Marc Sylva
Tucson,AZ
Summary
Dynamic Medical Billing Specialist with extensive experience at the United States Air Force, excelling in claim submission and denial management. Proven track record in enhancing revenue collection and patient satisfaction through effective communication and critical thinking. Skilled in HIPAA compliance and staff training, fostering a collaborative environment for optimal patient care.
Medical records professional skilled in overseeing documentation processes and ensuring compliance with healthcare regulations. Proven ability to lead teams in achieving accurate and timely record management. Known for effective collaboration and adaptability to evolving needs, with expertise in data integrity and process improvement.
Experienced with managing comprehensive medical programs, ensuring high standards of patient care and program efficiency. Utilizes strategic planning and project management to streamline operations and enhance outcomes. Knowledge of team collaboration and adaptable to changing healthcare needs.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Tech-savvy innovator with hands-on experience in emerging technologies and passion for continuous improvement. Skilled in identifying opportunities for technological enhancements and implementing effective solutions. Adept at leveraging new tools and methods to solve problems and enhance productivity. Excels in adapting to fast-paced environments and driving technological advancements. 6 years of experience in MHS Genesis and well versed in Revenue Cycle
Overview
6
6
years of professional experience
Work History
Medical Billing Specialist
United States Air Force
03.2023 - Current
- 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.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
Medical Records Supervisor
United States Air Force
12.2021 - 02.2024
- Managed a team of medical records clerks, providing guidance, support, and mentorship to ensure high-quality work output.
- Negotiated contracts with vendors for software solutions or services related to medical records management, resulting in cost savings without compromising quality standards.
- Oversaw the processing of subpoenas and requests for release of information while maintaining patient privacy rights.
- Streamlined medical records management by implementing efficient filing systems and digital archiving.
- Established criteria and procedures for releasing patient information according to facility policy and legal requirements.
Medical Administration Specialist
United States Air Force
02.2020 - 03.2023
- Conducted comprehensive audits of medical records to maintain compliance with industry regulations and protect patient privacy.
- Facilitated effective communication among interdisciplinary healthcare teams by coordinating meetings and distributing relevant information promptly.
- Conducted thorough analyses of departmental workflows, identifying areas for improvement that ultimately led to increased efficiency and patient satisfaction.
- Reduced appointment wait times for patients with effective scheduling and resource allocation strategies.
- Collaborated with clinical teams to optimize workflow processes, enhancing the overall quality of care provided to patients.
- Improved patient satisfaction by streamlining medical administration processes and enhancing communication between departments.
- Implemented a system for tracking patient referrals, leading to increased revenue from specialist consultations.
- Enhanced overall efficiency within the facility by implementing electronic health records and reducing paperwork redundancies.
- Trained new staff members in medical administration policies and procedures, fostering a collaborative work environment focused on patient care.
Senior Medical Secretary
United States Air Force
03.2019 - 03.2021
- Supported clinical research initiatives within the practice through diligent maintenance of study-related documents and protocol adherence.
- Maintained high levels of patient satisfaction through exceptional customer service skills during phone interactions or face-to-face encounters.
- Decreased wait times for patients, effectively prioritizing urgent cases and managing physician schedules accordingly.
- Assisted in accurate diagnostic coding for billing purposes, collaborating closely with medical providers to ensure proper documentation.
- Reduced administrative errors by creating comprehensive training materials for new medical secretary staff members.
- Contributed to a positive workplace culture by fostering teamwork among administrative staff and proactively addressing any conflicts that arose.
- Improved interdepartmental communication by serving as a liaison between physicians, nurses, and other healthcare professionals.
Education
No Degree - Medical Informatics
Community College of The Air Force
Montgomery, AL03-2027
No Degree - Certified Professional Coder (CPC)® Certification
American Academy of Professional Coders (AAPC)
Salt Lake City, UT02-2027
Skills
- HIPAA compliance
- Payment posting
- Claim submission
- Insurance verification
- Patient billing
- CPT knowledge
- Denial management
- Medicare and medicaid process
- Bill payment
- Accounts payable
- Insurance claims
- Medical terminology
- Critical thinking
- Staff supervision and training
- HIPAA regulations
- Effective communication techniques
- Insurance verification mastery
- Inpatient coding experience
Accomplishments
2023 Healthcare Operations Airman of the Quarter
- Supervised team of 18 staff members.
Timeline
Medical Billing Specialist
United States Air Force
03.2023 - Current
Medical Records Supervisor
United States Air Force
12.2021 - 02.2024
Medical Administration Specialist
United States Air Force
02.2020 - 03.2023
Senior Medical Secretary
United States Air Force
03.2019 - 03.2021
No Degree - Medical Informatics
Community College of The Air Force
No Degree - Certified Professional Coder (CPC)® Certification
American Academy of Professional Coders (AAPC)