Mary Klumpstra
White Cloud,MI
Summary
Dynamic billing and coding professional with over 37 years of experience in pain management. Expertise in analyzing reports, educating staff, and ensuring compliance with regulations to drive revenue growth.
Overview
36
36
years of professional experience
Work History
Educator
Haven Spine + Pain
Grand Rapids, MI
03.2023 - 10.2025
- Initialized reporting and analyzed claim denials for the purpose of investigating low revenue for this practice and improving.
- Educated billing and management staff on payer policies, billing with applicable diagnoses, modifiers and how to appropriately and compliantly review and interpret physician documentation.
- Review of physician documentation against payer policies and reporting of such to manager.
- Educated physicians on payer policies and required documentation guidelines, frequency limitations and payable diagnoses and conservative treatments prior to pain care.
- Handled Medicare audits for arthrodesis procedures.
- Worked complex appeals.
- Routinely reviewed payers frequently rejected claims, reasons for rejections and denials and advised on contractual agreements.
- Numerous attempts made to advise on credentialing issues causing claim denials.
- Ran monthly reports, analyzed them and reported back to each physician, stats, with monthly revenue.
Billing Manager
Javery Pain Institute
Grand Rapids, MI
07.2009 - 02.2023
- Billing. Coding, payment posting and working AR
- Ensuring correct payments (bilateral, multiple, etc) and that billings were correct (appropriate modifier usage as compared with documentation).
- interviewed and collaborated with hiring hiring manager when additional billing/coding staff was needed.
- Trained coding/billing staff and monitored work
- Performed yearly evaluations for billing/coding staff
- Stayed abreast of payer policies and routinely advised physicians on changes.
- Advised physicians on payer policy and documentation guidelines to ensure compliance.
- Led the billing/coding team to ensure healthy monthly revenue.
- Routinely ran reports and reported back to physicians
- Met with physicians and management as needed
- Handled audits
Billing/Scheduling Manager
Michigan Pain Consultants
Grand Rapids, MI
05.1996 - 08.2008
- Worked with PM to select and promote high achieving billing/scheduling staff to Team Leaders to help lead two large teams
- Trained and educated these teams to achieve high functioning and smooth work flows for the purpose of quick and efficient claim cycles: Referral, Record, Insurance verification, Authorization? File claim, Claim paid.
- Led, mentored and educated both teams in all aspects:
- Billing/coding/Modifier usage and how to review government website to find out which are applicable, per procedure
- Taught the importance of verifying insurance prior to administering treatment and the ROLE OF THE FRONT DESK PERSONNEL STAFF
- Taught the revenue cycle role and how it begins with the referral
- Educated scheduling staff on Pre-Authorization requirements, how to check and the differences between various plans (HMO, PPO, EPO, POS)
- Reviewed reports with PM
- Worked complex appeals and assisted staff with claim denials and rejections
Office Manager
Steven Ottenweller, MD
Grand Rapids, MI
06.1989 - 05.1996
- Managed office operations, as per surgeons schedule
- Coordinated scheduling for patient appointments, optimizing provider availability and patient flow.
- Oversaw inventory management, streamlining supply procurement and reducing costs.
- Assisted physician with minor office surgeries
- Performed and processed all sterilization packs
- Handled all billing and payment posting
- Met with applicable pharmaceutical and other representatives
- Performed all banking responsibilities
Education
High School Diploma -
Reed City
Reed City, MIAdvanced Pain Coding Certification - Pain Management Coding
Board of Medical Education
2012
Certified Medical Assistant - Medical
Ross Medical Education Center
Grand Rapids, MI05.1989
Skills
- Over 37 years Billing/Coding experience, 30 years in Pain Management
- Mentored and taught by some of the nations expert consultants and educators, to include Marvel Hammer, Devonna Slater, Judy Blasziek, Amy Turner and Attorney Vicky Myckowiak
- 20 years of attendance to Pain conferences in numerous states
- Numerous courses, classes and other educational events to ensure my skills and knowledge are maintained as per payer policies and how they relate to pain management treatment and guidelines
- Routine review of what and how Pain practitioners are doing that get themselves into trouble and how they are fighting it if they feel they are not wrong ie, USA vs Raj
- Expert knowledge of coding in this specialty
- Expert knowledge of government policy for Pain Management
- Ability to run and analyze reports for the practice to ensure highest revenue
- Ability to analyze physician documentation to ensure it meets policy criteria standards
- Knowledge of what auditors are looking for and what physicians can do to ensure guidelines are met in event of audit
- Knowledge and ability to teach and share with others
Timeline
Educator
Haven Spine + Pain
03.2023 - 10.2025
Billing Manager
Javery Pain Institute
07.2009 - 02.2023
Billing/Scheduling Manager
Michigan Pain Consultants
05.1996 - 08.2008
Office Manager
Steven Ottenweller, MD
06.1989 - 05.1996
High School Diploma -
Reed City
Advanced Pain Coding Certification - Pain Management Coding
Board of Medical Education
Certified Medical Assistant - Medical
Ross Medical Education Center