Donna Cihak
La Mesa,CA
Summary
Dynamic Billing Referral Specialist with proven expertise at Akane Institute in enhancing patient care coordination and reducing appointment wait times. Skilled in insurance verification and patient communication, I streamlined referral processes, achieving significant improvements in efficiency and patient satisfaction. A proactive team player dedicated to maintaining data integrity and delivering exceptional customer service.
Overview
18
18
years of professional experience
Work History
Billing Referral Specialist
Akane Institute
10.2023 - 10.2024
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
- Promoted clear communication between primary care providers and specialists through detailed documentation and follow-up calls.
- Built professional relationships with service providers.
- Developed strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.
- Reduced wait times for specialist appointments by diligently following up on pending referrals.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Entered Type data using Software to document referrals and results.
- Obtained prior authorization for Type procedures.
- Enhanced patient satisfaction by promptly addressing inquiries and resolving issues related to referrals.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Verified insurance benefits and eligibility for Type procedures before referring clients.
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Assisted patients in navigating insurance requirements, facilitating approval of necessary treatments.
- Responded to patient inquiries to offer timely updates regarding referral status.
- Assisted with completion of referral forms and verified data accuracy and completion
- Processed referral requests from patients, doctors and other health care professionals.
- Performed various administrative tasks by filing, copying and faxing documents.
- Obtained payments from patients and scanned identification and insurance cards.
- Assisted with medical coding and billing tasks.
- Prepared and processed patient referrals and transfer requests.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Managed office bookkeeping with insurance billing and patient payments.
Medical Billing Coordinator
La Jolla Orthopedic Surgery
01.2020 - 12.2020
- Assisted in the implementation of new software systems designed to streamline billing processes, leading to increased accuracy and reduced administrative burden on staff members.
- Reduced claim denials and rejections by conducting thorough audits and addressing discrepancies prior to submission.
- Effectively resolved disputes regarding coverage eligibility or claim denials through professional communication with patients and insurance representatives alike.
- Improved billing accuracy by implementing stringent quality control measures and enhancing documentation processes.
- Identified areas for process improvement within the billing department, leading to increased productivity among team members.
- Streamlined medical billing procedures for increased efficiency, resulting in faster reimbursement rates for the healthcare facility.
- Coordinated with clinical teams to ensure proper documentation was received for accurate coding and claim submissions, reducing delays in reimbursements.
- Collaborated with insurance providers to expedite claims processing and secure timely payments for services rendered.
- Optimized cash flow management by accurately forecasting monthly collections based on historical trends and current payer mix.
- Increased revenue collection by diligently following up on outstanding payments and negotiating payment plans with patients when necessary.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Verified insurance of patients to determine eligibility.
- Filed and updated patient information and medical records.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Delivered timely and accurate charge submissions.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Adhered to established standards to safeguard patients' health information.
- Posted payments and collections on regular basis.
- Liaised between patients, insurance companies, and billing office.
- Handled account payments and provided information regarding outstanding balances.
- Generated monthly billing and posting reports for management review.
- Audited and corrected billing and posting documents for accuracy.
Medical Biller
Claim It Medical Billing and Collecting LLC
03.2007 - 06.2019
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Verified insurance of patients to determine eligibility.
- Filed and updated patient information and medical records.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Delivered timely and accurate charge submissions.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Posted payments and collections on regular basis.
- Liaised between patients, insurance companies, and billing office.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Initiated peer review system for billing codes used, which significantly minimized coding discrepancies.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Conducted detailed analyses of billing cycles to identify patterns and implement strategies for reducing delays in payments.
- Enhanced accuracy of insurance claims with meticulous verification and updating of patient records.
- Organized filing system for patient records, expediting access to essential documents when needed.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Optimized reimbursement process with insurance companies by establishing effective communication channels.
- Assisted patients in understanding insurance benefits, leading to a positive experience during their visit.
- Improved patient satisfaction by providing clear explanations of billing procedures and addressing billing inquiries promptly.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Reduced instances of denied claims, carefully reviewing and rectifying coding errors before submission.
- Achieved significant reduction in outstanding accounts receivables by implementing rigorous follow-up procedures with insurers and patients.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Negotiated with insurance providers to resolve payment disputes, ensuring fair compensation for services rendered.
- Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
- Maintained accurate records of customer payments.
- Used data entry skills to accurately document and input statements.
- Responded to customer concerns and questions on daily basis.
- Handled account payments and provided information regarding outstanding balances.
- Generated monthly billing and posting reports for management review.
- Utilized various software programs to process customer payments.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- 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.
- Processed vendor and supplier payments on weekly basis.
- Collaborated with customers to resolve disputes.
- Monitored outstanding invoices and performed collections duties.
Education
Associate Of Applied Business - Secretary Practices
Kelsey Jenney Business College
San Diego, CA09.1994
High School Diploma - General Studies
Abraham Lincoln High School
San Diego, CA06.1981
Skills
- Patient confidentiality
- Medical terminology
- Follow-up skills
- Appointment scheduling
- Data entry proficiency
- Insurance verification
- Pre-authorizations
- HIPAA regulations
- Patient scheduling
- Multi-line telephone operation
- Medical terminology knowledge
- Scheduling software
- Notetaking and documentation
- Medical scheduling
- Outbound calls
- Referral tracking
- Insurance precertification processes
- Electronic patient charts
- Teamwork
- Patient care coordination
- Customer service
- Problem-solving
- Time management
- Multitasking
- Insurance authorizations
- Excellent communication
- HIPAA compliance
- Organizational skills
- Patient referral
- Self motivation
- Time management abilities
- Patient registration
- Office administration
- Data entry
- Team collaboration
- Effective communication
- Verbal and written communication
- Documentation review
- Active listening
- Problem-solving aptitude
- Reliability
- Data entry software
- Filing systems
- Professionalism
- Flexible schedule
- Interpersonal skills
- CPT coding
Timeline
Billing Referral Specialist
Akane Institute
10.2023 - 10.2024
Medical Billing Coordinator
La Jolla Orthopedic Surgery
01.2020 - 12.2020
Medical Biller
Claim It Medical Billing and Collecting LLC
03.2007 - 06.2019
Associate Of Applied Business - Secretary Practices
Kelsey Jenney Business College
High School Diploma - General Studies
Abraham Lincoln High School
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