Summary
Overview
Work History
Education
Skills
Timeline
Generic

Karen Scotti

Floral Park,NY

Summary

Efficient medical biller with 25 years of experience. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.

Overview

29
29
years of professional experience

Work History

Physician Biller

New York Hospital Queens
10.2005 - 02.2019
  • Verified insurance of patients to determine eligibility.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
  • Filed and updated patient information and medical records.
  • Ensured timely payments from insurance providers through submission of accurate and complete claims.
  • Collected payments and applied to patient accounts.
  • Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Delivered timely and accurate charge submissions.
  • Processed payment via telephone and in person with focus on accuracy and efficiency.
  • Maintained accurate records of customer payments.
  • Boosted customer satisfaction through professional handling of patient inquiries regarding billing matters and insurance coverage.
  • Ensured timely reimbursement for services by submitting clean claims to insurance carriers promptly.
  • Supported team members during periods of high workload or staff absences, ensuring uninterrupted service delivery in medical insurance billing operations.

Front Desk Receptionist

First Med
08.2003 - 09.2009
  • Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
  • Maintained organized and clean front office area to create professional and welcoming environment for visitors and employees.
  • Managed high-volume phone calls, directing inquiries to appropriate personnel for prompt resolution.
  • Collected room deposits, fees, and payments.
  • Supported administrative tasks such as filing, data entry, and document preparation for more efficient office workflow.
  • Completed data entry and filing to keep records updated for easy retrieval.
  • Expedited check-in and check-out procedures for guests, ensuring seamless experiences during their visits.
  • Resolved customer issues quickly and notified supervisor immediately when problems escalated.
  • Completed all tasks in compliance with company policies and procedures.
  • Maintained confidentiality of sensitive data to protect customer and business information.
  • Maintained accurate records of visitor logs for security purposes and compliance with company policies.
  • Welcomed customers with friendly greeting, answered general questions, gathered nature of visit and directed to specific offices.
  • Resolved customer problems and complaints.
  • Organized, maintained and updated information in computer databases.
  • Delivered outstanding first impressions by warmly greeting visitors upon arrival at the front desk.

Senior Medical Biller

Staffbuilders/TLC
08.1998 - 08.2005
  • Negotiated payment plans with patients experiencing financial difficulties, demonstrating empathy while maintaining professionalism.
  • Resolved complex billing issues through meticulous research, collaboration with colleagues, and effective communication with insurance carriers.
  • Reduced claim denials by diligently reviewing patient information and verifying insurance coverage.
  • Verified all home health care visits
  • Assigned to special billing projects


Team Leader/Billing Specialist

A&J Care
06.1992 - 08.1998
  • Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
  • Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
  • Managed conflict resolution among team members, fostering a positive and collaborative work environment.
  • Maintained an inclusive and diverse team culture, promoting respect and understanding among all members.
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Worked with multiple departments to check proper billing information.
  • Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
  • Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
  • Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.

Workers' Compensation Claims Representative/Billing Specialist

First Med
12.1989 - 06.1992
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Followed up with customers on unresolved issues.
  • Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
  • Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
  • Trained new Claims Representatives on company policies, procedures, and software systems, improving overall team productivity.
  • Provided exceptional customer service, addressing concerns and resolving issues promptly.
  • Collaborated with legal teams to defend against unjustified claims, protecting company assets.
  • Streamlined data entry processes, improving efficiency in claim file management.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Checked documentation for accuracy and validity on updated systems.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Worked with multiple departments to check proper billing information.
  • Negotiated with insurance companies to resolve disputed claims, securing rightful payments.

Education

Associate of Arts - Liberal Arts

Queensborough Community College
Oakland Gardens, NY

Skills

  • Medical Billing Software Proficiency
  • HIPAA compliance awareness
  • Medicare and Medicaid knowledge
  • Claims Processing Proficiency
  • Denial Resolution Techniques
  • Organizational abilities
  • Continuous Learning Attitude
  • Payment Posting Abilities
  • Patient Confidentiality Maintenance
  • Insurance Appeals Handling
  • Teamwork and Collaboration
  • Customer Service
  • Billing and Collection Procedures
  • Multitasking and Organization
  • Claims review
  • Insurance claims processing
  • CMS-1500 Billing Forms
  • Critical Thinking
  • Problem-solving abilities
  • Payment Processing
  • Microsoft Outlook
  • Follow-up skills

Timeline

Physician Biller

New York Hospital Queens
10.2005 - 02.2019

Front Desk Receptionist

First Med
08.2003 - 09.2009

Senior Medical Biller

Staffbuilders/TLC
08.1998 - 08.2005

Team Leader/Billing Specialist

A&J Care
06.1992 - 08.1998

Workers' Compensation Claims Representative/Billing Specialist

First Med
12.1989 - 06.1992

Associate of Arts - Liberal Arts

Queensborough Community College

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Karen Scotti