Christy Fucci
Rancho Santa Margarita,AL
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Billing Specialist
Intefusion, LLC
Mission Viejo
11.2018 - Current
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
- Provided customer service support to patients regarding billing inquiries.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Assisted with the development of departmental policies related to charge capture processes and coding practices.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Ensured timely filing of all claims within established guidelines.
- Submitted claims to insurance companies electronically or by mail.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Monitored aging accounts receivable report weekly to identify unpaid balances due.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Reviewed medical records to meet insurance company requirements.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Resolved coding discrepancies and denials to maximize reimbursement.
Billing Manager
Pacific Thoracic Surgery
Laguna Hills
06.2018 - 02.2019
- Verified accuracy of patient information and insurance data in billing system.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
- Provided customer service support to patients regarding billing inquiries.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Ensured timely filing of all claims within established guidelines.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Submitted claims to insurance companies electronically or by mail.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Reviewed medical records to meet insurance company requirements.
- Filed and submitted insurance claims.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Office Manager/Medical Biller
Alliance Home Care/BHME
Prescott, AZ
06.2014 - 05.2018
- Managed team of 4 employees, coordinated schedules and allocated assignments.
- Provided training to new hires on office policies and procedures.
- Reviewed contracts for accuracy prior to signing off on behalf of the company.
- Resolved customer inquiries in a timely manner while maintaining positive relationships with clients.
- Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
- Monitored inventory levels and placed orders when needed.
- Verified accuracy of patient information and insurance data in billing system.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Ensured timely filing of all claims within established guidelines.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Tracked details such as authorizations, pre-certifications or referrals required prior to service delivery.
- Submitted claims to insurance companies electronically or by mail.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Reviewed medical records to meet insurance company requirements.
- Documented and filed patient data and medical records.
- Expertly assigned charges and payments for medical procedures.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Pulled patient records and transferred information to appropriate parties.
- Compiled and coded patient data using standard classification systems.
- Maintained positive working relationship with fellow staff and management.
- Ordered and restocked supplies in line with budget limits and office needs.
- Purged inactive files and destroyed obsolete files following procedures.
- Ensured accurate documentation was maintained for all transactions involving DME equipment.
- Monitored inventory levels of durable medical equipment; ordered new items as needed.
- Assisted with troubleshooting technical issues related to the use of DME equipment.
- Negotiated contracts with third-party payers to maximize reimbursement rates for services provided.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
Office Manager
Association of South Bay Surgeons
Torrance, CA
05.2013 - 05.2014
- Provided leadership and supervision to a diverse team of 25 employees and managers in various departments such as Call Center operations, Medical Records/Testing, and Billing.
- Collaborated closely with COO and 16 providers on a daily basis
- Provided technical support to 65 employees and 16 providers, assisting with software and phone system issues.
- Collaborated with Torrance Memorial Hospital administrative staff to enhance our participation in ACO.
- Successfully integrated electronic lab results from Lab Corp and Quest Diagnostic into our software system.
- Successfully achieved Meaningful Use 1 attestation for both 2012 and 2013.
- Ensured the seamless functioning of the patient portal
- Administered our third-party transcription service
- Assisted in resolving conflicts between staff members and addressing any issues that arose related to patient care or safety concerns.
- Managed accounts receivable for the practice, ensuring timely payments from insurance companies and patients.
- Prepared weekly reports summarizing financial performance metrics, such as revenue collections, accounts receivable balances.
- Trained new staff on office procedures, software programs and customer service protocols.
- Interviewed, hired and trained medical office teams and conducted performance reviews.
- Developed plans to streamline patient flows, increase office and patient care efficiency and generate new revenues.
- Pitched in to help with office tasks during busy periods and staff absences.
- Worked with management team to improve workflows and eliminate unnecessary tasks.
- Streamlined office processes and procedures to boost profits and productivity and facilitate continuous improvements.
- Negotiated and reviewed contracts, rates and terms with current facilities and suppliers.
- Analyzed internal processes and recommended and implemented procedural or policy changes to improve operations.
- Trained employees on best practices and protocols while managing teams to maintain optimal productivity.
- Read through contracts, regulations and procedural guidelines to verify comprehension and compliance.
Billing Manager
Association of South Bay Surgeons
Torrance, CA
03.2012 - 05.2013
- Managed a team of 7 employees
- Discovered contract discrepancies leading to the recovery of $100,000.00 in outstanding claims
- Successfully updated and revised terms of the Blue Cross contract with improvements in negotiations for the Endovascular Surgery Center.
- Conducted comprehensive research and successfully communicated with Medi-Cal to optimize revenue from Medicare/Med-cal cross over claims
- Participated in process improvement initiatives to increase efficiency within the department.
- Worked with customers to resolve billing disputes in a timely manner.
- Prepared monthly reports on accounts receivable status and aging analysis.
- Researched complex billing issues using internal resources and external sources as needed.
- Developed and implemented billing procedures to ensure accurate data entry and timely payment collection.
- Resolved billing issues by applying knowledge and completing in-depth research.
- Managed the setup and billing of complex client accounts, ensuring compliance with contractual agreements.
- Processed electronic payments from payers in a timely manner according to established deadlines.
- Trained other staff members in medical billing processes and procedures.
- Worked collaboratively with providers, coders, billers, auditors, and finance team members as needed.
- Monitored changes in healthcare regulations that could affect the organization's revenue cycle processes.
- Identified areas of improvement within current workflows in order to increase revenue cycle efficiency.
- Participated in regular meetings with senior management teams regarding financial performance metrics.
- Assisted with the implementation of new billing software upgrades.
- Researched rejected claims due to incorrect coding or inaccurate information submitted by providers.
- Submitted appeals to insurance carriers on denied claims.
- Addressed and responded to staff and client inquiries regarding CPT and diagnosis codes.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
- Answered customer questions to maintain high satisfaction levels.
Billing Specialist
Cardiovascular Medical Group
Los Angeles, CA
02.2011 - 03.2012
- Proficient in coding for E/M, Laboratory, Radiology, Echo and Stress Echo procedures. Skilled in coding for Treadmill and Holter Monitors. Experienced in coding for Pacemakers/ICD and Vascular Diagnostic tests.
- Processed appeals for denied or rejected claims in a timely manner.
- Prepared bills according to established procedures, including correct coding techniques.
- Ensured accuracy of all data entry into the electronic health record system.
- Updated patient demographic information, insurance details, financial data, as necessary.
- Investigated third-party payer denials and provided solutions to resolve them quickly.
Billing Specialist
Newport Center Medical Group
Newport Beach, CA
03.1999 - 05.2005
- Led billing activities for a prominent Internal Medicine Group
- Monitored past due accounts and pursued collections on outstanding invoices.
- Submitted electronic claims to various insurance carriers.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-9 coding system.
- Created monthly aging reports to identify delinquent accounts for review by management team.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Provided training and support to new staff members regarding billing processes.
- Prepared detailed financial reports as requested by management team.
- Ensured compliance with HIPAA guidelines when handling confidential patient information.
- Compiled and processed data for billing purposes utilizing billing software programs.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Reviewed claims for coding accuracy.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Answered customer questions to maintain high satisfaction levels.
- Eliminated inaccuracies in accounts payable payments by verifying information prior to generating checks and electronic payment transfers.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
Education
High School Diploma -
Lake Havasu High School
Lake Havasu City, AZ06-1995
Skills
- Contract Negotiation
- Ability to Multi Task
- Work Independently
- Meet Deadlines and Maintain Focus on Detail
- Analytical Skills
- Attention to Detail
- Billing Document Creation
- Analytical Thinking
- Self Motivation
- Team building
- Excellent Communication
- Decision-Making
- Claims Processing
- Payment posting
- Contract Preparation
- Coding proficiency
- HIPAA Compliance
- Collections
- Billing dispute resolution
- Research and due diligence
- Customer Service
- Discrepancy Resolution
- Deadline Adherence
- 50 WPM
- 10 Key Touch
- CPT,HCPC, ICD-10
- Quick Books
- Light Book Keeping
- Computer Proficient in MS Office Products
Accomplishments
- Discovered contract discrepancies leading to the recovery of $100,000.00 in outstanding claims
- Increased revenue by cleaning up old accounts
- Reached Million Dollar Club at Millennia Mortgage
Certification
Medical Terminology
Timeline
Billing Specialist
Intefusion, LLC
11.2018 - Current
Billing Manager
Pacific Thoracic Surgery
06.2018 - 02.2019
Office Manager/Medical Biller
Alliance Home Care/BHME
06.2014 - 05.2018
Office Manager
Association of South Bay Surgeons
05.2013 - 05.2014
Billing Manager
Association of South Bay Surgeons
03.2012 - 05.2013
Billing Specialist
Cardiovascular Medical Group
02.2011 - 03.2012
Billing Specialist
Newport Center Medical Group
03.1999 - 05.2005
High School Diploma -
Lake Havasu High School
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