JENNIFER RIVERA
MEDICAL BILLING MANAGER
BOYNTON BEACH,FL
Summary
Accomplished Medical Billing Manager with a proven track record at Hematology Oncology /Genesis Care, enhancing revenue cycle management and leading teams to peak performance. Expert in claims processing and HIPAA compliance, I significantly reduced claim denials and fostered cross-departmental collaboration, showcasing exceptional teamwork and leadership qualities.
Overview
24
24
years of professional experience
Work History
Medical Billing Manager
Hematology Oncology /Genesis Care
11.2010 - Current
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Reviewed billing problems, researched issues, and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Served as an expert resource on complex patient account issues or high-dollar claims requiring specialized handling, ultimately resolving outstanding balances in an efficient manner.
- Trained team members on best practices in medical billing, ensuring consistent high-quality work across the department.
- Facilitated cross-departmental collaboration between clinical teams as well as finance and administrative staff to ensure seamless integration of billing-related tasks into daily workflows.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Supported financial director with special projects and additional job duties.
Medical Billing Lead
Hodge Biomotion Orthopedics
07.2005 - 10.2010
- Demonstrated leadership skills by delegating tasks effectively and providing support to team members, contributing to a cohesive and high-performing billing department.
- Managed accounts receivable aging reports, prioritizing collections efforts for overdue balances.
- Handled account payments and provided information regarding outstanding balances.
- Audited and corrected billing and posting documents for accuracy.
- Generated monthly billing and posting reports for management review.
- Monitored outstanding invoices and performed collections duties.
- Responded to customer concerns and questions on daily basis.
- Identified trends in denied claims, addressing root causes to prevent future issues and improve overall success rates.
- Reduced claim denials by meticulously reviewing and correcting billing errors before submission.
- Maintained strict adherence to HIPAA privacy guidelines, protecting sensitive patient information at all times during the billing process.
Medical Billing Specialist
Palm Beach Pain
05.2000 - 07.2005
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Posted and adjusted payments from insurance companies.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Delivered timely and accurate charge submissions.
- Posted payments and collections on regular basis.
- Generated monthly billing and posting reports for management review.
- Liaised between patients, insurance companies, and billing office.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Located errors and promptly refiled rejected claims.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Identified and resolved patient billing and payment issues.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
- Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
Education
High School Diploma -
Lake Worth High School
Lake Worth, FL 05.2001 -
Skills
Team Leadership Qualities
Accounts receivable management
Revenue Cycle Management
Claims Processing Proficiency
Payment Posting Proficiency
HIPAA Compliance Knowledge
Collections Process Handling
CPT Coding Understanding
ICD-10 Proficiency
Claims Processing Proficiency
Electronic Health Records Experience
Teamwork and Collaboration
Timeline
Medical Billing Manager
Hematology Oncology /Genesis Care
11.2010 - Current
Medical Billing Lead
Hodge Biomotion Orthopedics
07.2005 - 10.2010
High School Diploma -
Lake Worth High School
05.2001 -
Medical Billing Specialist
Palm Beach Pain
05.2000 - 07.2005