Kevin Silva
Miami,FL
Summary
Extensive knowledge of billing and coding. Highly skilled in reviewing the patient’s chart/documents and assigning medical codes by ensuring 100% accuracy. Relentless professional known for working hard to determine risk levels. A well-spoken Fraud Analyst promoting exemplary talents in reviewing accounts and identifying issues.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Customer Service Representative Mentor
Sitel Nicaragua
02.2015 - 01.2017
- Helping customers to place orders online, replacement orders, refunds, mentoring groups, escalation support
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Reduced fraudulent activities by thoroughly investigating suspicious transactions and reporting findings to management.
- Enhanced customer trust by promptly addressing their concerns regarding potential fraud incidents and providing recommendations for safeguarding their accounts.
- Enhanced mentee performance by providing personalized guidance and support.
- Managed escalated support tickets, ensuring timely responses and effective problem-solving strategies.
- Served as a resource to Tier 1 support technicians, providing guidance and advice on complex issues to ensure seamless escalation of cases when needed.
- Reviewed and updated policies regularly to ensure compliance with industry standards and regulatory requirements related to fraud prevention.
- Managed complex cases involving identity theft, credit card fraud, and other forms of financial crime, resulting in successful resolution for affected customers.
Medical Billing Specialist
SmrtDo Medical Billing
01.2017 - 12.2020
- Responsible for all billing cycle such as Data Entry, rejections, denials, correspondence, payment posting AR follow up for rural health and family medicine clinics for the state of Louisiana
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
Sales and Production Assistant
C&D Producciones
01.2021 - 12.2021
- Coordinate client's interview to close sales, assisting productions for digital marketing strategies, assisting director to create scripts for audio visual projects, promoting national brands for their digital projections in television and social networks.
- Facilitated smooth project execution by managing deadlines, resources allocation, and progress updates.
- Assisted manager in all aspects of business operations.
Billing Team Lead
The Auctus Group
12.2021 - 03.2023
- Receive training and billing instructions from RCMs or Billing Director, Conduct 1-2 weeks of training for new clients to the final assigned biller, Provide Medical billing mentorship to the billing team if needed, Lead training sessions on new, current billing and coding information to assure coding quality, Communicate changes to billing staff if needed, Hold weekly meetings to discuss changes.
- Streamlined billing processes by implementing efficient procedures, resulting in reduced errors and increased productivity.
- Managed a team of six billing specialists for timely and accurate invoice generation and payment processing.
- Developed comprehensive training materials for new hires, expediting the onboarding process and ensuring consistent performance standards.
- Ensured compliance with federal, state, and industry regulations by staying informed of updates in policies or guidelines related to medical coding practices or other relevant financial matters.
- Created monthly reports highlighting revenue generation patterns as well as potential bottlenecks affecting cash flow or invoice accuracy rates; facilitating informed decision making at the executive level.
- Provided excellent customer service, developing and maintaining client relationships.
Medical Billing and Collections Specialist
Paragon Medical
03.2023 - 10.2023
- Increased successful debt collections by implementing effective communication and negotiation strategies with insurances.
- Collaborated with healthcare providers to ensure accurate billing and coding, minimizing disputes and accelerating resolution times.
- Facilitated timely resolutions for disputed claims by thoroughly investigating supporting documentation and negotiating mutually beneficial agreements between patients and providers.
- Worked closely with insurance companies to verify coverage details, coordinate benefits, and secure prompt payment for outstanding medical debts.
Medical Billing Coordinator
Petit Smiles LLC
01.2021
- Create monthly insurance AR report, Patient AR report, follow up on claims, and provide medical billing training to the staff
- Responsible for the verification's team as well as the scheduling team, and audit outsource billing company
- Provide accounting and metrics reports to clients and ensure tasks assigned to the team are completed on time.
Medical Billing Specialist
iMark Consulting
06.2020
- Follow up on Medicare account receivable (rejections and RTPs) for home health agencies.
Tier 2 Technical Support Specialist
Concentrix Nicaragua
02.2016 - 01.2017
- Enhanced customer satisfaction by resolving complex technical issues and providing efficient solutions.
- Streamlined troubleshooting processes for quicker issue resolution and improved customer experience.
- Managed escalated support tickets, ensuring timely responses and effective problem-solving strategies.
- Served as a resource to Tier 1 support technicians, providing guidance and advice on complex issues to ensure seamless escalation of cases when needed.
- Reviewed and updated policies regularly to ensure compliance with industry standards and regulatory requirements related to fraud prevention.
- Managed complex cases involving identity theft, credit card fraud, and other forms of financial crime, resulting in successful resolution for affected customers.
Medical Billing Specialist
Integra MDP
08.2019 - 12.2020
- Responsible for all billing cycles such as Data Entry, rejections, denials, correspondence, payment posting AR follow up for plastic surgeries clinics for multiple states
- Weekly meetings with clients to review all assignments, provide feedback if necessary, review daily and weekly work
- Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Developed customized reports for management review, highlighting trends in key performance metrics such as claim denial rates and days outstanding for accounts receivable balances.
- Identified and resolved patient billing and payment issues.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Education
Advanced Excel -
ILCOMP
01.2019
English -
Universidad Thomas More
01.2014
System Engineering -
Universidad Centroamericana
01.2010
system engineering -
Universidad lberoamericana de Ciencia y Tecnologia
01.2010
Skills
- Organizational abilities
- Critical thinking abilities
- Analytical mindset
- Investigative abilities
- Financial Transactions Monitoring
- Attention to Detail
- Multitasking Abilities
- Financial Data Analysis
- Team Collaboration
- Claims Processing Proficiency
- HIPAA Compliance Understanding
Certification
HIPAA for Business Associates, 10/08/2021, 310736, 0.2
Software Management
- Google Suit Package
- EHR Systems
- Medical Billing Systems
- Asana
- Microsoft Office Package
- Canva
- Social Networks
Languages
Spanish
Native or Bilingual
Timeline
Medical Billing and Collections Specialist
Paragon Medical
03.2023 - 10.2023
Billing Team Lead
The Auctus Group
12.2021 - 03.2023
Sales and Production Assistant
C&D Producciones
01.2021 - 12.2021
Medical Billing Coordinator
Petit Smiles LLC
01.2021
Medical Billing Specialist
iMark Consulting
06.2020
Medical Billing Specialist
Integra MDP
08.2019 - 12.2020
Medical Billing Specialist
SmrtDo Medical Billing
01.2017 - 12.2020
Tier 2 Technical Support Specialist
Concentrix Nicaragua
02.2016 - 01.2017
Customer Service Representative Mentor
Sitel Nicaragua
02.2015 - 01.2017
Advanced Excel -
ILCOMP
English -
Universidad Thomas More
System Engineering -
Universidad Centroamericana
system engineering -
Universidad lberoamericana de Ciencia y Tecnologia
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