Summary
Overview
Work History
Education
Skills
Quote
Timeline
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Kristine Cowper-Drozdoski

Kristine Cowper-Drozdoski

Greenville,SC

Summary

Highly qualified, professional individual with excellent critical thinking skills in specialized Health Information Management, as well as experience in Revenue Cycle Data Analysis. Known for being reliable and independent, and for successfully handling various tasks in deadline-driven environments.

Overview

36
36
years of professional experience

Work History

RCM Accounts Receivable Coordinator

OB Hospitalist Group
Greenville, SC
02.2018 - Current
  • Analyzes billing and accounts receivable reports. Identifies trends, categories of aged receivables and provides feedback to stakeholders to improve results.
  • Analyzes workflow and operational procedures of billing department to ensure smooth operations and to improved reimbursement.
  • Analyzes ICD-10-codes assignment to medical claims by using ICD-10-CM code book.
  • Prepares and distributes reimbursement/revenue cycle reports for departments.
  • Ensures payment is received, credited and recorded at contracted rates.
  • Identifies and researches discrepancies through data analytics and root cause analysis to improve upstream processes.
  • Working with third party healthcare payers to identify their new requirement and guidelines.
  • Reviews, modifies and recommends changes to policies and procedures to improve Accounts Receivables Days.
  • Reviews Medicare and Medicaid billing requirements regularly to decrease claims denials.
  • Managing revenue cycle operation from patient access to patient accounting phase, by tracking claims from point of claim submission through payment collection.
  • Determine root cause of payer rejections or delays in reimbursement.
  • Resolve claims disputes and increase reimbursement, by getting to root of claims denials.
  • Processing received electronic remittance advice and reviewing rejections or denial claims to determine validity of rejections and taking appropriate actions to resolve problems.
  • Adjusts patients’ balances based on third-party reimbursement guidelines and contracts.


Office Manager

Saratoga Ear & Sinus Surgery PC
Saratoga Springs, NY
11.2009 - 05.2016
  • Manage staff and ensure HIPAA compliancy
  • Maintain EMR Database
  • Maintain Clinic Accounts Payable using Quickbooks
  • Maintain Physician's professional and personal schedules
  • Schedule surgical procedures and diagnostic testing
  • Secure authorizations for surgical procedures and diagnostic testing
  • Maintain all office correspondence
  • Triage Phone Calls
  • Work closely with patients to ensure needs are met



Office Manager

Mitchell Singer MD
Schenectady, NY
03.1987 - 12.2006
  • Managed Office Staff and maintained all inventory for office
  • Handled coding of all diagnosis, procedures and professional services applying accurate and descriptive ICD9-CM, CPT, E&M, and HCPCS code for reimbursement purposes.
  • Posted payment from Medicare, Medicaid and other third-party insurances EBO to patients’ accounts
  • Set up and maintained original practice management computer system and trained all staff as needed
  • Sent out patients’ statements every month.
  • Performed billing and coding procedures for emergency room, impatient and outpatient services.
  • Implemented new coding procedures that reduced mistakes by 10% and simplified processes.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Interacted with physicians and other healthcare staff to ask questions regarding patient services.
  • Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
  • Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
  • Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.

Education

No Degree - Psychology

SUNY Albany
Albany, NY

Certificate, Medical Billing and Coding - Medical Secretary

Spencer Business & Technical Institute
Schenectady, NY
12.1986

Skills

  • Microsoft Word, Excel, Power-Point, and Adobe
  • Extensive knowledge of Government and Commercial Payors as it relates to Credentialing and Claims Set-up in both electronic and paper format, and including Taxonomy/NPI/TIN information
  • Proficient in EMR Systems, MMIS, Lyra, Patient Keeper, ECHO One, Symplr, Ebridge, Healthmap, Availity, Navinet, Payspan, and various Payor Portals
  • Review Monthly/Yearly AR Data trends for approximately 100 locations and approximately 500 physicians
  • Responsible for Outstanding AR of upwards of $6,000,00000 monthly
  • Prepare Daily Transaction Report for Corporate, including Daily Charges/Payments and Lockbox/EFT for all locations
  • Liason between Patient Accounts Collectors and Provider Enrollment Team
  • Excellent Verbal and written communication skills and problem solving skills
  • Conflict Resolution Skills
  • ICD-9-CM, ICD-10-CM knowledge in multiple specialties
  • Medical Billing and Follow-up Experience
  • Able to both follow and develop Policies and Procedures
  • Work closely on special projects with Contracting Department and Operations Manager
  • Payment plan processing

Quote

Learn to be thankful for all that you have while you pursue all that you want.
Jim Rohn

Timeline

RCM Accounts Receivable Coordinator

OB Hospitalist Group
02.2018 - Current

Office Manager

Saratoga Ear & Sinus Surgery PC
11.2009 - 05.2016

Office Manager

Mitchell Singer MD
03.1987 - 12.2006

No Degree - Psychology

SUNY Albany

Certificate, Medical Billing and Coding - Medical Secretary

Spencer Business & Technical Institute

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Kristine Cowper-Drozdoski