Elona Arqimandriti
Naples,FL
Summary
Analytical Claims Manager managing internal functions of teams, promoting high levels of quality production and overseeing specialized operational functions. Constructed concurrent objectives to promote efficiency and influence positive outcomes. Dedicated to team success while solving problems with minimal oversight.
Overview
8
8
years of professional experience
Work History
Claims Manager
GenesisCare
Naples, FL
07.2017 - Current
- Took billing calls, questions and concerns from patients and third party carriers.
- Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
- Entered patient charges and payments into electronic health records.
- Identified discrepancies and carrier issues regarding billing and reimbursements.
- Corrected, completed and processed claims for payer codes.
- Protected medical office operations and integrity by keeping patient information confidential.
- Processed refund requests and reconciled deposit and patient collections.
- Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
- Attended provider meetings and workshops when appropriate.
- Submitted claims to insurance companies.
- Managed all payments processing, invoicing and collections tasks.
- Monitored past due accounts and pursued collections on outstanding invoices.
Health Information Management Specialist
Physicians Regional Medical Center
Naples, FL
09.2015 - 09.2017
- Upgraded medical record documentation system to meet federal and state regulations, continually monitored medical records and contacted physicians for deficient or delinquent data.
- Facilitated document import into electronic health records using variety of applications and workflows, executed scanning and indexing and organized patient records for quick reference.
- Created and updated statistical reports required by applicable legal, accrediting and licensing health information bodies and proactively maintained current mastery of such requirements.
- Addressed customer information requests promptly and courteously, maintained strict confidentiality and respect and identified potential improvements to inquiry response processes.
- Determined and implemented techniques to improve medical records retrieval process.
- Worked with physicians and nurses to find methods to improve quality of patient health documents and records.
Education
Bachelor of Science - Healthcare Services Administration
Hodges University
Naples, FL04.2014
Skills
- Reimbursement Management
- Issue Resolution
- Analytics Skills
- Contract Negotiation
- Billing and Collections Procedures
- Team Assistance and Oversight
- File Management
- Effective Customer Communication
- Policy Evaluation
- Financial Calculation
- Client Service
- Clerical Writing
- Vision Planning
- Program Design
- Forecasting Skills
- Vendor Relationship Management
- Conflict Resolution
- Supervision & Leadership
- Good Work Ethic
- Critical Thinking
Timeline
Claims Manager
GenesisCare
07.2017 - Current
Health Information Management Specialist
Physicians Regional Medical Center
09.2015 - 09.2017
Bachelor of Science - Healthcare Services Administration
Hodges University
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