Emanuela Schmuelian
Great Neck,NY
Summary
Detail-oriented and professional individual with a strong emphasis on meeting deadlines. Possessing extensive expertise in the field of medical billing, skilled in handling complex billing processes with precision and accuracy. Experience includes successfully reconciling insurance and patient payments, as well as effectively resolving any account disputes that may arise.
Overview
9
9
years of professional experience
Work History
Medical Coding Supervisor
Mark Reynolds RCM
11.2023 - Current
- Increased efficiency within the department by delegating tasks strategically based on coder expertise and workload capacity.
- Assisted in recruitment efforts for new coding staff members, interviewing candidates and providing recommendations for hiring decisions.
- Promoted a positive work environment by addressing coder concerns promptly and effectively while fostering open lines of communication among team members.
- Supported continuous improvement initiatives within the department by actively participating in relevant conferences, workshops, or seminars related to medical coding best practices.
- Developed strong relationships with key stakeholders, including physicians and other healthcare professionals, to foster a collaborative approach toward accurate medical coding.
- Ensured adherence to organizational policies regarding patient privacy and confidentiality while handling sensitive medical information during the coding process.
- Reduced errors in medical coding by developing and maintaining a thorough understanding of current regulations, industry trends, and best practices.
- Maximized revenue recovery through effective management of denials related to incorrect or incomplete medical codes; collaborated with billing department to resolve issues promptly.
- Served as a liaison between the coding department and other hospital departments, addressing any concerns or discrepancies related to medical coding or reimbursement matters.
- Led the successful transition from ICD-9-CM to ICD-10-CM/PCS code sets within the organization, ensuring timely implementation and minimal disruption in workflow processes.
- Facilitated communication among coding staff through regular team meetings, fostering an environment of collaboration and knowledge sharing.
- Contributed to the development of departmental budgets by providing input on staffing needs, resource allocation, and projected expenses related to coding operations.
- Conducted internal audits of coded records to identify potential compliance issues or areas requiring additional training for coders.
- Managed a team of coders, providing guidance, support, and mentorship to enhance their professional growth and development.
- Monitored coder productivity to ensure timely completion of assignments while maintaining high-quality standards.
- Maintained up-to-date knowledge on ICD-10-CM/PCS codes as well as CPT-4 procedural codes through ongoing education efforts and certifications renewals when applicable.
- Enhanced coding accuracy by implementing regular training sessions and performance evaluations for coding staff.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Communicated with insurance companies to research and resolved coding discrepancies.
Medical Coding and Billing Specialist
Thriveworks Counseling And Coaching
01.2022 - 10.2023
- Provided exceptional customer service to patients, addressing their concerns regarding insurance claims or billing issues with empathy and professionalism.
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- Maintained patient confidentiality by adhering to strict HIPAA regulations during all aspects of the coding and billing processes.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Medical Billing Supervisor
Lewin, Fagen & Lown
11.2020 - 12.2022
- Maintained current accounts through aged revenue reporting.
- Complied with HIPAA privacy and security regulations to protect patients' medical records and information.
- Confirmed backup and proper storage of sensitive information in event of data breach or outage.
- Reviewed services rendered and completed to reconcile codes.
- Reviewed outgoing bills for eligibility and accurateness.
- Analyzed medical records to satisfy insurance company mandates.
- Researched and followed up on denied insurance claims.
- Devised new methods to improve billing workflows.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Trained new employees on multiple medical billing programs and data entry software.
Medical Billing and Coding Supervisor
Long Island Medical and Gastroenterology Group
09.2015 - 09.2020
- Experienced billing for Internal Medicine, Gastroenterology, Pathology, Ambulatory Surgery Center(UB-04 claims), Procedure, and Telehealth claims
- Ensure claims are entered and submitted within 48 hours of receipt
- Assign ICD to physician diagnosis and confirm correct level of service for CPT codes
- Set-up practice management software for submission of electronic claims to clearinghouse
- Retrieve and review Electronic Remittance Advice (ERA)
- Submit secondary claims upon processing of primary insurance payment
- Insurance denial management, correcting claims, and resubmission of claims
- Running monthly patient and insurance account receivables
- Posting payments and managing patient payment plans
Education
Medical Billing and Coding Program - Medical Billing And Coding
Sanford Brown Institute
Garden City, NY09.2015
Skills
- Excellent with Microsoft Word, Excel,Outlook, E-Clinical Works, Cure MD, Quickbooks
- Enthusiastic demeanor, bright attitude, team player and excellent customer service
- Computer savvy, fast typing skills, punctual and the ability to multitask independently
- ICD-10 Proficiency, HIPAA Compliant
- Performance Optimization
- Expert Programming
- HIPAA Compliance
- Claims Processing
- Clinical Documentation
- Insurance coding (ICD-9 and CPT)
- Training and mentoring
- Data Entry
- Insurance Verification
- Medical claims coding
- Medical Terminology
- Regulatory guidelines
- Workflow Management
- Document Management
- Performance Improvement
- Insurance claims analysis
- Revenue Cycle Management
- Coding Error Resolution
- Teamwork and Collaboration
- Customer Service
- Time Management
- Attention to Detail
- Problem-solving abilities
- Excellent Communication
- Organizational Skills
- ICD-10 Coding
- Electronic Health Records
- Microsoft Excel
- Self Motivation
- EMR Systems
Timeline
Medical Coding Supervisor
Mark Reynolds RCM
11.2023 - Current
Medical Coding and Billing Specialist
Thriveworks Counseling And Coaching
01.2022 - 10.2023
Medical Billing Supervisor
Lewin, Fagen & Lown
11.2020 - 12.2022
Medical Billing and Coding Supervisor
Long Island Medical and Gastroenterology Group
09.2015 - 09.2020
Medical Billing and Coding Program - Medical Billing And Coding
Sanford Brown Institute