Kristen DeMichele
Cape Coral,FL
Summary
Medical billing manager, highly skilled in medical coding, hoping to expand my skillset by utilizing many years of knowledge in the field. Experience on both the clinical and financial side of healthcare with an extensive understanding of medical terminology, anatomy, as well as all facets of the revenue cycle.
Overview
7
7
years of professional experience
Work History
Revenue Cycle Supervisor
Advanced Orthopedics and Sports Medicine of SWFL
01.2024 - Current
- Accurately code approximately 150 orthopedic evaluation and management services and physical therapy charges per day
- Research inpatient consultations and surgeries and correctly code/enter into practice management software
- Maintain an above average knowledge of ICD10/ CPT/ HCPCS codes, as well as all current CMS guidelines
- Utilize a patient's medical record to extract the information needed to appropriately code their visit and query physician when necessary
- Collaborate with other departments such as benefits and authorizations when a discrepancy is found in a patient's account that could generate issues with proper adjudication
- Transmit electronic claims and patient statements daily using practice management software
- Ensure all necessary information for accurate and timely submission of worker's compensation and motor vehicle claims is obtained and documented
- Run monthly reports to asses which patient accounts are outstanding and research each account before turning over to collections agency
- Import all ERA payments and post into practice management, working all line item denials and nonpayments within the electronic remittance file
- Prepare and submit written appeals to insurance companies when unwarranted denials arise and follow up with second level appeals when original denial is upheld
- Run a weekly report to show which patient ledgers reflect overpayment and process refunds in a timely manner
- Deposit all checks into company bank account while cross referencing against bookkeeper's records to ensure all transactions balance
- Address billing or authorization related issues and develop solutions to prevent similar issues from reoccurring
- Foster positive relationships with team members to ensure a collective effort towards the common goal of maximizing profits for the practice, while providing excellent customer service to patients
- Enrolled multiple payers that were previously being adjudicated via paper in EFT/ERA to streamline efficiency and reduce costs
- Assumed the lead on and successfully recouped tens of thousands of dollars in unpaid claims amongst third party accident policies
Medical Billing Manager
OnPoint Medical Billing
12.2020 - 07.2024
- Manage multiple client accounts across a broad range of medical specialties
- Perform insurance verifications and notate patient accounts to reflect accurate benefits information
- Transmit electronic claims daily to insurance companies and resolve any clearinghouse or payer rejections
- Import electronic remittance advice from clearinghouse and post into the practice management system, filtering out any non-payments or line item denials and working until resolved
- Maintain an above average knowledge of all current CMS guidelines
- Ensure team compliance with established goals including timely submission of all charges as well as appropriate coding
- Research EHR records as well as communicate with providers to ensure charges being billed are coded to the highest level of specificity
- Ensure clients are hitting optimal numbers, weekly as well as monthly by running detailed financial reports and being available to clients to help interpret the data whenever needed
- Efficiently operate company's in house EHR/EMR software
- Remotely log in to client's practice management systems and operate from their preferred software of choice
- Work aging accounts of unpaid claims 60 days or older to ensure all claims are being adjudicated in a timely manner
- Assume the responsibility of cross training employees on additional job positions to maintain coverage of roles
- Develop process guides in areas of the business where goals are not being met as efficiently or accurately as possible
Medical Assistant/Scribe
Raso Pain Center
07.2018 - 11.2019
- Collect patient vitals and document in chart
- Obtain a detailed description of any changes, improvement, or concerns that may have occurred since last visit
- Prepare all supplies for any procedures/injections being performed
- Administer corticosteroid injections
- Observe medical exam being performed by MD and transcribe all pertinent information into patient's electronic health note
- Obtain pre-authorization when necessary for procedures and injections per patient's insurance policy
- Enter proper medical diagnosis codes into each visit note and forward to billing department upon completion
- Ensure patient has had all question answered and a full understanding of their treatment plan at the conclusion of their appointment.
Education
Certified Professional Coder - Medical Coding
AAPC
Remote04-2025
Associate of Science - Behavioral Sciences
Florence Darlington Technical College
Florence05.2010
Skills
- Revenue Cycle Management
- Billing Dispute Resolution
- Accounts Receivable
- ICD10/CPT/HCPCS Medical Coding
- Strong attention to detail
- Excellent oral and written communication skills
- Proficient use of Microsoft Office Suite and Adobe
- Highly experienced utilizing multiple different EHR/EMR platforms such as All Scripts PM and EHR, Total MD, E-Clinical Works, Practice Fusion, and Epic
- Excellent customer service skills
Timeline
Revenue Cycle Supervisor
Advanced Orthopedics and Sports Medicine of SWFL
01.2024 - Current
Medical Billing Manager
OnPoint Medical Billing
12.2020 - 07.2024
Medical Assistant/Scribe
Raso Pain Center
07.2018 - 11.2019
Certified Professional Coder - Medical Coding
AAPC
Associate of Science - Behavioral Sciences
Florence Darlington Technical College
Similar Profiles
Jessica BoydeJessica Boyde
Medical Receptionist at Advanced Orthopedics & Sports MedicineMedical Receptionist at Advanced Orthopedics & Sports Medicine
Barbara ThomasBarbara Thomas
Front Office Coordinator II at ADVANCED ORTHOPEDICS AND SPORTS MEDICINEFront Office Coordinator II at ADVANCED ORTHOPEDICS AND SPORTS MEDICINE
Stephen BrownStephen Brown
Physician Assistant at Center For Advanced Orthopedics & Sports MedicinePhysician Assistant at Center For Advanced Orthopedics & Sports Medicine