Madeline Choy
North Port,FL
Summary
Detail-oriented Billing Specialist with expertise in claims processing, insurance verification, and HIPAA compliance. Proven ability to resolve rejected claims swiftly, ensuring timely reimbursement.
Overview
30
30
years of professional experience
Work History
Billing Specialist II
Shared Services Center - Nashville
09.2025 - Current
- Review and resolve rejected hospital claims, determine root causes of rejections, and implement corrective actions to ensure timely claim resolution and payment.
- Prioritize payer-rejected claims based on cash cut-off deadlines to ensure timely resolution and reimbursement.
- Prioritize payer-rejected claims based on cash cut-off deadlines to ensure timely resolution and reimbursement.
Billing Specialist II
Shared Services Center - Sarasota
04.2016 - 08.2025
- Responsible for the editing of primary, secondary, and tertiary hospital claims prior to submitting to insurance companies.
- Submit Inpatient, Outpatient, Auto, Workers Compensation, Downgraded and MSP claims.
- Review rejected hospital claims and conduct insurance verification to confirm eligibility and benefits to support accurate claim corrections and resubmission.
Accounts Receivable Specialist
Tidewell Hospice
10.2014 - 03.2016
- Work closely with the Medicare Billing Specialist, auditing patient accounts.
- Assist the Medicare Billing Specialist with the submittal of claims.
- Submittal of Hospice Medicaid and Medicaid Room and Board claims.
- Responsible for working the Medicare and Medicaid monthly aging reports.
- Keep up to date with Medicare guidelines, as well as with Tidewell's policies and procedures.
Admissions Processor
Tidewell Hospice
05.2010 - 10.2014
- Verification of Medical Insurance: Medicare, Medicaid and Long Term Care
- Initiate authorization from Insurance Companies for Hospice Services.
- Responsible for maintaining the policy and procedures for Face-to-Face visits.
- Assist Admissions Coordinators with processing new Hospice referrals.
Provider Relations Representative (Hybrid-Remote)
Quality Health Plans, Inc
08.2008 - 11.2009
- Cultivated strong relationships with healthcare providers to enhance collaboration and communication.
- Resolved provider inquiries efficiently, ensuring high levels of satisfaction and support.
- Facilitated training sessions for new providers on system tools and best practices.
- Analyzed feedback from providers to identify areas for service improvement and operational efficiency.
Physician Billing Specialist
Tidewell Hospice And Palliative Care
03.2004 - 08.2008
- Prepared Medicare and private insurance claims for company payments.
- Created and maintained bi-weekly reports of physician services for payroll to include in the physicians' salaries.
- Handling and processing of claims for three major medical services.
- Responsible for the creation and maintenance of the policy and procedures for the Palliative care program as well as the Room and Board billing.
Medical Biller
HEALTHCARE MANAGEMENT CONSULTANTS, INC
02.2002 - 08.2003
- Medical Billing Services for Physicians. Responsibilities covered such areas as assigning diagnostic and procedure codes using the ICD-9CM and CPT manuals to accurately process electronic and paper health insurance claims forms for physician offices.
- Entering and posting of insurance payments and adjustments to patient financial records.
- Prepared and issued outstanding balance statements to patients on a daily basis.
Medical Biller / Payment Poster
Horizon Open MRI
08.2002 - 02.2003
- Specializing in Medical Billing for MRI's. Responsible for posting of payments to patient accounts for five centers throughout Florida and Texas.
- Entered data information daily in balancing and closing of the Deerfield, Florida Center.
- Handled reviewing of encounter forms, scripts, insurance verification forms and patient identification as well as various clerical duties.
Senior Sales Assistant / Administrative Assistant
Morgan Stanley
07.1996 - 01.2002
- Opened and maintained various brokerage and retirement accounts.
- Updated and entered option orders through the Boss System.
- Placed security and mutual fund orders as requested by Financial Advisors through the order entry system.
Office Manager
Bruegger's Bagels
08.1997 - 11.1998
- Oversaw daily office operations, ensuring efficiency and adherence to company policies.
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
- Developed and implemented office procedures that improved workflow and reduced errors.
Education
High School Diploma -
John Adams High School
Ozone Park, NY06-1986
Skills
- Knowledge of billing processes and tools
- Claims processing
- Claim submission
- HIPAA compliance
- Insurance verification
- Invoice processing
- Customer service
Timeline
Billing Specialist II
Shared Services Center - Nashville
09.2025 - Current
Billing Specialist II
Shared Services Center - Sarasota
04.2016 - 08.2025
Accounts Receivable Specialist
Tidewell Hospice
10.2014 - 03.2016
Admissions Processor
Tidewell Hospice
05.2010 - 10.2014
Provider Relations Representative (Hybrid-Remote)
Quality Health Plans, Inc
08.2008 - 11.2009
Physician Billing Specialist
Tidewell Hospice And Palliative Care
03.2004 - 08.2008
Medical Biller / Payment Poster
Horizon Open MRI
08.2002 - 02.2003
Medical Biller
HEALTHCARE MANAGEMENT CONSULTANTS, INC
02.2002 - 08.2003
Office Manager
Bruegger's Bagels
08.1997 - 11.1998
Senior Sales Assistant / Administrative Assistant
Morgan Stanley
07.1996 - 01.2002
High School Diploma -
John Adams High School