Dynamic Revenue Cycle Specialist with a proven track record at Eyecare Medical Group, enhancing revenue through meticulous billing audits and effective dispute resolution. Proficient in CPT and ICD coding, I excel in fostering patient trust and optimizing reimbursement rates, while training teams to uphold best practices in a fast-paced environment.
Analyze & approve Group Life Insurance claims
Approve or deny of life claims involving limits risk to management issues
Effectively use of outside vendors according to guidelines to obtain information
Prepare denials with approval from Consultant or Manager
Make claim decision recommendation in accordance with terms fo the contract
Interpret Insurance contract to determine liability
Review Daily report to process new, miscellaneous mail, pend claims
Review & work emails received
Follow up on claims pended for missing or additional documentation
Complete 15 courses yearly for compliance
Organize team building activity for monthly meeting
Review practice bank account Daily for EFT payments
Download all EOB's from Website for all EFT payments
Posting of EFT, insurance and personal payments
Balance end of day
Run financial procedure reports requested by accountant
Process end of month, end of quarter and end of year for practice
Collections
Follow Up on outstanding account receivable
Completing insurance appeals
Process & post insurance & patient refunds
Research insurance recoupment request
Answer incoming calls to billing department
Meet with patients
Contact with provider representatives
License in Cosmetology/Maine State Hair Academy 1992
Knowledge of several software programs, ICP, Nextech, IDX, GPMS, EPIC, therapy source system, Windows, Microsoft word, Excel, Outlook, ESW
Medical terminology, proficiency with CPT, ICD9 & ICD10 coding
Typing (90WPM)