Karen Scotti
Floral Park,New York
Summary
Adaptable professional with a quick-learning ability and a talent for adjusting to new environments. Skilled in rapidly acquiring new knowledge and applying it effectively. Driven by a passion for continuous learning and successfully navigating change. Efficient Physician Billing Specialist known for high productivity and accurately completing billing tasks in fast-paced environments. Possess specialized skills in medical coding, claims processing, and compliance with healthcare regulations. Excel using critical thinking, problem-solving, and communication to navigate complex billing issues and enhance revenue cycle management.
Overview
13
13
years of professional experience
Work History
New York Hospital Queens
Lake Success, New York
10.2005 - 02.2019
- Performed data entry to enter patient demographics, insurance information and billing codes into practice management software.
- Processed reimbursement submissions received from healthcare providers
- Resolved discrepancies between insurance companies, patients and providers with regards to billing errors.
- Generated invoices for services rendered by physicians and other healthcare providers.
- Monitored aging accounts receivable balances in order to ensure timely payment from insurers.
- Implemented tactics for boosting collections of allocated debts
- Reviewed prior authorization submissions for completeness and accuracy prior to submission.
- Assisted in the preparation of monthly financial statements related to accounts receivable activities.
- Submitted appeals when necessary on denied or underpaid claims due to incorrect coding issues or missing documentation.
- Provided customer service support for patients regarding their account status, payments.
- Processed credit card payments received from patients utilizing secure online payment systems.
- Maintained detailed records of claim statuses including denials, appeals status, resubmissions and adjustments made on accounts receivable transactions.
- Conducted audits of electronic medical records systems in order to verify accuracy of billing codes associated with services provided.
- Corresponded with third party payers via phone calls or emails regarding claim resolution.
- Assisted in training new employees on various aspects of the billing process.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Input details into accounts and tracked payments.
- Handled billing, waivers and claims for private and commercial clients.
- Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
- Organized information for past-due accounts and transferred to collection agency.
- Answered customer questions to maintain high satisfaction levels.
- Submitted claims to insurance companies.
- Managed all payments processing, invoicing and collections tasks.
- Developed strong professional rapport with vendors and clients.
Education
Associate of Arts - General Studies
Queensborough Community College of The City University of New York
Oakland Gardens, NY02-2006
Skills
- HIPAA Compliance
- Claims Evaluation
- Analytical Problem Solving
- Efficient Payment Processing
- Insurance Eligibility Review
- Accounts receivable management
- Collection calls
- Account follow-up
- Patient Billing
- Claim review
- Work Prioritization
- Availity
- Athena
- TCMS
- Navinet
- epaces
- Billing and Collection Procedures
- Medical billing knowledge
- Insurance Verification
Timeline
New York Hospital Queens
10.2005 - 02.2019
Associate of Arts - General Studies
Queensborough Community College of The City University of New York
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