Kim Corridon
Holmdel,NJ
Summary
Detail-oriented revenue cycle specialist with a systematic nature and excellent grasp of billing processes. Successful planner and problem-solver with a strong work ethic. Adept at working effectively unsupervised or in a team setting and ready to take on a challenging role.
Overview
15
15
years of professional experience
Work History
Revenue Cycle Specialist
Orthopaedic Sports Medicine and Rehab Center
Red Bank, NJ
10.2013 - Current
- Extensive experience in all phases of revenue cycle collections for Orthopedic, PM&R and Physical Therapy.
- Audited payments from third-party payers to ensure accuracy of reimbursement amounts for both in and out of network carriers.
- Processed appeals related to denied or rejected claims in a timely manner.
- Advised healthcare providers on best practices for submitting accurate claims for optimum reimbursement.
- Monitored accounts receivables daily to determine appropriate follow-up action needed.
- Reviewed patient charts for accuracy prior to submitting claims for reimbursement.
- Maintained current knowledge of insurance policies, procedures, regulations, and guidelines.
- Identified areas where process improvements can be made within the revenue cycle.
- Negotiate claim payments for out of network insurance carriers for prompt payment.
- Electronic transmission for claims to assigned carriers along with corrections on error reports.
- Contacted insurance providers to check patient coverage for patients out of pocket cost when needed. Obtained SPD for non-contracted payers for accurate reimbursement.
- Provided training sessions on billing software applications and procedures to new revenue cycle staff members.
- Analyzed claims data to identify trends in denials, rejections and payments.
- Displayed strong telephone etiquette, effectively handling difficult calls when answering patients questions.
- Coordinated with insurance companies regarding retro-active authorization requests for certain pain management procedures.
- Ensured compliance with HIPAA guidelines when handling confidential patient information.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Reviewed claims for coding accuracy.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Submitted appeals using provider portals and phone communication.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
- Checked claims coding for accuracy with ICD-10 standards.
Medical Biller, Accounts Receivable
Ani Orthopaedic
Hazlet, NJ
05.2012 - 10.2013
- Responsible for all insurance claim follow up to ensure timely and accurate claim payments.
- Investigate and resolve claim submission errors.
- Verified accuracy of account information to ensure optimum reimbursement through coding discrepancies.
- Provided customer service to both internal and external customers regarding billing inquiries.
- Tracked aging reports of unpaid claims and took corrective action when necessary through mult-level appeal process.
- Monitored out of network accounts for insurance kept checks. Created kept checks policies and implemented patient letters for resolution of balances due.
- Resolved discrepancies on patient accounts by contacting the insurance companies or patients.
- Analyzed medical coding issues, identified errors, made corrections, and followed up with insurance providers on denied claims as necessary.
- Ensured compliance with HIPAA guidelines when handling confidential patient information.
- Identified potential areas of improvement in existing processes or procedures.
Medical Biller
The Plastic Surgery Center
Shrewsbury, NJ
05.2009 - 08.2012
- Created monthly aging reports to identify delinquent accounts for review by management team.
- Ensured compliance with HIPAA guidelines when handling confidential patient information.
- Performed extensive follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Completed and submitted multi-level appeals for denied claims.
- Facilitated claim payment negotiations with insurance carriers and set up patient payment plans.
- Provided customer service support to patients who had questions about their bills or payments due.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Resolved discrepancies between insurance companies and patients regarding payment of bills.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
Education
Medical Billing Certification - Medical Billing
Bryan Scool of Technology
East Brunswick, NJSkills
- Extensive Medical Billing and Collection
- ICD 10
- Medicare
- Insurance Policies
- Proficient in Microsoft Word
- Document Mangement
- HIPAA Compliance
- Insurance Verification
- Analytical Problem Solving
- Trends Analysis
Timeline
Revenue Cycle Specialist
Orthopaedic Sports Medicine and Rehab Center
10.2013 - Current
Medical Biller, Accounts Receivable
Ani Orthopaedic
05.2012 - 10.2013
Medical Biller
The Plastic Surgery Center
05.2009 - 08.2012
Medical Billing Certification - Medical Billing
Bryan Scool of Technology