Mandy Caban
Dana Freeman
North Attleboro,MA
19
years of professional experience
Accomplished Medical Billing Lead with over 23 years of experience in streamlining billing processes and leading teams. Known for enhancing operational efficiency and accuracy, while ensuring compliance with industry regulations. Committed to driving revenue growth and exceptional customer service.
Work History
Medical Billing Administrator
4 Months- Processed medical claims accurately to ensure timely reimbursement and reduce billing discrepancies.
- Utilized billing software to generate invoices and track payments efficiently.
- Resolved billing inquiries by coordinating with insurance companies and healthcare providers.
- Assisted in maintaining patient records and billing documentation for compliance with regulations.
- Collaborated with healthcare providers to resolve discrepancies in patient accounts and optimize revenue cycle management.
Medical Billing Specialist
6 Months- Processed medical claims accurately using billing software to ensure timely reimbursements.
- Reviewed patient accounts for discrepancies, resolving issues to maintain billing integrity.
- Assisted in verifying insurance eligibility and benefits for patients prior to service delivery.
- Collaborated with healthcare providers to gather necessary documentation for claim submissions.
- Maintained organized records of patient accounts, ensuring compliance with HIPAA regulations.
- Supported financial reporting by compiling data on billing activities and outstanding claims.
- Adapted quickly to changes in coding procedures and regulations to enhance workflow efficiency.
- Communicated effectively with patients regarding their bills, addressing inquiries and payment options.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Located errors and promptly refiled rejected claims.
- Identified and resolved patient billing and payment issues.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
Medical Billing Lead
13 Years 7 Months- Led team in resolving complex billing issues, enhancing operational efficiency and accuracy.
- Implemented new software solutions that streamlined billing workflows, reducing turnaround times.
- Oversaw medical billing processes to ensure compliance with industry regulations and standards.
- Developed training materials for staff to improve knowledge of billing systems and procedures.
- Analyzed billing data to identify trends, leading to strategic adjustments in revenue cycle management.
- Collaborated with healthcare providers to clarify billing discrepancies and optimize patient accounts receivable.
- Enhanced revenue by streamlining medical billing processes and improving accuracy in claims submissions.
- Identified trends in denied claims, addressing root causes to prevent future issues and improve overall success rates.
- Oversaw patient payment plans, ensuring timely remittance while maintaining compassionate customer service practices for those experiencing financial hardships.
- Maintained strict adherence to HIPAA privacy guidelines, protecting sensitive patient information at all times during the billing process.
- Collaborated with clinical staff to ensure accurate coding of procedures and diagnoses for proper claim submission.
- Assisted management in developing annual budgets based on historical data and projected growth in patient volume.
- Reduced claim denials by meticulously reviewing and correcting billing errors before submission.
- Expedited payment processing with timely follow-ups on outstanding insurance claims.
- Demonstrated leadership skills by delegating tasks effectively and providing support to team members, contributing to a cohesive and high-performing billing department.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
Education
GED
Skills
Claims processing proficiency
Organizational development
HIPAA compliance
Electronic claims
Collections experience
Collections management
Regulatory compliance updates
Time management
Organizational growth
Fluent English and Spanish
Customer service
Continuous learning mindset
Teamwork
Timeline
Medical Billing Administrator
Dana Freeman
03.2024 - 07.2024Read More
Medical Billing Specialist
Fenway Health
03.2022 - 09.2022Read More
Medical Billing Lead
Fenway Health
01.2006 - 08.2019Read More
South Boston High School
GED
Read More