Microsoft Office
DIANA SHACKLETT
Customer/Client Relations Specialist
LINTON,IN
Summary
Certified Medical Billing Specialist with 11 years of experience in fast-paced, multiple-client medical billing company serving large private practice conglomerates and outpatient clinics. Researched denied claims and submitted appeals. Familiar with health billing and collections. Competent office manager and billing specialist with 11 years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices. Reliable and competent Medical Billing professional with exceptional data entry and customer service skills.
Overview
29
29
years of professional experience
Work History
Medical Billing Specialist/Office Manager
Physicians Service Bureau
10.2013 - Current
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Located errors and promptly refiled rejected claims.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- 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.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Collected payments and applied to patient accounts.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Precisely evaluated and verified benefits and eligibility.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Filed and updated patient information and medical records.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Liaised between patients, insurance companies, and billing office.
- Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
- Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Prepared billing correspondence and maintained database to organize billing information.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Contributed to overall office organization by maintaining up-to-date records of all billed services and payments received.
- Evaluated patients' financial status and established appropriate payment plans.
- Continuously updated knowledge of industry regulations and compliance requirements, ensuring adherence to all applicable standards.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
- Educated colleagues on best practices in medical billing, providing ongoing training sessions as needed.
- Developed customized reports for management review, highlighting trends in key performance metrics such as claim denial rates and days outstanding for accounts receivable balances.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Posted payments and collections on regular basis.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Delivered timely and accurate charge submissions.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Adhered to established standards to safeguard patients' health information.
- Responded to customer concerns and questions on daily basis.
- Collaborated with customers to resolve disputes.
- Used data entry skills to accurately document and input statements.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Audited and corrected billing and posting documents for accuracy.
- Maintained accurate records of customer payments.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Generated monthly billing and posting reports for management review.
- Handled account payments and provided information regarding outstanding balances.
- Processed vendor and supplier payments on weekly basis.
- Monitored outstanding invoices and performed collections duties.
- Facilitated smooth transitions during periods of organizational change by effectively communicating new technologies'' benefits.
- Enhanced team productivity through the development of comprehensive training programs for new software applications.
- Conducted regular audits of existing systems to identify areas for improvement, streamlining their functionality where possible.
- Reduced downtime by proactively addressing IT issues and providing timely resolutions.
- Collaborated closely with senior leadership to develop strategic plans aligned with company objectives, leveraging technology as a competitive advantage.
- Implemented cybersecurity best practices to protect sensitive company data from potential threats or breaches.
- Streamlined office operations by implementing efficient technical systems and processes.
- Ensured compliance with industry regulations by maintaining up-to-date knowledge of relevant laws and guidelines pertaining to technology use in the workplace.
- Improved customer satisfaction by ensuring seamless communication between the technical department and other business units.
- Identified opportunities for process improvements using data analysis techniques, leading to increased operational efficiency and cost savings.
- Mentored junior staff members in technical competencies, fostering a culture of continuous learning throughout the organization.
- Fostered an environment conducive to innovation by encouraging open dialogue about emerging trends and technological advancements.
- Led cross-functional teams to complete complex technical projects on time and within budget constraints.
- Organized and updated databases, records and other information resources.
- Created organized filing system to manage department documents.
- Identified opportunities to streamline processes and improve office operations and efficiency.
- Created reports, presentations and other materials for executive staff.
- Coordinated office events, seminars and meetings for staff and clients.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Maintained primary relationship accountability for clients, overall servicing responsibility and client satisfaction to maximize profitability of client relationships.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
- Implemented project management techniques to overcome obstacles and increase team productivity.
- Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
- Created improved filing system to maintain secure client data.
Postal Service Employee
USPS, United States Postal Service
08.2013 - 10.2013
- Fostered strong relationships with local businesses through reliable pick-up and delivery services tailored to their specific needs.
- Ensured compliance with all USPS regulations while performing daily tasks such as mail collection, sorting, and delivery.
- Expedited package delivery with careful attention to detail, ensuring proper handling and routing of parcels.
- Enhanced the reputation of the postal service through exemplary customer interactions, fostering trust and loyalty among patrons.
- Improved mail delivery efficiency by accurately sorting and organizing mail for carrier routes.
- Demonstrated adaptability during peak seasons or high-volume periods by effectively balancing quality service provision with time management strategies.
- Sorted and placed mail into mailboxes and post office boxes with high levels of accuracy.
- Increased customer engagement using personalized service approaches that demonstrate an understanding of individual preferences.
Customer Service Associate Hardware Store
Shields Hardware
10.2010 - 04.2012
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Handled customer complaints professionally, resulting in satisfactory outcomes and positive feedback.
- Maintained a high level of product knowledge, providing accurate information to customers.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Enhanced customer satisfaction by effectively addressing inquiries and resolving issues.
- Developed strong relationships with clients through attentive listening and empathetic understanding of their needs.
- Trained new associates in customer service protocols, elevating overall team's performance.
- Enhanced customer loyalty by providing empathetic and efficient resolution to issues.
Customer Service Rep & Data Entry
Samsonite /Halcyon Outdoor Patio Furniture
Bradenton, FL
02.1996 - 05.1997
- Coordinated with logistics department to expedite shipping for urgent customer orders.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Participated in cross-functional teams to discuss ways to improve overall customer satisfaction across company.
- Responded proactively and positively to rapid change.
- Developed feedback system for customers to share their service experience, leading to actionable improvements.
- Sought ways to improve processes and services provided.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Responded to customer requests for products, services, and company information.
- Collected and returned unpurchased or returned items to correct shelf locations and arranged displays to promote sales.
- Resolved escalated customer issues, restoring confidence in company's commitment to service excellence.
- Calculated correct order totals, updated accounts, and maintained detailed records for inventory management.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
- Managed timely and effective replacement of damaged or missing products.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Increased efficiency and performance by monitoring team member productivity and providing feedback.
Education
High School Diploma -
Southeast High School
Bradenton, FLAssociate of Science - Cosmetology
Manatee Technical College
Bradenton, FL1991
Skills
- HIPAA Compliance
- Payment posting
- Claim submission
- Insurance Verification
- Patient Billing
- CPT Knowledge
- ICD-10 Proficiency
- Medicare and Medicaid process
- Bill payment
- Insurance Claims
- Billing and Collection Procedures
- Data Entry
- Commercial and Private Insurance
Timeline
Medical Billing Specialist/Office Manager
Physicians Service Bureau
10.2013 - Current
Postal Service Employee
USPS, United States Postal Service
08.2013 - 10.2013
Customer Service Associate Hardware Store
Shields Hardware
10.2010 - 04.2012
Customer Service Rep & Data Entry
Samsonite /Halcyon Outdoor Patio Furniture
02.1996 - 05.1997
High School Diploma -
Southeast High School
Associate of Science - Cosmetology
Manatee Technical College
Certification
- Microsoft Office Specialist (MOS) Certification
- Certified Data Professional (CDP)
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Work Preference
Work Type
Full TimePart TimeWork Location
RemoteImportant To Me
Work-life balanceWork from home optionPaid time offPaid sick leave401k match4-day work weekCareer advancementPersonal development programsFlexible work hoursQuote
My Father has always said to " Find a job that you love, and you'll never have to work a day in your life"
Software
Adobe
Kaspersky
Norton
Interests
To have quality time with my daughters and my grandchildren
Similar Profiles
Raymond StoneRaymond Stone
Customer Service Representative II at Wisconsin Physicians Service InsuranceCustomer Service Representative II at Wisconsin Physicians Service Insurance
Sheryl TorresSheryl Torres
Manager, Provider Outreach and Education at Wisconsin Physicians Service InsuranceManager, Provider Outreach and Education at Wisconsin Physicians Service Insurance
Luke MullinsLuke Mullins
Emergency Medical Technician at Physicians Ambulance ServiceEmergency Medical Technician at Physicians Ambulance Service
Mackenzie ShawMackenzie Shaw
Machine Operator at Hershey'sMachine Operator at Hershey's
Dorothy ToerpeDorothy Toerpe
Care Giver at Cheryl MeyersCare Giver at Cheryl Meyers