Denise Macaso
Manvel,TX
Summary
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
5
5
years of professional experience
Work History
Revenue Integrity Supervisor
Simple Laboratories
01.2024 - 05.2025
- Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Boosted customer satisfaction through professional handling of patient inquiries regarding billing matters and insurance coverage.
- Enhanced overall revenue collection by identifying and resolving billing discrepancies proactively.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Streamlined claim processing for faster payments by maintaining accurate patient records and insurance information.
- Ensured timely reimbursement for services by submitting clean claims to insurance carriers promptly.
- Supported team members during periods of high workload or staff absences, ensuring uninterrupted service delivery in medical insurance billing operations.
- Trained new employees on multiple medical billing programs and data entry software.
- Participated in regular audits of billing processes to maintain high-quality performance standards and identify areas for improvement.
- Assisted in policy development related to medical billing operations, contributing to the continuous improvement of organizational processes.
- Provided training sessions for new employees on best practices in medical insurance billing procedures and guidelines.
Client Services Team Lead
Lifescan Laboratories
01.2021 - 01.2024
- Enhanced client satisfaction by promptly addressing concerns and providing tailored solutions.
- Exceeded performance targets consistently, contributing to the success of the Client Services department.
- Proactively identified potential challenges facing clients, offering strategic support in navigating these situations successfully.
- Achieved timely resolution of client issues through effective collaboration with cross-functional teams.
- Mentored junior staff members, sharing expertise and guidance for professional growth within the company structure.
- Introduced innovative ideas that improved workflow processes, resulting in more efficient service delivery to clients.
- Managed escalations effectively by collaborating with relevant departments for quick resolutions while maintaining open lines of communication with affected clients.
Billing Specialist
Lifescan Laboratories
06.2020 - 01.2021
- Researched and resolved billing discrepancies to enable accurate billing.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Precisely evaluated and verified benefits and eligibility.
Education
Bachelor of Science - Psychology
San Pedro College
Philippines03-2015
Skills
- Achievement-focused
- Processes and procedures
- CPT knowledge
- Customer service
- ICD-10 proficiency
- Medicare and medicaid process
- Insurance claims
- Patient collections
- Process improvement
- Telcor experience
- HIPAA compliance
- Claim submission
- Insurance verification
- HIPAA compliance certification
- Insurance collections
Timeline
Revenue Integrity Supervisor
Simple Laboratories
01.2024 - 05.2025
Client Services Team Lead
Lifescan Laboratories
01.2021 - 01.2024
Billing Specialist
Lifescan Laboratories
06.2020 - 01.2021
Bachelor of Science - Psychology
San Pedro College
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