Results-driven Billing Operations Manager with 17 years of experience managing revenue cycle processes in vascular surgery. Expertise in medical billing, coding compliance, and insurance reimbursement enhances financial performance and streamlines operations. Proficient in claims submission and denial resolution, ensuring adherence to HIPAA and other regulations while improving financial reporting.
Overview
28
28
years of professional experience
Work History
Billing Operations Manager
Vascular Specialists of Central Florida, Inc.
Orlando
12.2008 - Current
Medical Billing for a single specialty medical practice over 4 locations.
Professional fee medical record extraction surgical, E & M & vascular lab coding with CPT, ICD10 for outpatient hospital, ASC, OBL, E & M well as trauma coverage services for up to 7 providers
Managed complete revenue cycle, ensuring timely billing and collections.
Executed claims submission and follow-up processes to maximize reimbursement.
Oversaw denial management, resolution, and appeals to recover lost revenue.
Processed Medicare and commercial insurance claims for timely reimbursement.
Credentialing & Provider Enrollment Assuring physician compliance with state licensure, DEA & certification renewals
Monthly Financial Reporting
Ensured HIPAA compliance through regular training and audits.
Medical claims Auditor
Surgery One IPA
Clermont
01.2015 - 12.2021
Audited surgical claims to identify discrepancies and prevent potential fraud.
Created detailed audit reports to present findings for management review.
Maintained current knowledge of industry regulations affecting claims processing.
Maintained up-to-date knowledge of regulatory requirements impacting healthcare insurance billing.
Facility Manager
Mid Florida Imaging
Winter Park
04.2002 - 04.2008
Ensured compliance with healthcare regulations and safety standards to maintain quality care and patient safety.
Managed daily operations of medical imaging facility efficiently.
Coordinated staff and patient appointment schedules to optimize workflow and minimize wait times.
Oversaw day-to-day operations of the front desk area to ensure efficient flow of patients through check-in and checkout processes.
Maintained accurate patient data, including medical history, laboratory results, billing information and other relevant documents.
Facilitated patient communication regarding procedures and insurance issues.
Handled telephone inquiries from patients regarding appointment scheduling or general questions about the practice's services.
Trained new staff on office procedures and software programs to enhance service delivery and operational efficiency.
Seasonal Tax Preparer
H & R Block
Casselberry
01.1999 - 05.2003
Prepared individual and business tax returns, ensuring compliance and accuracy through H & R Block software.
Organized and streamlined paperwork for timely review by senior staff members.
Assisted clients in understanding tax obligations and available deductions.