Heather Duhaime
Lincroft
Summary
Experienced with medical billing processes, including claim submission and follow-up. Utilizes knowledge of insurance guidelines to ensure accurate and timely billing. Track record of effective communication and problem-solving, consistently supporting healthcare providers' financial goals.
Professional with strong expertise in medical billing, bringing reliable and adaptable approach to navigating evolving needs. Proven track record in team collaboration and achieving results through effective communication and problem-solving. Skilled in coding, claims processing, and patient account management, with keen eye for accuracy and compliance. Known for dependability and focus on efficiency, ready to contribute to streamlined billing operations.
Overview
12
12
years of professional experience
Work History
Medical Biller/Account Resolution Specialist
Mill Basin Multi Medicine
04.2011 - 05.2023
- Filed and updated patient information and medical records.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Supported efficient scheduling practices by verifying patient eligibility and coverage prior to appointments.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.
- Organized filing system for patient records, expediting access to essential documents when needed.
- Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Adhered to established standards to safeguard patients' health information.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Verified insurance of patients to determine eligibility.
- Liaised between patients, insurance companies, and billing office.
- Delivered timely and accurate charge submissions.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Streamlined billing processes by implementing efficient procedures to improve accuracy and reduce errors.
- Initiated peer review system for billing codes used, which significantly minimized coding discrepancies.
- Enhanced accuracy of insurance claims with meticulous verification and updating of patient records.
- Negotiated with insurance providers to resolve payment disputes, ensuring fair compensation for services rendered.
- Orchestrated transition to ICD-10 coding system, minimizing disruptions to billing operations.
- Conducted detailed analyses of billing cycles to identify patterns and implement strategies for reducing delays in payments.
- Used data entry skills to accurately document and input statements.
- Monitored outstanding invoices and performed collections duties.
- Audited and corrected billing and posting documents for accuracy.
Education
Bachelor of Science - Mental Health And Human Services
Kingsborough Community College
Brooklyn, NYNo Degree - Credentialed Alcohol And Substance Abuse Councelor
Kingsborough Community College
Brooklyn, NYSkills
- Insurance claims
- Insurance billing
- Medical billing
- Electronic claims
- HIPAA compliance
- Patient billing
- CPT knowledge
- Customer service
- Billing and collection procedures
- Accounts receivable
- Insurance claims processing
- Claim submission
- Medicare and medicaid process
- Data entry
- Denial management
- CMS-1500 billing forms
- Payment posting
- ICD-10
- Patient account analysis
- ICD-10 proficiency
- Claims review
- Records management
- Multitasking and organization
- Account reconciliation
- Accounts receivable management
- Data analysis
- Account management
- Collections management
- Proficiency in eclipse
- Chart auditing
- Collection calls
- Invoice coding
- ICD-9
- Account follow-up
- CPT code modifiers
- Claim review
- Balance reconciliation
Timeline
Medical Biller/Account Resolution Specialist
Mill Basin Multi Medicine
04.2011 - 05.2023
Bachelor of Science - Mental Health And Human Services
Kingsborough Community College
No Degree - Credentialed Alcohol And Substance Abuse Councelor
Kingsborough Community College
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