Danielle Gruber
Mesa,USA
Summary
Detail-focused Coding Specialist known for high productivity and efficient task completion. Specialized in medical billing, record accuracy, and regulatory compliance to ensure top performance in coding operations. Excel in problem-solving, time management, and adaptability which enhance capabilities in fast-paced environments.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Medical Billing and Coding Specialist
CCRM Fertility
Scottsdale, AZ
07.2024 - Current
- Accurately assigned medical codes to patient records using ICD-10 and CPT coding systems
- Submitted claims electronically to insurance companies, resulting in faster reimbursement turnaround time
- Identified and resolved billing errors or discrepancies, resulting in additional reimbursement
- Collaborated with healthcare providers to obtain missing documentation necessary for accurate coding and billing
- Utilized electronic health record (EHR) systems to access patient information for accurate code assignment
- Provided exceptional patient care by answering billing questions and collecting outstanding balances
- Followed up on unpaid claims or denied reimbursements, resolving issues promptly to maximize revenue collection
- Ensured timely submission of clean claims by meeting daily productivity targets
Financial Coordinator
IVF Phoenix
Scottsdale, AZ
01.2022 - 06.2024
- Highly proficient in Infertility billing and coding
- Assist Provider with HSG & SHG diagnostic procedures
- Ensure procedure room is cleaned & all supplies are restocked for next schedule procedure
- I.e
- HSG, SHG & Hysteroscopy
- Responsible for coding all insurance claims by assigning correct ICD10 codes and billing out all charges with appropriate CPT codes for insurance reimbursement
- Settling patient balances and generating patient billing statements for unpaid charges
- Obtaining eligibility and benefits for infertility coverage
- I.E, diagnostic testing, treatment, surgery, etc
- Providing patients with a cycle cost sheet, outlining their financial responsibilities for upcoming treatment - Insurance and Cash Pay
- Working directly with patients to explain their financial responsibilities and then collecting their portion prior to treatment
- Responsible for obtaining all required prior authorizations for Infertility treatment
- Schedule patient appointments for surgery, consults, ultrasound, labs and other in-office procedures
- Experience with taking patient phone calls and scheduling appointments as needed
- Familiar with front desk responsibilities such as check-ins, collecting copays/patient account balances and explaining benefits
Medical Biller and Coder
Atlas Neurosurgery & Spine
Scottsdale, AZ
06.2021 - 01.2022
- Responsible for entering surgery charges and billing claim out to the appropriate insurance carrier
- Worked all insurance denials by any means necessary
- E.g
- Submitting corrected claims, filing claim reconsideration requests, filing appeals
- Posted all insurance payments, including EFTs, ERAs and paper checks, ensuring all batches balanced at the end of each day
- Answered patient phone calls and provided explanations for account balances
- Posted all patient payments received via phone and/or mail
- Ran patient eligibility and benefit information, calculating patient responsibility for upcoming surgery
Billing Specialist
Embry Health
Phoenix, AZ
11.2020 - 04.2021
- Responsible for billing and coding of COVID19 claims
- Corrected and resubmitted denied claims
- Knowledge of all commercial, Medicaid, Medicaid HMO, Medicare, Medicare HMO payers
- Took patient phone calls in order to explain billing procedures
- Contacted insurance companies regarding denied claims
Reimbursement Specialist
Quadris Teams
Chandler, AZ
03.2020 - 08.2020
- Responsible for submitting timely and contractual adjustments for unpaid claims
- Exemplary skills working for third party billing agency
- Ability to meet and exceed performance guidelines set forth by multiple clients
- Familiar working with Medicare Bad Debt accounts
- Currently working remotely
Trauma Medical Biller and Coder
Advanced Surgical Associates LTD
Mesa, AZ
07.2019 - 03.2020
- Entered patient insurance, demographic and health information
- Used eClinical Works software for working accounts
- Responded to coding questions from patients and other internal departments
- Assigned value codes and modifiers to provide specific information for services provided
- Reviewed account information to confirm patient and insurance balances
- Reviewed and coded hospital reports for all E/M services provided to trauma patients
- Worked unpaid accounts that had been denied incorrectly by insurance to collect payment based on a contractual agreement
- Responsible for billing and coding of provided services
- Accurately coded E/M codes based off hospital report
- Worked under 7 trauma surgeons who provided care to emergency patients out of Banner Desert Medical Center
Patient Account Representative
Anesthesia Specialty Billing Services
Scottsdale, AZ
03.2019 - 05.2019
Billing Clerk
Western Vascular
Mesa, AZ
10.2018 - 02.2019
Sr. Reimbursement Specialist
Reimbursement Concepts, LLC
08.2016 - 10.2017
- Bill and collect on Home Health and Hospice claims
- Monitoring claims to ensure billing is clean and timely
- Responsible for posting all cash that is received from insurance companies
- Ensure that all cash balances in order to complete month end reporting
- Filing appeals for underpaid claims
- Working Medicare A/R for RAP, LUPAs and FINALs
- Complete understanding of HIPPA compliance
- Verify health insurance benefits, including remaining deductible and out of pocket costs
- Obtain prior authorization according to insurance
Infusion Reimbursement Specialist Lead
Preferred Homecare
06.2013 - 08.2016
- Was promoted to Lead in August 2015
- Manage / Audit employee productivity
- Conduct weekly team meetings, keeping line of communication open in regards to payer issues and trends
- Create electronic claims and transmit to insurance
- Ensure accuracy of corrected claims
- Assist Supervisor with month end reports for billing/ collection numbers
- Assist in training of new and current employees
- Resolve escalated patient phone calls
- Assist Supervisor in the hiring process, including scheduling and conducting interviews
Education
Diploma - Scholastic
Mesa High School
Mesa05.2011
Skills
- DME
- Medical records
- Organizational skills
- Microsoft Word
- EClinicalWorks
- EMR Systems
- Sales
- ICD-10
- Reception
- Accounts Receivable
- Cash Posting
- Microsoft Office
- Medical coding
- Medical billing
- Microsoft Excel
- AdvancedMD
- Customer Service
- Medical Scheduling
- Ob/Gyn
- Ambulatory surgery center
- HIPAA
- Time management
- Leadership
- CPT Coding
- Medical Terminology
- Medical Office Experience
- Insurance Verification
- Infusion Experience
- Medical collection
- Supervising experience
Certification
Driver's License
Timeline
Medical Billing and Coding Specialist
CCRM Fertility
07.2024 - Current
Financial Coordinator
IVF Phoenix
01.2022 - 06.2024
Medical Biller and Coder
Atlas Neurosurgery & Spine
06.2021 - 01.2022
Billing Specialist
Embry Health
11.2020 - 04.2021
Reimbursement Specialist
Quadris Teams
03.2020 - 08.2020
Trauma Medical Biller and Coder
Advanced Surgical Associates LTD
07.2019 - 03.2020
Patient Account Representative
Anesthesia Specialty Billing Services
03.2019 - 05.2019
Billing Clerk
Western Vascular
10.2018 - 02.2019
Sr. Reimbursement Specialist
Reimbursement Concepts, LLC
08.2016 - 10.2017
Infusion Reimbursement Specialist Lead
Preferred Homecare
06.2013 - 08.2016
Diploma - Scholastic
Mesa High School