Kelsey Sandberg
Grantsburg ,WI
Summary
Dynamic Billing Specialist with expertise in medical billing and claims processing at Osceola Medical Center. Proven ability to resolve discrepancies and streamline prior authorization processes, enhancing patient satisfaction. Strong attention to detail and conflict resolution skills contribute to effective patient account management and improved billing accuracy.
Overview
6
6
years of professional experience
Work History
Billing Specialist
St Croix Health
08.2024 - Current
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- 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.
- Maximized revenue potential by identifying and resolving under-billed accounts.
Prior Authorization Specialist
St Croix Health
12.2023 - 08.2024
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
Billing Specialist
Osceola Medical Center
01.2021 - 11.2023
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- 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.
Prior Authorization
Osceola Medical Centet
01.2020 - 01.2021
- Acted as a liaison between patients, healthcare providers, and insurance companies to facilitate prior authorization approvals for necessary medications and procedures.
- Conducted thorough reviews of medical records, identifying necessary documentation to support prior authorization requests.
- Developed strong working relationships with insurance companies to streamline prior authorization processes.
Patient Scheduling
Osceola Medical Center
07.2019 - 01.2020
- Optimized patient scheduling by coordinating appointments with various medical specialists involved in the treatment process.
- Enhanced workflow efficiency by assisting in managing patient scheduling for radiologic examinations.
- Streamlined patient scheduling to accommodate emergency appointments and reduce wait times.
- Streamlined workflow by efficiently managing patient scheduling, documentation, and case followups.
Education
Bachelor Of Health Science - Health Management
University of Wisconsin, Stevens Point
Stevens Point, WI05.2019
Skills
- Billing systems and software
- Insurance verification
- Invoice processing
- Customer service
- Claims processing
- Decision-making
- HIPAA compliance
- Claim submission
- Denial management
- Medical billing expertise
- Patient account management
- Research and due diligence
- Problem-solving
- Attention to detail
- Conflict resolution
- Insurance claim processing
- Billing software proficiency
Timeline
Billing Specialist
St Croix Health
08.2024 - Current
Prior Authorization Specialist
St Croix Health
12.2023 - 08.2024
Billing Specialist
Osceola Medical Center
01.2021 - 11.2023
Prior Authorization
Osceola Medical Centet
01.2020 - 01.2021
Patient Scheduling
Osceola Medical Center
07.2019 - 01.2020
Bachelor Of Health Science - Health Management
University of Wisconsin, Stevens Point
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