Kimberly Machado

• EMS RCM Project Coordinator creating invoices for hospitals, skilled nursing facilities, funeral homes, correctional facilities, and morgues.

• Run monthly reports to create excel and PDF invoices for payments from facilities.

• Coordinated and managed multiple projects simultaneously, ensuring all deadlines were met.

• Reviewed medical documentation and coding to identify any discrepancies or errors that could impact reimbursement

• Generated monthly financial reports detailing revenue trends, outstanding balances, and collection efforts

• Conducted regular audits of billing records to identify errors or discrepancies that could impact reimbursement rates

• Verify the correct payer is selected and review coding.

• Send invoice through sharefile and emails.

• Contact customer for any questions or concerns.

• Follow up on past due payments from facilities.

• Return phone calls as needed.

• Accurately entered data into computer system, ensuring all information was correct before submitting.
• Created and maintained detailed reports regarding charge entry activities and discrepancies.
• Monitored aging receivables to ensure timely collection of all outstanding monies due.
• Resolved customer inquiries promptly while providing exceptional customer service.
• Collaborated with insurance carriers regarding any rejected claims or denied payments.
• Entered patient charges into multiple billing systems.
• Processed payments from insurance companies and other third parties.
• Confirmed patient information is current within the practice management system.
• Expertly reviewed insurance claims for accuracy prior to submission.
• Responded promptly to incoming calls from patients or providers regarding billing questions or concerns.
• Adapted well under pressure by multitasking between various projects simultaneously without compromising quality of work.

• Reconciled discrepancies between invoices received from providers and payments received from third-party payers.
• Collaborated with external vendors such as clearinghouses and collection agencies as needed.
• Entered patient charges into billing software accurately and timely, ensuring all data was complete and correct.
• Implemented corrective action plans when errors were identified in billing processes or procedures.
• Resolved customer inquiries regarding billing statements, payment options and account balances.
• Worked closely with other departments such as clinical services and finance to ensure proper coordination of care throughout the entire revenue cycle process.
• Maintained accurate records of all claims submitted to payers for reimbursement purposes.
• Utilized strong organizational skills to prioritize tasks to meet tight deadlines.

• Trained new hires and provided guidance and feedback to colleagues.
• Demonstrated expertise in ICD-10 and CPT coding systems, as well as HCPCS Level II codes.
• Utilized coding software to verify accuracy of diagnosis and procedure codes assigned to patient accounts.
• Prepared and submitted claims to insurance companies and governmental agencies using electronic billing system.
• Reviewed documentation from providers to ensure compliance with coding guidelines and standards.
• Resolved rejected or denied claims by contacting insurance companies to correct errors or obtain additional information.
• Monitored aging accounts receivable balances to ensure timely collection of payments due from patients or insurance carriers.
• Created spreadsheets tracking individual account histories for follow up action when necessary.
• Researched payer specific reimbursement policies for correct billing process adherence.
• Answered all patient or insurance telephone inquiries pertaining to assigned accounts.
• Negotiated payment arrangements with delinquent accounts to collect outstanding balances.

• Trained and supervised new staff, providing orientation and training for new practices and procedures.
• Effectively managed patient scheduling, registration, and billing processes with a focus on accuracy and efficiency.
• Developed and implemented standard policies and procedures to verify compliance with regulations.
• Oversaw inventory to purchase needed medical and office supplies.
• Obtained proper authorizations for services, procedures, and equipment necessary for patient care.
• Posted insurance payments accurately and efficiently, ensuring accuracy of information entered into the system.
• Processed payments from patients for services rendered at the time of their appointment.
• Maintained accurate logs of incoming referrals, cancellations or changes in appointments or surgery schedules.
• Conducted preoperative phone calls with patients to verify insurance benefits, review instructions for arrival time, location, and preparation requirements.

• Monitored shipments for accuracy and quality assurance purposes by verifying product information and delivery details against invoices.
• Acted as a liaison between logistics, carriers, and customers.
• Produced purchase orders and updated shipment status information.
• Managed daily delivery operations, including receiving, stocking, and shipping processes.
• Implemented cost-saving initiatives such as reducing freight charges through carrier negotiations.
• Facilitated communication between vendors, customers, and internal staff regarding changes in shipments due to unforeseen circumstances.
• Resolved issues during shipping, communicating delays to relevant individuals.
• Prioritized tasks and managed deadlines under strict time constraints.

• Streamlined office procedures and policies to support efficiency and accuracy.
• Provided customer service support, responding to inquiries in a timely manner.
• Answered phone calls and managed inquiries from customers and vendors.
• Managed digital and analog filing systems to organize documents and records.
• Opened, sorted, and distributed incoming correspondence.
• Performed daily reviews of freight bills to ensure accuracy in billing processes.
• Monitored trucking equipment availability to meet customer demands.
• Maintained accurate records of shipments, routes, and driver activities.
• Ensured compliance with DOT regulations regarding hours-of-service limits.
• Collaborated with warehouse personnel to ensure timely loading and unloading of merchandise.

• Supervised and coordinated overall operation of clinical and administrative functions.
• Successfully managed patient scheduling, billing, and insurance verification processes in a busy medical office setting.
• Provided clerical support for medical providers by copying documents, filing records in electronic or hard copy format and mailing correspondence to patients.
• Monitored appointment calendars for physicians to schedule patient visits efficiently.
• Prepared documents required by state or federal agencies related to health care services provided by the facility.
• Ensured that all relevant paperwork was accurately completed prior to submission to insurance companies or other third-party payers.
• Advised patients of financial responsibility and obtained credit agreements for outstanding balances.