Dynamic billing and insurance professional with extensive experience at Progressive Medical Associates. Proven track record in insurance claim processing and patient account management, ensuring accuracy and efficiency. Recognized for exceptional customer service and training abilities, fostering team collaboration and enhancing operational workflows. Committed to delivering results in fast-paced environments.
Overview
37
37
years of professional experience
1
1
Certification
Work History
Billing Manager/Records
Progressive Medical Associates, PLLC
Huntersville, NC
10.2023 - Current
Key and post all patient insurance claims.
Review the provider-selected codes for accuracy, and change them as needed.
Research complex billing issues using internal resources and external sources, as needed.
Serve as a resource on current coding regulations by proactively tracking changes, and educating providers and staff to ensure compliance.
Post all insurance and patient payments with accuracy.
Follow up on claims, and submit appeals if warranted.
Reconcile the batch sheet daily.
Communicate with patients regarding account balances and payment plans.
Process customer refunds promptly upon request.
Work with customers to resolve billing disputes in a timely manner.
Investigate unapplied payments or credits to determine the appropriate application method.
Monitor delinquent accounts, and work with the collections company when necessary.
Prepare monthly reports on accounts receivable status, and aging analysis.
Establish clear, detailed reference materials for cross-training, improving team readiness, and ensuring uninterrupted workflow coverage.
Pull, create an invoice, and then fax records requested by patients, attorneys, and insurance companies.
Facilitate the secure and timely transfer of medical records between providers and specialists to support continuity of care.
Update the online rolodex with providers from whom records are being requested.
Work closely with the office manager to create and execute policies that improve operational efficiency and compliance.
Function as the go-to resource for staff and providers during the office manager's absence.
Ensure accurate and timely processing of weekly timesheets in the absence of the office manager, to maintain payroll continuity.
Assist in covering the front desk and referrals when necessary.
Referrals Coordinator/Records
Progressive Medical Associates, PLLC
Huntersville, NC
05.2019 - 10.2023
Overhauled the system from paper to computer-based referrals.
Created an online rolodex of providers to whom the office refers.
Obtained prior authorizations, utilizing medical knowledge to answer clinical questions.
Created and faxed specialist and imaging referrals.
Maintained and updated referral forms as needed to ensure accuracy and current information.
Provided smooth and efficient patient check-outs, while arranging timely follow-up appointments.
Created patient portals and addressed all calls from patients with technical portal questions.
Pulled, created an invoice, and then faxed records requested by patients, attorneys, and insurance companies.
Facilitated the secure and timely transfer of medical records between providers and specialists to support continuity of care.
Updated the online rolodex with providers from whom records were being requested.
Assisted with incoming calls and scheduling appointments.
Worked closely with the office manager to create and execute policies that improved operational efficiency and compliance.
Functioned as the go-to resource for staff and providers during the office manager's absence.
Lead Teacher
Denver United Methodist Church Preschool
Denver, NC
09.2014 - 05.2019
Planned and executed activities to promote the physical, social, and emotional development of four-year-old children in preparation for kindergarten.
Administered assessments for each child, and tracked results.
Maintained frequent and open communication with parents via email, telephone, and in-person conferences.
Answered inquiries and addressed, resolved, or escalated issues to management personnel to ensure parent satisfaction.
Finance Department Assistant
Mega Force Temporary Agency
Mooresville, NC
01.1997 - 01.1998
Assisted with Accounts Payable and Accounts Receivable.
Worked on general accounting projects and reports.
Verified data integrity and accuracy.
First assignment as the Finance Department Assistant at PGI Nonwovens led to a year of full-time, temporary work, followed by a job offer.
Insurance Billing Specialist
Carpenter Chiropractic
Bridgeport, CT
08.1995 - 06.1996
Handled all phases of Worker's Compensation and private insurance billing for five doctor practice.
Responded to patient inquiries via telephone.
Entered details such as payments, account information and call logs into the computer system.
Verified data integrity and accuracy.
Office Manager
Vision Center LTD.
Shelton, CT
08.1990 - 07.1995
Maintained computer and physical filing systems.
Received, screened and routed incoming calls.
Scheduled appointments.
Transcribed dictated files.
Processed all patient insurance claims.
Lead the hiring process for new employees, from screening to selection.
Trained all employees in insurance processing.
Researched and acquired employee benefits plan.
Reconciled checkbook.
Insurance Coordinator/Bookkeeper
Jon Chadys, D.M.D.
Monroe, CT
10.1988 - 06.1990
Filed dental, Worker's Compensation, and auto accident insurance claims for patients.
Supervised billing, bookkeeping, and payroll.
Education
Bachelor of Arts - Corporate Communications
Southern Connecticut State University
New Haven, CT
01.1988
Skills
Customer service orientation
Insurance claim processing
Billing reconciliation
Patient account management
Medical coding
Data entry accuracy
Attention to detail
Team collaboration
Insurance verification
Training and mentoring
Personable demeanor
Computer proficiency
Multi-tasking skills
Organizational abilities
Clear communication skills
Punctuality
Accounts receivable management
Working independently
Volunteer Experience
St. Therese Church, Library Committee Member, 01/01/11, 12/31/19
Rock Springs Elementary School PTO, Board Member, 01/01/04, 12/31/10
Boy Scouts of America, Tiger Cub Den Leader, 01/01/07, 12/31/08
Bridgeport Hospital, Volunteer Cuddler-Newborn Intensive Care Unit, 01/01/91, 12/31/93