Laura Buckley
Orlando,FL
Summary
Dynamic Reimbursement Specialist with proven success at Johnson & Johnson, adept in medical billing and coding. Expert in accounts receivable management, achieving an 80% reduction in aging claims. Exceptional customer service skills and proficiency in Excel and QuickBooks ensure efficient operations and enhanced patient satisfaction.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Reimbursement Specialist
Johnson & Johnson
Orlando, FL
01.2024 - Current
- Reviewed insurance policies and claims to determine eligibility and coverage limits with all the major medical carriers & PBM's.
- Communicated with patients to inform them of their insurance benefits
- Documented and update patient records with insurance information
- Accurately interpreted patient insurance, prescription and other health-related documentation
- Analyzed and recorded to transcribe appropriate ICD-9, ICD-10, CPT, HCPCS codes
- Processed insurance claims and patient statements
- Followed up on unpaid claims within standard billing cycle timeframe
- Check insurance payments for accuracy and compliance with contract discount
- Coordinated with medical coding team to ensure correct billing codes for services
- Interacts with Reimbursement Supervisor and Billing management to ensure timely collection of accounts
- Contacted insurance companies to obtain pre-authorization for medical procedures and treatments
AR Billing/ Collection/Authorization Specialist
DRS Medical- DME
Longwood, FL
05.2019 - 11.2023
- BILLING/COLLECTIONS OF PIP/WC for DME & Drug claims. Prepare, review, and transmit claims using billing software and paper claim processing of approximately 100-125 accounts monthly.
- DME billing, collections, Intake, authorization, obtained Purchase orders. communicated directly with Adjusters, Attorneys and claim representatives- reducing turnaround time.
- Timely collections of insurance payments on assigned accounts with a 30-60-day collection rate with meeting collection goals and decreasing aging by 80%.
- Obtain status of outstanding claims listed in the follow-up work queues from insurance companies and worked to for resolution collections of $150,000.
- Written/filed appeals to insurance companies to overturn denied or short paid claims
- Negotiated payment terms for DME equipment and supplies with patients, Insurance Adjusters and Attorneys while keeping above company's contracted rates.
- Increased customer satisfaction for communicating professionally and effectively with patients, insurance companies, physicians and clinical personnel.
- Adhered to all corporate policies and procedures related to the company's corporate compliance HIPAA programs. Ensured established practices are compliant with Medicare, CHAP and other regulatory agencies.
AR Billing & Collection Specialist
Apex Billing Solutions, LLC
Sanford, FL
07.2016 - 05.2019
- Skilled Nursing Facility Billing & Collections
- Billed and collected in excess of $1,250,00.00 for Skilled Nursing Facility claims. Generated 300-350 claims bi-monthly & monthly via Medicaid, Medicare Part A & B and Co-Insurance.
- Met weekly, bi-weekly and month-end claim submission deadlines.
- Worked/resolved correspondence received from third party payers including remittance advice, Explanation of Benefits, denial letters, etc. within the 30-day timeframe.
- Followed up on unpaid claims within standard billing cycle timeframe of 30-60 days.
AR Billing and Collection Specialist
Boulder Outreach Solutions
Oviedo, FL
05.2015 - 05.2016
- Hospital Medicaid Authorization/AR/Collections
- Reviewed for Medicaid Eligibility. Prepared, billed & collected Hospital Emergency Room Medicaid claims $543,750.00. Transmitted 125+ weekly clean claims using billing software, including electronic and paper claim processing.
- Via Navi-Net, web portals- checked eligibility and benefits verification for treatments, hospitalizations, and procedures.
- Followed up on unpaid claims within standard billing cycle timeframe of 30 days.
- Checking each insurance payment for accuracy and compliance with contract discount.
- Provider Credentialing-Prepare Documents for Hospital Provider Enrollment.
- Accurately collect, code, and enter all services performed including hospital charges.
AR Billing and Collections Specialist
Consulate Healthcare
Maitland, FL
12.2013 - 01.2015
- Skilled Nursing Facility Billing & Collections.
- Billed and collected Medicare Part A & B and Co-Insurance. Transmitted claims using billing software including electronic and paper claim processing.
- Meet weekly, bi-weekly and month-end claim submission deadlines. Responsible for maintaining low A/R and bad debt for assigned payors.
- Resolve rejected claims from the claim's clearinghouse daily.
- Prepared and submitted reports in regard to insurance billing as required.
- Stayed in compliance with all state, federal, and government agencies.
- Performed all other duties as assigned.
Billing Office Manager
Yeomans Chiropractic
Winter Park, FL
09.2011 - 08.2013
- Billed & collected for all payer types including Medicare A & B, Medicaid, Primary Insurance, Managed Care, Workers Comp and Auto (PIP).
- Analyzed and worked appeal denials from EOB's and correspondence daily.
- Posted co-payments, patient payments, and insurance company payments (paper and electronic) and denials. Performed reconciliation of payments and prepared deposit for payments received.
- Processed patient billing, statements, reimbursement claims, post transaction and data.
- Produced transaction analysis reports: Write-offs, payment type and credit balances.
Education
Some College (No Degree) - Business Management
Suffolk County Community College
Brentwood, TNSkills
- Excel and QuickBooks
- Navi-Net and Isynergy
- Anatomy knowledge
- Accounts receivable management
- Medical billing and coding
- CPT and ICD-10 coding
- Medical scheduling and records
- Microsoft Office suite proficiency
- Customer service excellence
- Managed care experience
- EMR systems expertise
- HIPAA compliance knowledge
- Administrative and clerical skills
- Workers' compensation processing
- Insurance verification strategies
Certification
- MIC Audit Webinar
- May 2017 to May 2017
- Medicare/Medicaid denial and appeals management.
- April 2017 to April 2017
- Managed Care denials Management
- Email Etiquette: Protecting confidential Information.
- Paychex E-Learning Seminar: Customer Service, valuing diversity in the workforce for employees.
- United Healthcare Sponsored HIPPA 5010 and ICD10 Implementation Workshop
- March 2013 to March 2013
- ICD-10 transition coding training. Training of the ICD10 HCPC codes and associated crosswalks.
- Markson Practice Management
- April 2009 to December 2009
- Completed Chiropractic Assistant certification and attained 1600+ hours of continuing ED in practice management and Insurance Billing/Collections
Timeline
Reimbursement Specialist
Johnson & Johnson
01.2024 - Current
AR Billing/ Collection/Authorization Specialist
DRS Medical- DME
05.2019 - 11.2023
AR Billing & Collection Specialist
Apex Billing Solutions, LLC
07.2016 - 05.2019
AR Billing and Collection Specialist
Boulder Outreach Solutions
05.2015 - 05.2016
AR Billing and Collections Specialist
Consulate Healthcare
12.2013 - 01.2015
Billing Office Manager
Yeomans Chiropractic
09.2011 - 08.2013
Some College (No Degree) - Business Management
Suffolk County Community College
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