Leslie Reed
Holland,MI
Summary
Proven Medical Billing Specialist with a track record of enhancing revenue cycle management at MiKids Pediatrics through meticulous claims submission, insurance knowledge and denial management. Leveraged detail-oriented and customer service skills to reduce claim denials by over 30% and reduce A/R by 35%. Expert in ICD-10 coding and proficient in EMR systems, demonstrating a commitment to accuracy and patient privacy.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet practice goals and excellent time management.
I am seeking a full-time position to further follow my 15+ year passion in medical billing & coding. My ideal position offers professional challenges, opportunities for continued learning, education, training and advancement; while allowing me to share my knowledge, ideas, problem-solving skills and interpersonal skills.
Overview
29
29
years of professional experience
Work History
Medical Biller and Coder
MiKids Pediatrics
Caledonia, MI
05.2023 - Current
- Correctly coded and billed medical claims for pediatric primary care, mental/behavioral health and dietitian services
- Reduced claim denials through meticulous verification of patient eligibility and coverage benefits prior to claim submission.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Expedited payment processing by promptly addressing any discrepancies or issues raised by insurance carriers.
- Provided support to administrative staff by ensuring proper handling of sensitive patient data according to HIPAA regulations.
- Collaborated with healthcare providers to ensure accurate documentation, leading to timely reimbursements for services rendered.
- Safeguarded practice revenue by diligently following up on outstanding account balances and initiating collection efforts when necessary.
- Streamlined billing processes by implementing efficient coding practices, resulting in reduced errors and improved revenue generation.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Assisted patients with understanding their insurance coverage and financial responsibilities, fostering positive relationships and trust between the practice and its clients.
- Enhanced compliance with industry regulations by staying up-to-date on changes to medical billing and coding guidelines.
- Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
- Guarded against fraud and abuse by verifying coded data accurately reflected services provided.
- Developed effective communication channels with insurance companies to facilitate prompt resolution of claim inquiries and disputes.
- Maintained high levels of customer satisfaction through prompt resolution of disputes related to charges on patient accounts or insurance claims.
- Ensured continuous improvement in billing processes through regular audits of medical codes and charge entries for accuracy.
- Participated in continuing education opportunities to stay current on advancements within the field of medical billing and coding, thereby elevating the overall quality of work.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Verified signatures and checked medical charts for accuracy and completion.
- Generated reports to identify coding trends and discrepancies.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Followed up with medical staff regarding missing information in patient records.
- Maintained accuracy, completeness, and security for medical records and health information.
- Verified accuracy of patient information in medical records.
Insurance & Billing Specialist
Lakewood Family Medicine LLC
Holland, MI
11.2021 - 05.2023
- Accurately posted payments for assigned carriers
- Accurately posted and sent out all medical claims
- Managed collections claims for unpaid bills against debtors
- Liaised between patients, insurance companies and billing office.
- Communicated effectively and extensively with other departments to resolve claims issues
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy
- Located errors and promptly refiled rejected claims
- Precisely completed appropriate claims paperwork, documentation and system entry
- Precisely evaluated and verified benefits and eligibility
- Adhered to established standards to safeguard patients' health information.
- Delivered timely and accurate charge submissions
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
- Identified over-payments and processed refunds for insurance carriers and patients
- Accurately posted payments and adjustments both electronically and manually
- Managed large volumes of data efficiently and with great care on daily basis
- Verified postings to ledgers to ensure proper entry and account balances
- Provided outstanding customer service by quickly and professionally handling issues
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
- Carried out day-day-day duties accurately and efficiently.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
- Determined client needs and financial situations by listening and setting up payment plans that suit patient needs.
Medical Billing Specialist
North Ottawa Community Hospital
Grand Haven, MI
03.2021 - 10.2021
- Precisely completed appropriate claims paperwork, documentation and system entry for facility based services.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Liaised between patients, insurance companies and billing office.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Adhered to established standards to safeguard patients' health information.
- Delivered timely and accurate charge submissions
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Devoted special emphasis to punctuality and worked to maintain outstanding attendance record, consistently arriving to work ready to start immediately.
- Resolved problems, improved operations and provided exceptional service.
- Participated in continuous improvement by generating suggestions, engaging in problem-solving activities to support teamwork.
- Led projects and analyzed data to identify opportunities for improvement.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
- Located errors and promptly refiled rejected claims.
- Posted and adjusted payments from insurance companies.
- Trained new employees on multiple medical billing programs and data entry software.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Identified and resolved patient billing and payment issues.
- Prepared billing correspondence and maintained database to organize billing information.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Offered friendly and efficient service to customers, handled challenging situations with ease.
- Carried out day-day-day duties accurately and efficiently.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Collaborated with Wound Care Center to achieve correct billing for claims and provided ono on one customer satisfaction.
- Organized team-building activities to enhance working relationships.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity
Realtor
Coldwell Banker Preferred Realtors
Plymouth, MI
11.2014 - 07.2019
- Interviewed clients and generated lists of potential properties meeting specific requirements from available listings
- Advised and informed prospective clients on current market activities/conditions
- Reviewed property listings, interviewed potential clients, accompanied clients to properties and effectively communicated condition of sales
- Assisted buyers with finding ideal homes by assessing needs, requirements and budgets
- Resolved client concerns related to home purchases to maintain high satisfaction ratings
- Followed-up escrow process, coordinated contingency removal of property inspection and maintained timely closing of escrow
- Negotiated contracts with buyers and sellers to maximize customer savings
- Provided relevant real estate investments for customers based on close professional relationships and accurately defining customer needs
- Completed property analysis before completing deals, upholding accuracy in listings and appraisals
- Advised sellers on ways to increase curb appeal and make homes more appealing to potential buyers
- Compared recently sold area properties to determine competitive market prices
- Handled day-to-day happenings of real estate office to consistently grow client base and increase revenue
Medical Front Office Receptionist/Medical Records Clerk
IHA Family Practice
Ann Arbor, MI
04.2009 - 04.2010
- Accurately pulled patient records for upcoming appointments and procedures, typically within 12-hour period
- Managed system conversion and maintained minimal downtime during updates
- Identified new methods to optimize medical records management
- Kept accurate log of all requests for medical information and records
- Communicated effectively with staff, patients and insurance companies by email and telephone
- Reviewed charts and flagged incomplete or inaccurate information
- Utilized NextGen to manage and confirm patient data, such as insurance, demographic and medical history information
- Interacted and communicated easily with department personnel and public
- Maintained accuracy, completeness and security for medical records and health information
- Possessed expert knowledge of competitive and third party products and translated knowledge into business strategy
- Worked with patients to understand insurance requirements and provide exceptional customer service
- Managed and archived quality documentation and participated in internal and external quality audits
- Utilized PowerChart to sort incoming medical records from the hospital and specialty offices into patient charts through the electronic portal
- Received incoming calls and messages and addressed or triaged phone requests
- Maintained current and accurate medical records for a large family medicine office
- Managed master calendar and scheduled appointments for 6 providers based on optimal patient loads and clinician availability
- Documented patient medical information, case histories and insurance details to facilitate smooth appointments and payment processing
- Completed and filed financial documentation for accounting purposes
- Organized paperwork such as charts and reports for office and patient needs
- Completed skilled administrative work to support all office staff and operational requirements
- Managed office logistics by scheduling appointments, maintaining files and collecting payments
- Scheduled, rescheduled and handled cancelled appointments for patients
- Checked patient data including insurance, demographic and health history to ensure all information was current
- Responded to correspondence from insurance companies to verify patient's coverage
- Promptly answered multi-line phone system and greeted callers enthusiastically
Contract Resource
Enmark Systems Inc.
Ann Arbor, MI
01.2001 - 08.2017
- Facilitated cost savings analysis of health insurance and helped the Company Principals make financially and considerate choices for employees benefit packages
- Liaison for employees with questions regarding company insurance plan and educated employees on company provided HSA plan
- Assisted with purchasing and maintaining investment properties for the Company
- Ensured each employee was provided a company cell phone and maintained the entire plan
- Managed full procurement cycle by planning, reviewing, soliciting, awarding, administering and closing out a yearly user group conference held each year around the US
- Coordinated complex travel schedules, accommodations and trip logistics for candidates and executives
- Explained employee compensation, benefits, schedules, working conditions and promotion opportunities
Medical Billing Specialist
IHA Billing Office
Ann Arbor, MI
01.1996 - 1 2000
- Accurately posted surgeries, hospital visits and payments for assigned carriers
- Accurately posted and sent out all medical claims
- Managed collections claims for unpaid bills against estates of debtors
- Communicated effectively and extensively with other departments to resolve claims issues
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy
- Located errors and promptly refiled rejected claims
- Precisely completed appropriate claims paperwork, documentation and system entry
- Precisely evaluated and verified benefits and eligibility
- Performed clerical duties, such as word processing, data entry, answering phones and filing
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment
- Identified over-payments and processed refunds for insurance carriers and patients
- Communicated effectively with others through active listening and dynamic interpersonal skills
- Accurately posted payments and adjustments both electronically and manually
- Managed large volumes of data efficiently and with great care on daily basis
- Processed payments that had been received from insurance companies and Medicare
- Verified postings to ledgers to ensure proper entry and account balances
- Applied mathematical abilities on daily basis to calculate and check figures in all areas of accounting systems
- Proactively identified all accounting errors by developing cross-referencing databases
- Provided outstanding customer service by quickly and professionally handling issues
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
Education
Some College (No Degree) - General Studies
Adrian College
Adrian, MISome College (No Degree) - General Studies
Michigan State University
East Lansing, MIReal Estate License - Real Estate
Michigan Institute of Real Estate
Livonia, MI04.2010
High School Diploma -
Adrian High School
Adrian, MI06.1993
Skills
- Detail driven
- Customer Service-oriented
- Medical claims submission
- Working insurance denials
- Billing statement review
- Insurance verification
- EMR / EHR
- Patient privacy
- Written and verbal communication
- Computer proficient
- Works well independently
- Excellent teamwork
- HIPAA compliance
- Payment posting
- ICD-10 proficiency
- CMS-1500 form completion
- Patient account management
- Medicare and medicaid billing
- Claim submission
- Medical coding expertise
- Diagnostic coding
- Appeals processing
- Procedural coding
- Commercial insurance billing
- Revenue cycle management
- Denial management
- CPT coding
- Medical billing procedures
- HCPCS level II coding
- Claims processing
- Data entry
- Medical billing
- Medical terminology
- Insurance claims analysis
- Medical claims coding
- Document management
- Coding error resolution
- Patient data compilation
- Documentation oversight
- Data verification
- Knowledgeable in NEXTGEN
- Proficiency in EPIC, ALLSCRIPTS
- Regulatory guidelines
- Training and mentoring
- Workflow management
- Continuing education
- Medical record security
- Error reporting
- Patient data identification
- Ethical standards
- Medicare insurance regulations
- Code assignment research
- Coding appeals
- Statement analysis
- Doctor communication
- Attention to detail
- Customer service
- Records review
- Electronic filing system organization
- EMR systems
- Insurance and coding specialist
- Certified medical coder-pending completion of certification course
- Patient information verification
- Billing procedures
- Insurance billing
- Compliance verification
- Certified coding specialist; physician based-pending completion of certification course
- ICD-10 coding
- Patient rights
- Interpersonal communication
- Records maintenance
- Past due account management
- Medical recordkeeping
- Electronic health record specialist
Affiliations
Member of AAPC
Timeline
Medical Biller and Coder
MiKids Pediatrics
05.2023 - Current
Insurance & Billing Specialist
Lakewood Family Medicine LLC
11.2021 - 05.2023
Medical Billing Specialist
North Ottawa Community Hospital
03.2021 - 10.2021
Realtor
Coldwell Banker Preferred Realtors
11.2014 - 07.2019
Medical Front Office Receptionist/Medical Records Clerk
IHA Family Practice
04.2009 - 04.2010
Contract Resource
Enmark Systems Inc.
01.2001 - 08.2017
Medical Billing Specialist
IHA Billing Office
01.1996 - 1 2000
Some College (No Degree) - General Studies
Adrian College
Some College (No Degree) - General Studies
Michigan State University
Real Estate License - Real Estate
Michigan Institute of Real Estate
High School Diploma -
Adrian High School