies
  • Helped team members deliver polite and positive service to every customer by closely monitoring behaviors and offering constructive guidance
  • Collaborated with department heads to identify opportunities, develop timely solutions and create action plans
  • Maintained organized store, responded to customer complaints and answered questions quickly
  • Monitored supplier operations to verify quality, delivery schedule and conformance to contract specifications
  • Completed frequent walk-throughs and directed team members to correct any issues impacting store appearance or professionalism
  • Achieved or exceeded business plans on consistent basis by engaging employees in key processes
  • Performed daily activities in timely manner, including managing housekeeping and inventory needs of store
  • Encouraged professional growth and talent development in associates to increase performance in all areas.
  • Responded to customer concerns, working with manager to significantly raise customer satisfaction ratings.

Dog Grooming Assistant

Best Friends Grooming Spa
05.2007 - 08.2011
  • Bathed approximately 10 to 15 animals per 10-hour shift
  • Laundered soiled animal bedding immediately to reduce infection using appropriate chemicals
  • Cleaned and disinfected kennels and common areas to reduce spread of illness from infected animals
  • Consulted with owners and made recommendations on individual grooming needs of pets
  • Provided direct care for animal patients in post-operative recovery,closely monitoring vital signs and progress
  • Washed, groomed and trimmed each animal to enhance coat health
  • Removed animal waste from kennels, runs and exercise areas, placing in trash receptacles or in-ground septic systems
  • Treated basic wellness issues such as superficial wounds and called in veterinarian assistance for more complex concerns
  • Identified animal health concerns and discussed problems with owners
  • Administered treatments to sick or injured animals and consulted veterinarians to handle more complex concerns
  • Pitched in with laundry duties, including washing, drying and folding towels during busy periods, ensuring consistent workflow
  • Offered every owner exceptional customer service and support, as well a stop-notch care to each animal
  • Refilled shampoo bottles, sanitized clippers, combs and brushes and placed clean towels at each station following shift completion
  • Adhered to all pet care plans, medication requirements and dietary restrictions while providing care.

Education

High School Diploma -

Vista Nueva High School
Aztec, NM
05.2011

Skills

  • Skills
  • Accounts Payable and Accounts Receivable
  • Billing Codes
  • Legal Standards
  • Active Listening
  • File and Records Management
  • Medicare and Medicaid Processes
  • Data Analysis
  • System Updates
  • Time Management
  • Reviewing Patient Information
  • Information Updates
  • Healthcare Terminology
  • Client Inquiries
  • Database Systems
  • Collection Calls
  • CPT Code Modifiers
  • Physician Interaction
  • Customer Service
  • Data Entry
  • Account Management
  • Bill Payment
  • Strategic Initiatives
  • Critical Thinking
  • Diagnostic Codes
  • Till Counting
  • Information Inputting
  • Verbal and Written Communication
  • Medical Billing
  • Medical Billing Technology
  • Invoice Processing
  • Regulatory Compliance
  • Patient Identification
  • CMS-1500 Billing Forms
  • Work Prioritization
  • Electronic Health Record Software
  • Medical Claims Submission
  • Training and Development
  • Patient Account Analysis
  • ICD-10 Coding
  • Workers' Compensation Knowledge
  • Insurance Authorizations
  • Auditing Proficiency
  • Adjustment Posting
  • Records Maintenance
  • Claims Review
  • Medical Coding Knowledge
  • Statement Billings
  • Payments Posting
  • Claim Verifications
  • Speaking Clearly
  • Signature Verification
  • 10-Key Data Entry

Timeline

Temporary Bartender

Dino's Hideaway
06.2019 - 09.2019

Medical Billing Specialist

Reliance Medical Group LLC
03.2018 - Current

Lead Daycare Teacher

Children's Discovery Place
12.2014 - 01.2018

Assistant Store Manager

Family Dollar Stores Inc
04.2009 - 12.2012

Dog Grooming Assistant

Best Friends Grooming Spa
05.2007 - 08.2011

High School Diploma -

Vista Nueva High School
CASSANDRA MAPLES