Julianne Turner
Philippi
Summary
Dynamic Medical Billing Specialist with expertise in Medicare HMO billing at Davis Medical Center. Proven track record in denial management and claim submission, enhancing revenue cycle efficiency. A quality-oriented team player skilled in Quadax and committed to maintaining HIPAA compliance while fostering positive relationships with payers and colleagues.
Overview
5
5
years of professional experience
Work History
Medical Billing Specialist
Davis Medical Center
07.2023 - Current
- Review and resolve claim edits in Quadax for Medicare HMO payers prior to submission.
- Investigate and work rejected claims in Quadax, ensuring timely resubmission.
- Conduct regular follow-ups with Humana Medicare, Aetna Medicare, and UnitedHealthcare to expedite claim processing and payment.
- Manage and respond to billing-related emails and payer inquiries in a timely manner.
- Combine multiple patient visits into a single claim to ensure proper billing.
- Identify and process late charges to maintain accurate and complete billing records.
- Contact insurance payers directly to resolve claim issues and facilitate payment.
- Identify and hold double visits to prevent duplicate billing.
- Utilize the Availity portal to review claim denials and submit appeals with appropriate documentation.
- Track and locate missing insurance payments to maintain financial accuracy.
- Analyze and resolve payer denials, ensuring proper reimbursement and compliance.
- Collaborate with coworkers, supervisors, and other departments to resolve billing discrepancies.
- Submit appeal packets with medical records to challenge unjust denials.
- Coordinate with the credentialing specialist to ensure billing readiness for new providers.
- Partner with the coding department to correct coding errors and facilitate claim approvals.
- Used data entry skills to accurately document and input statements.
Daycare Teacher
Cubbys ChildCare Center
01.2022 - 12.2022
- Sanitized toys and play equipment each day to maintain safety and cleanliness.
- Provided a safe and nurturing environment for children, regularly monitoring indoor and outdoor spaces for potential hazards.
- Actively encouraged children to develop their communication, problem-solving and social skills.
- Developed strong relationships with parents through regular communication about their child''s progress and needs.
- Assisted in preparation of meals and snacks to provide children with proper nutrition.
- Oversaw daily transitions between various activities such as snack time, outdoor playtime, naptime ensuring smooth operation of daily schedule.
- Gathered materials and resources to prepare for lessons and activities.
- Engaged with children on individual basis to build positive relationships and promote learning.
- Guided students through daily routines, instilling a sense of responsibility and independence within each child.
- Promoted language acquisition in young learners with engaging storytelling, songs, and word games.
- Intervened in disruptive behavior, using positive reinforcement strategies to redirect and calm children.
- Documented behavior, development and learning of children to enable tracking history and maintain accurate records.
- Collaborated with fellow daycare teachers to create a cohesive educational experience across all classrooms within the center.
- Led small group instruction tailored to each child''s unique abilities and interests, ensuring personalized attention during learning activities.
- Maintained open lines of communication with other staff members regarding any concerns or updates on individual students'' progress.
- Maintained tidy environment to comply with cleanliness and sanitation standards.
Student Assistant
Preferred Primary Care Physicians
04.2020 - 09.2022
- Maintained confidentiality of sensitive patient information by adhering to HIPAA regulations throughout all aspects of job duties.
- Increased patient satisfaction by providing compassionate assistance during medical visits.
- Reduced wait times by efficiently managing patient flow within the clinic setting.
- Promoted a positive work environment through effective teamwork and open communication among staff members.
- Contributed to the prevention of infections by sterilizing medical instruments and equipment according to established protocols.
- Enhanced clinic efficiency by maintaining accurate patient records and scheduling appointments.
- Demonstrated professionalism and ethical conduct by adhering to all established policies, procedures, and regulations within the healthcare setting.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Check in patients during Covid-19 making sure to follow all of the necessary precautions to prevent the spread.
Education
High School Diploma -
Albert Gallatin Senior High School
Uniontown, PA05-2022
Skills
- HIPAA compliance
- Claim submission
- Insurance verification
- Denial management
- Quadax
- Quality-oriented team player
- Insurance billing
- Medical billing
- ICD-10
- Claims review
- Multitasking and organization
- Knowledgeable in Medicare HMO billing
Timeline
Medical Billing Specialist
Davis Medical Center
07.2023 - Current
Daycare Teacher
Cubbys ChildCare Center
01.2022 - 12.2022
Student Assistant
Preferred Primary Care Physicians
04.2020 - 09.2022
High School Diploma -
Albert Gallatin Senior High School
Similar Profiles
Kaylee OursKaylee Ours
Registered Nurse at Davis Medical CenterRegistered Nurse at Davis Medical Center
Heidi DennisonHeidi Dennison
Registered Nurse, Medical-Surgical Unit at Davis Medical CenterRegistered Nurse, Medical-Surgical Unit at Davis Medical Center
Hannah HillHannah Hill
Registered Nurse at Davis Medical CenterRegistered Nurse at Davis Medical Center
Lillian CrissLillian Criss
Personal Clinical Associate at J.W. Ruby Memorial HospitalPersonal Clinical Associate at J.W. Ruby Memorial Hospital
Rachel CrossRachel Cross
Patient Care Manager at Preston Memorial Home CarePatient Care Manager at Preston Memorial Home Care