KELLY M FARIA
FALL RIVER,MA
Summary
Detail-oriented and quality-focused billing manager with over 20 years of comprehensive experience in the healthcare industry. Proven track record of successfully handling complex assignments and delivering exceptional results. Highly skilled in reconciling insurance and patient payments, resolving account disputes, and implementing efficient billing practices. Proficient in a wide range of practice management software applications, with a strong ability to adapt to new systems quickly. I am known for excellent communication skills and a collaborative approach to problem-solving, consistently enhancing operational efficiency and contributing to improved patient satisfaction.
Overview
21
21
years of professional experience
Work History
Medical Billing Manager
New Medical Billing
10.2004 - Current
- Improved revenue for most recent provider over 32% with same patient load
- Experienced billing for Cardiologist, Speech Pathologist, Durable Medical Equipment, and Mental Health specialties
- Ensure claims are entered and submitted with 48 hours of receipt
- Accurately apply payments to patient accounts
- Post and reconcile insurance and patient payments. Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
- Insure accuracy of insurance claims. Verify correct ICD-9 and CPT codes for a variety of specialties
- Set up new patient accounts
- Assign ICD-10 to physician’s diagnosis and insure correct level of service and various other CPT codes
- Set-up practice management software for submission of electronic claims to clearinghouse. Work with clearinghouse to resolve file compatibility issues
- Retrieve Electronic Remittance Advice (ERA’s)
- Send secondary claims upon processing of primary insurance.
- Monthly processing of Patient statements. Answer and resolve patient billing inquires
- Follow up on Insurance and patient aging. Re-submit insurance claims as necessary. Knowledgeable in timely filing restrictions
- Reference: Available upon request
- Reviewed billing problems, researched issues, and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Increased patient satisfaction by addressing billing inquiries promptly and professionally.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Managed a team of dedicated medical billers, focusing on professional development opportunities and maintaining a positive work environment conducive to high levels of productivity.
- Streamlined claim appeals process by creating clear documentation guidelines and templates for staff use.
- Enhanced revenue cycle management by overseeing timely and accurate claims submission.
- Developed policies and procedures for the medical billing department, establishing a strong foundation that supported growth and operational success within the organization.
- Collaborated with providers and staff to ensure accurate coding for billing purposes.
- Optimized cash flow by regularly reviewing aging account balances and implementing tactics for timely collections from patients or insurers.
- Analyzed reports to identify areas for improvement in the overall billing process, leading to increased revenue collection rates.
- 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.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Improved medical billing processes by streamlining workflows and implementing efficient systems.
- Implemented new software systems for better tracking of accounts receivable and payable balances.
- Achieved key performance metrics goals by setting expectations for the team''s output quality standards while monitoring progress toward objectives closely throughout each reporting period.
- Evaluated vendor contracts for external services such as collections agencies or clearinghouses, negotiating favorable terms that improved bottom-line results.
- 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.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Conducted performance reviews and implemented improvement plans.
- Performed testing for billing modules, enhancing new functionality and process improvements.
- Established and checked coding procedures, monitored reports and updated internal files.
- Established internal audit procedures to validate and improve accuracy of financial reporting.
- Developed strategic plans for day-to-day financial operations.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Utilized financial software to prepare consolidated financial statements.
- Analyzed business processes to identify cost savings and operational efficiencies.
- Complied with established internal controls and policies.
- Designed and maintained financial models to identify and measure risks.
- Supported financial director with special projects and additional job duties.
- Improved overall financial reporting by streamlining control processes and reporting structures.
- Performed banking, business administration and financial tasks to guarantee five-star service for clients.
- Created and managed financial models to evaluate corporate investments and acquisitions.
- Conducted financial due diligence on potential investments and acquisitions.
- Prepared cash flow projections, cost analysis and monthly, quarterly and annual reports.
- Evaluated and negotiated contracts to procure favorable financial terms.
- Implemented and regularly reviewed financial controls to generate accurate and reliable financial data.
- Created financial dashboards to provide insights into key performance indicators.
Education
Associate of Science - Occupational Therapy
Bristol Community College
Fall River, MA07-2017
Skills
- ICD-9 and CPT-10 coding
- Insurance claims management
- Strong communication skills
- Skilled in utilizing various practice management tools
- Consistent on-time delivery
- Medical billing expertise
- Skilled in Microsoft Word, Excel, and Outlook
- Insurance management
- Understanding of HIPAA standards
- Claims management and ERA handling
- Bilingual proficiency in English and Portuguese
- Highly organized with strong attention to detail
- Supportive team participant
- Demonstrated problem resolution ability
Languages
English
Full Professional
Portuguese
Native or Bilingual
Timeline
Medical Billing Manager
New Medical Billing
10.2004 - Current
Associate of Science - Occupational Therapy
Bristol Community College
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