Summary
Work History
Overview
Education
Skills
Timeline
Generic

Danielle Peters

Reconsideration/Billing Specislist
Reynoldsburg,OH

Summary

With over 20 years of experience in medical office billing and management, seeking an organization that values growth and the application of accumulated knowledge. Goal is to create an efficient and positive team-building work environment while delivering the best healthcare to patients. Possesses extensive expertise in CPT, ICD-9, and ICD-10, as well as training in management, medical terminology, human anatomy, documentation and coding. Additionally, has a strong focus on providing positive customer service, better business writing, listening to customers, cultural diversity and ethics, and workers' compensation. Proficient in various electronic billing software and EMR systems such as Medent and ECW. Also skilled in Microsoft Office/Outlook/Teams, spreadsheets, and electronic payments. Excellent leader with problem-solving abilities. Consistently projects a positive company image while fostering an exceptional team-building environment.

Work History

Reconsideration Specialist/Payment Poster/ Change Entry Specialist

Orthopedic One
04.2015 - Current
  • Work Insurance and Patient Unapplied reports to resolve overpayments and report unapplied numbers to management
  • Work with the Finance team, Management, Posting Specialist and satellite office with balancing out each daily and monthly
  • Assist in training new hires, Provide backup to Team members
  • Work closely with Financial Counseling Teams on surgery pre-collects and patient accounts needs
  • Work collection accounts with reporting payment, verifying balances due and posting payment to patients accounts
  • Audit account for errors and report to team managers
  • Daily claim entry of multiple physician office charges
  • Monthly reports to assure all open fee slip have been billed
  • Work closely with Management and co-workers to assure claims are entered timely, billed timely, insurance appeal and denials worked timely
  • Posting of all insurance and patient payments
  • Assist Management with any special projects as needed
  • Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
  • Followed all company policies and procedures to deliver quality work.
  • Verified accuracy of accounts payable payments, resulting in 98% reduction in payment errors and check reissues.

National Bill Review

Sedgwick
06.2014 - 04.2015
  • Process workers' compensation claims according to State Guidelines
  • Assure claims are processed correctly and in a timely manner
  • Work closely with claims examiner to assure claims are processed accordingly
  • Self-motivated, with a strong sense of personal responsibility.
  • Worked effectively in fast-paced environments.
  • Skilled at working independently and collaboratively in a team environment.
  • Proven ability to learn quickly and adapt to new situations.
  • Worked well in a team setting, providing support and guidance.

Billing Specialist

Columbus Aesthetic and Plastic Surgery
10.2011 - 04.2014
  • Manage Account Receivables
  • Assure all claims/charges are billed to the insurance companies in a timely manner
  • Assist clinical teams with Per-Determination/Authorization of all surgical producers
  • Work with patients in regards to account balances, payments and payment arrangements, and all insurance related questions
  • Balance the daily/monthly financials; prepare financial reports for company accountants and company banking
  • Work closely with physicians and the Medical Group of Ohio on coding changes, producers and physician contracts
  • Verified accuracy of accounts payable payments, resulting in 98% reduction in payment errors and check reissues.
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
  • Maximized revenue potential by identifying and resolving under-billed accounts.
  • Contributed to positive work environment by offering support and guidance to junior billing staff.

Billing Manager

The Winchester Institute
07.2009 - 10.2011
  • Managed Accounts Receivable & Payable
  • Responsible for monthly reports, patient statements and collection accounts
  • Manage all personal injury and workers' compensation claims/accounts
  • Verification of insurance benefits and reviewing benefits with patients
  • Assuring all claims was billed in a timely manner
  • Posting of insurance payments and working denials
  • Entrusted in managing banking duties
  • Multiple administrative duties
  • Reviewed billing problems, researched issues, and resolved concerns.
  • Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.

Billing Specialist

Midwest Allergy
03.2007 - 07.2009

Bill Review Coordinator

Comp Management Health Systems
10.2002 - 12.2006

Billing Lead

MedAssist, Inc.
03.1998 - 10.2002

Overview

27
27
years of professional experience

Education

High School Diploma -

Whitehall Yearling High School
Whitehall, OH
05-1992

Skills

  • Claims processing
  • Payment posting
  • Account reconciliation
  • Financial reporting
  • Insurance verification
  • Training new hires
  • Data entry
  • Problem solving
  • Attention to detail
  • Effective communication
  • Time management
  • Expert problem solving

Timeline

Reconsideration Specialist/Payment Poster/ Change Entry Specialist

Orthopedic One
04.2015 - Current

National Bill Review

Sedgwick
06.2014 - 04.2015

Billing Specialist

Columbus Aesthetic and Plastic Surgery
10.2011 - 04.2014

Billing Manager

The Winchester Institute
07.2009 - 10.2011

Billing Specialist

Midwest Allergy
03.2007 - 07.2009

Bill Review Coordinator

Comp Management Health Systems
10.2002 - 12.2006

Billing Lead

MedAssist, Inc.
03.1998 - 10.2002

High School Diploma -

Whitehall Yearling High School
Danielle PetersReconsideration/Billing Specislist