Karen Schultze
North Miami Beach
Summary
Dedicated professional seeking a full-time position in a dynamic environment that fosters growth and development. Eager to leverage a diverse skill set to contribute effectively while continuously enhancing expertise. Committed to delivering high-quality results and collaborating with teams to achieve organizational goals. Passionate about embracing new challenges and driving success in every endeavor.
Overview
17
17
years of professional experience
Work History
Hedis Specialist/Medical Biller
Chen Medical Corp.
01.2014 - 01.2025
- Medical Record Review and Collection
- Data Analysis and Reporting Healthcare Data
- Data Collection and Abstraction
- Billing - Fee for Service
- Billing - High Risk Claims
- Verifying ICD-10 Codes
- Correspondence to offices regarding Verifications for Vaccinations
- Hedis Auditor
- Patient Engagement and Outreach
- Compliance and Regulatory Adherence
- Billing - SNF/LSNF/Inpatient Hospital visits
- Verification of Eligibility in the AMD and Availity programs
- Billing - Home Visits in AMD and HEDIS
Medical Biller
Therapro Corp., Inc.
01.2013 - 01.2014
- Medicare/Medicaid Procedures
- Verification of primary insurer
- Handled MVA, WC, and Medical Claims
- Scan Documentation for Attorneys/Insurance Co.
- Itemization of Bills
- Sent and Handled Appeals for MVA, WC, Medical Claims
- Verification of payment status for each claim/appeal
- Correspondence to attorneys requesting LOP
- Investigations of Denials for MVA, WC, and Medical Claims
- Run and Read Eligibility/Checked Authorizations
Account Representative/Medical Biller
ASA Medical Billing Services
01.2012 - 01.2013
- Run and Read Eligibility
- Charge Entry Claim Transmission and Verification
- Scan Documentation
- Accounts Receivable
- CPT Code/ICD-9 Code
- Adherence to Policies and Practices
- Able to interpret which insurance company is Primary
- Medicare Procedures/Medicaid Procedures
- Manage Accounts
- Processed Medical Claims/Electronic Billing
- Internship
Office Manager/Assistant to the CEO
Disc Disease Solutions, Inc.
01.2008 - 01.2010
- Answered and Directed Incoming Calls
- Responsible for Shipping/Handling
- Coordinated Medical Inventory/Medical Supplies
- Accounts Receivable
- Clinical Assistance to Patients
- Customer Service/Office Procedures
- Scheduled Meetings with DME/Physicians/Patients
- Marketing of the Traction Belt to Physicians/DME
- Therapeutic Modalities
- Coordinated Medical Supply Events/Conventions
- Handled All Purchase Orders
- Researched Plane Tickets, Hotel and Limousine Services
- Provided Medical Diagnostic Codes for Spinal Injuries
- Provided San Marc Documentation to DME/Physicians
Education
Certified Medical Billing & Coding -
Institute of Science and Technology
West New York, NJ01.2013
Certified Medical Assistant - undefined
Finlay Medical Institute
West New York, NJ01.2011
Associate Degree - Business Administration
Berkeley Business College
West Paterson, NJ01.1998
Skills
- Experienced in Word, Excel, Outlook, and PowerPoint
- Financial transaction oversight
- Electronic health record management
- Medical inventory management
- Navi-Net and Emdeon expertise
- Medical Billing & Coding
- Skilled in using QuickBooks Pro 2009
- Support for clinical patients
- Certified Medical Assistant
- Client support and administrative tasks
- Skilled in Spanish-English translation
- Verification of insurance qualifications
- Scheduling coordination
- Managed MVA, WC, and medical claims
- Experience with Clinician software
- VMware virtualization expertise
- ICD-10 coding proficiency
- Processed workers' compensation claims
- Developing skills in AI cybersecurity
Languages
Spanish
Native or Bilingual
Timeline
Hedis Specialist/Medical Biller
Chen Medical Corp.
01.2014 - 01.2025
Medical Biller
Therapro Corp., Inc.
01.2013 - 01.2014
Account Representative/Medical Biller
ASA Medical Billing Services
01.2012 - 01.2013
Office Manager/Assistant to the CEO
Disc Disease Solutions, Inc.
01.2008 - 01.2010
Certified Medical Assistant - undefined
Finlay Medical Institute
Associate Degree - Business Administration
Berkeley Business College
Certified Medical Billing & Coding -
Institute of Science and Technology