Hi, I’m
Kristal Blair
Summary
Billing professional with proven track record in financial management and billing accuracy. Known for improving billing procedures and resolving discrepancies efficiently. Reliable team collaborator focused on achieving results and adapting to changing needs, with keen eye for detail and problem-solving skills.
Overview
22
years of professional experience
Work History
Argyll Medical Group
Billing Specialist
01.2016
Job overview
- Company Overview: Experience in Primary care
- Knowledge of ICD 10, CPT codes and modifiers
- Utilization of Form-1500 for professional claims
- E clinical works EMR Platform
- Change-healthcare experience with reviewing rejections and resolving claims getting stuck in the clearinghouse due to a multitude of issues
- Scrub and process claims daily, upwards of (45) claims a day
- EFT and insurance check postings
- Insurance credit card and patient credit card processing
- A/P Balance and reconciliation of both patient and insurance payments on the daily utilizing a Excel spreadsheet for tracking and preparing banking deposits for week end
- Maintain patient payment plan agreements
- Maintain up to date knowledge of insurances policies and contracted rates familiar with multi payers
- Maintain provider credentials
- Maintain provider onboarding
- Maintain provider PECOS
- Strong communication skills with both provider and teammates, consistently educating self in collaborative teamwork and improving communication skills within LinkedIn courses
- Interact with pharmaceutical representatives to establish a relationship in order to have a better understanding of specialty medications and tx billed for better billing practices and gain knowledge of patient assistance programs to provide patient support and financial assistance
- Excellent customer service, listens clearly to patients in order to resolve their issue and better assist with their account, effectively communicate a better understanding of their financial responsibility, explain coinsurance, deductible and OOP expenses
- Strong history of company A/R cleanup projects with a Significant decrease in A/R by more than 50%
- Experience with the VA/Triwest payer, SEOCC, RFS Reconsideration, Timely Filing, Appeals and initiating a peer to peer review if needed
- Experience in working both patient and payer A/R, investigates claim fully, experience with denials, corrected claims, appeals, consistent follow up on A/R
- Experience with collections from start to finish
- Maintain staff logins for various insurance companies, assist with Medicare accounts
- CCM time & misc charges added per providers requests
- Experience in Primary care
Therapeutic Solutions
Remote Billing Specialist
08.2021 - Current
Job overview
- Company Overview: Experience in Behavioral Health
- Knowledgeable in Advanced Md, Credible and Athena medical EMR platforms
- Experience in problem solving EMR issues
- Experience in ICD10, CPT, modifiers and Telehealth billing
- Insurance eligibility and benefit investigation
- Experienced in Facility claims for IOP, PHP, TMS, ECT and Ketamine services, utilizing both Form-1500 and UB04 Forms.
- Researched and resolved billing discrepancies to enable accurate billing.
- Authorizations
- Maintaining patient payment plan
- A/R project clean up
- Collections
- Effectively communicating with management and leadership in regards to areas needing improvement and or redirection within the billing department
- Recoupment
- Communicates with providers, management, leadership and coworkers professionally
- Shares knowledge and informs of new findings, policies and billing rules
- Communicates with patients clearly and effectively
- Credentialing and Contracting of two locations for CA and WA.
NSC Inc
Owner /Office Manager
01.2003 - 01.2016
Job overview
- Managed day-to-day business operations, including accounting, finance, HR, payroll, marketing and public relations
- Monitored and evaluated employee performance, records and bi and annual reviews
- Utilized Quickbooks software for general bookkeeping for A/P, A/R, and vendor accounts
- Sourced vendors for special project needs and negotiated contracts
- Management of each individual job sites, maintained organization of contracts, insurance, certified payroll per LEAD job, materials, material specs and OSHA standards, plans and communication with project managers, supers and office staff on timely completion
- Met with clients to review project expectations, discuss bids and contracting
Education
James Lick High SchoolSan Jose, CA
High School Diploma
06.1989
Oroville Adult Education
Certified Medical Assistant from Medical Assistant / Medical Terminology
06.2017
Skills
- Billing Software Management
- Insurance Eligibility Verification
- Claims Management
- Claims Denial Management
- Proficient in Medical Billing
- Collaborative Teamwork
- Accounts Receivable Oversight
Timeline
Remote Billing Specialist
Therapeutic Solutions
08.2021 - Current
Billing Specialist
Argyll Medical Group
01.2016
Owner /Office Manager
NSC Inc
01.2003 - 01.2016
Oroville Adult Education
Certified Medical Assistant from Medical Assistant / Medical Terminology
James Lick High School
High School Diploma
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