Leriana Demo
Keansburg,US
Summary
Highly skilled healthcare professional with extensive expertise in medical billing and coding. Demonstrated ability to accurately process patient data and insurance claims, ensuring compliance with regulations. Strong emphasis on collaborating with team members and achieving results, while remaining adaptable to changing needs. Proficient in medical terminology, coding systems, and electronic health records, with a reliable and efficient work ethic.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Outpatient/ In Patient Billing Specialist
Lifeline Medical Associates OBGYN
09.2022 - Current
- Supported organizational budgeting efforts by providing detailed revenue projections based on historical trends in the patient billing domain.
- Collaborated with healthcare providers to obtain necessary documentation for accurate bill submissions, reducing delays in payments.
- Ensured timely payment collections by promptly following up on outstanding balances and negotiating payment plans.
- Maintained strict compliance with HIPAA regulations when handling sensitive patient information during the billing process.
- Conducted thorough audits of patient accounts, identifying discrepancies and ensuring billing accuracy before finalizing statements.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Liaised between patients, insurance companies, and billing office.
- Verified accuracy of accounts payable payments, resulting in 30% reduction in payment errors and check reissues.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
Office Medical Staff / Inpatient Medical Coder
Meleis Medical Group LLC.
12.2016 - 03.2020
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Enhanced patient satisfaction by efficiently managing the front desk operations and addressing inquiries in a timely manner.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
Education
Bachelor of Science - Psychology
William Patterson University
Wayne, NJ05.2016
Skills
- Patient account management
- Insurance claims processing
- Medical claims submission
- Medical terminology expert
- ICD-10
- Insurance collections
- Reimbursements
- Documentation skills
Certification
Certified Professional Coder
Languages
Albanian
Native or Bilingual
Macedonian
Native or Bilingual
Timeline
Outpatient/ In Patient Billing Specialist
Lifeline Medical Associates OBGYN
09.2022 - Current
Office Medical Staff / Inpatient Medical Coder
Meleis Medical Group LLC.
12.2016 - 03.2020
Certified Professional Coder
Bachelor of Science - Psychology
William Patterson University
Accomplishments
Completed an AAPC credentialed course and obtained my Certified Professional Coder certification.
Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Work-life balanceCareer advancementFlexible work hoursWork from home optionWork Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Similar Profiles
Elen HambardzumyanElen Hambardzumyan
Director of Nursing (RN, BSN) at Lifeline Medical AssociatesDirector of Nursing (RN, BSN) at Lifeline Medical Associates
Emma MarsanEmma Marsan
Medical Assistant at Women's Care Source at Lifeline Medical AssociatesMedical Assistant at Women's Care Source at Lifeline Medical Associates
Cecily JuarezCecily Juarez
Phone Triage Nurse at OBGYN Medical Center AssociatesPhone Triage Nurse at OBGYN Medical Center Associates