Elizabeth schaeffer
Flagstaff
Summary
Dedicated Medical Billing Specialist with over 20 years of experience in insurance claims processing and accounts receivable management. Proven ability to resolve billing discrepancies and enhance patient communication while maintaining strict HIPAA compliance.
Overview
20
20
years of professional experience
Work History
Medical Billing Specialist
North Country HealthCare
Flagstaff
07.2006 - Current
- Process insurance claims for various healthcare services and procedures.
- Verify patient information and insurance eligibility before billing.
- Review and resolve billing discrepancies with healthcare providers.
- Maintain accurate patient records in electronic health systems.
- Communicate with patients regarding billing inquiries and payment options.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Adhered to HIPAA regulations when handling confidential patient information.
- Completed appeals and filed and submitted claims.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Reviewed and corrected rejected claims to facilitate prompt resubmission for payment.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Provided customer service support to patients who had questions about their bills or payments due.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Ensured HIPAA compliance by maintaining confidentiality of all patient information.
- Resolved discrepancies between insurance companies and patients regarding payment of bills.
- Collaborated closely with other departments to resolve claims issues.
- Monitored aging accounts receivable balances to expedite resolution of outstanding payments.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Submitted claims to insurance companies.
- Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Submitted appeals using provider portals and phone communication.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Applied HIPAA privacy and security regulations while handling patient information.
- Conducted research on insurance policies, procedures, and regulations to ensure compliance with all applicable laws.
- Meticulously tracked and resolved underpayments.
- Maintained timely and accurate charge submission through electronic charge capture, including billing, and account receivables (BAR) system and clearing house.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
Education
High School Diploma -
Coconino High School
Flagstaff, AZ06-1977
Skills
- CPT and ICD-10 coding
- Medical billing
- Claims processing
- Billing compliance
- Insurance claims management
- Accounts receivable management
- Accounts receivable monitoring
- Claims processing proficiency
- Claim denial resolution
- Insurance verification
- Billing discrepancies resolution
- Thorough claims reviews
- Quality assurance checks
- Healthcare billing
- Private insurance policies
- Medicaid guidelines
- HIPAA compliance
- Medical Terminology Familiarity
- Patient communication
- Problem-solving
- Problem solving
- Communication skills
- Billing discrepancies resolution
Timeline
Medical Billing Specialist
North Country HealthCare
07.2006 - Current
High School Diploma -
Coconino High School