Kristen Brown
University,OH
Summary
Highly motivated Billing Specialist with 18 years of experience who desires to take on new challenges. Exhibits a strong work ethic, adaptability, excels at prioritizing, and completing multiple tasks simultaneously. Adept at working effectively unsupervised and quickly mastering new skills
Overview
18
18
years of professional experience
Work History
Senior Medicare Analyst, Revenue Cycle Management
Cardinal Health
Twinsburg, Ohio
04.2019 - Current
- Implement compliance strategies to maintain accuracy and integrity in Medicare billing operations.
- Process Medicare claims efficiently, ensuring accurate billing and compliance with relevant regulations.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Set specific goals for projects to measure progress and evaluate end results.
- Conducts research to determine corrected coding for service rendered by provider for ICD-10 Coding and Modifiers.
Senior Medicare Biller, Contract and Billing
Cardinal Health
Twinsburg, Ohio
12.2018 - 04.2019
- Maintained compliance with federal billing regulations, resulting in error-free processing.
- Addressed and resolved complex billing issues, enhancing customer satisfaction and operational efficiency.
- Managed denials and adjustments effectively, maintaining financial integrity and customer satisfaction.
- Processed appeals to insurance companies related to denied or underpaid Medicare claims.
- Responsible for creating and monitoring Advance Beneficiary Notices given and received for patients.
Senior Medicare Team Lead Biller
Cardinal Health
Twinsburg, OH
01.2018 - 12.2018
- Directed a team in the accurate processing of Medicare claims, ensuring compliance and regulatory standards.
- Managed workflow, assigned and monitored workload, ensured that work is completed accurately and efficiently.
- Training and mentoring team members and new hires.
- Communicating and providing feedback to staff and management on department issues.
- Assisted with updates on billing policies, procedures, and guidelines.
Medicare Biller, Contract and Billing
Cardinal Health
Twinsburg, Ohio
01.2017 - 01.2018
- Reviewed and processed Medicare-related claims for accuracy and completeness.
- Performed data entry of patient information into medical billing system.
- Resolved discrepancies on Medicare claims with insurance carriers.
- Generated financial reports and tracked accounts receivable balances.
- Performed insurance verification for Medicare coverage and Home Health Care for (PPS) Perspective Payment System issues.
Senior Medicare Documentation Coordinator
Cardinal Health
Twinsburg, Ohio
07.2014 - 01.2017
- Created and maintained a database of documents, ensuring accurate version control.
- Reviewed and updated existing documentation to ensure accuracy and completeness.
- Maintained records of all documents produced or modified by the organization.
- Conducted research to determine correct coding for services rendered by provider for ICD-10 coding and Modifiers.
Medical Prior Authorization Coordinator
Cardinal Health
Twinsburg, Ohio
06.2012 - 07.2014
- Reviewed and processed prior authorization requests according to insurance guidelines.
- Determined medical necessity of requested services by reviewing patient records and corresponding with providers as needed.
- Created and maintained accurate documentation for all prior authorization activities.
- Researched payer coverage policies, procedures, and requirements.
- Provided customer service support by responding promptly to provider inquiries regarding authorization status or policy information.
Medical Documentation Coordinator HMO/Medicaid Billing Specialist
Cardinal Health
Twinsburg, OH
08.2006 - 06.2012
- Reviewed and processed Medicaid claims for accuracy, completeness, and compliance with applicable regulations.
- Created and maintained detailed records of billing activities to ensure timely payments from Medicaid providers.
- Performed insurance verification, pre-certification and pre-authorization.
- Collaborated with medical staff to determine appropriate coding for services rendered.
- Communicated regularly with patients regarding outstanding balances or other issues related to their accounts.
Education
Medical Billing And Coding
Sanford Brown Institute
05-2008
Some College (No Degree) - Health Information Management
Cuyahoga Community College
Cleveland, OHSkills
- Proficient in IBM PC's Skills (Word, Excell,Outlook and Other Windows Environment)
- Types Alpha/Numeric at 65WPM
- Knowledge of Medical Terminology
- Knowledge of ICD-10 CM/CPT Coding
- Ability to handle escalated /high volume calls
- Knowledge of Insurance Verification
- Data Extraction
- Data Processing
- Data Analysis
- EMR
- Continuous Improvement
- Multiple Priorities Management
- Deadline Adherence
- Analytical Thinking
- Process Improvements
- Project Management
- Documentation And Reporting
- Team Collaboration and Leadership
Timeline
Senior Medicare Analyst, Revenue Cycle Management
Cardinal Health
04.2019 - Current
Senior Medicare Biller, Contract and Billing
Cardinal Health
12.2018 - 04.2019
Senior Medicare Team Lead Biller
Cardinal Health
01.2018 - 12.2018
Medicare Biller, Contract and Billing
Cardinal Health
01.2017 - 01.2018
Senior Medicare Documentation Coordinator
Cardinal Health
07.2014 - 01.2017
Medical Prior Authorization Coordinator
Cardinal Health
06.2012 - 07.2014
Medical Documentation Coordinator HMO/Medicaid Billing Specialist
Cardinal Health
08.2006 - 06.2012
Medical Billing And Coding
Sanford Brown Institute
Some College (No Degree) - Health Information Management
Cuyahoga Community College
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