Melanie Bolta
Brentwood,NY
Summary
Medical Billing Collections Specialist
Detail oriented quality focused professional billing specialist. Successful track record handling complicated assignments. Highly experienced In reconciling insurance and patient payments and resolving account disputes. Proficient in a variety of practice management software applications. Dedicated to maintaining strict patient confidentiality.
Detail oriented quality focused professional billing specialist. Successful track record handling complicated assignments. Highly experienced In reconciling insurance and patient payments and resolving account disputes. Proficient in a variety of practice management software applications. Dedicated to maintaining strict patient confidentiality.
Overview
15
15
years of professional experience
Work History
Account Manager
Medical 360
Hauppauge, NY
02.2014 - Current
- Prepares and submits clean claims to various insurance companies either electronically or by paper.
- Answers questions from patients, clerical staff and insurance companies.
- Identifies and resolves patient billing complaints.
- Prepares, reviews and sends patient statements
- Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
- Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor, also prepares information for the collection agency.
- Performs daily backups on office computer system
- Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers. Processes payments from insurance companies and prepares a daily deposit.
- Participates in educational activities and attends monthly staff meetings.
Billing Specialist
Progressive Urology
Manhasset, NY
06.2013 - 01.2014
- Responsible
for retrieving and posting payments and adjustments (insurance & patient)
- Entering daily charges for hospital and office
visits, processing electronic claims and paper claims
- Insurance
verification, audit patient accounts, transmitting claims, sending patient
statements
- Follow-up/appeals
on all unpaid claims
- Verifying
Eligibility for Insurance, entering patient demographics into computer system
Billing Collections Specialist
21St Century Oncology/Urology
Plantation, FL
06.2012 - 05.2013
- Managed
Billing Department For 2 Doctors
- Cross
Trained & Reconstructed Billing Department
- Pre
Certifications, Referrals, Patient Eligibility
- Patient
Representative & Counseling, Out of Pocket & Budget Plans Patient
Assistance Programs
- Skilled
Nursing Facility Billing & Contracts
- Produced
Financial Aged & Activity Reports
- A/R
Check Posting, EOB Correspondence, Bank Deposits
- Appeals
& Follow up, Statements, Self-Pay & Collection Agency Supervised
Daily CPT & ICD-9 Coding & Transmission for Office & Hospital
Charges
- Calculated
Totals, Daily & Monthly Closes
Updated Computer & Spread Sheet for Quarterly, Yearly CPT Fee Schedule
- Insurance
Specialist Coordinator for HMO, PPO & Commercial Carriers Coordinate
with other Departments, Conducted Staff & Management Meetings
- Implemented
EMR Software (Urochart)
Setup office for medicare incentive program
Senior Billing Collections Specialist
Premier Urology Associates
Lawrenceville, NJ
08.2008 - 06.2012
- Improved revenue for most recent provider over 32% with same patient
load
- Experienced billing for Urology, Pathology, Oncology Radiation
Therapy
- Ensure claims are entered and submitted with 48 hours of receipt Accurately apply payments to patient accounts
- Post and reconcile insurance and patient payments
Research and resolve incorrect
payments, EOB rejections, and other issues with outstanding accounts Insure
accuracy
of insurance claims.
- Specialist in Medicare, Medicaid, Workers Comp and all commercial
insurances including Medicare replacement plans
- Verify correct ICD-9 and CPT codes for a variety of specialties
- Set up new patient accounts Assign ICD-9 to physicians diagnosis and
insure correct level of service and various other CPT codes
- Set-up practice management software for submission of electronic
claims to clearinghouse
- Work with clearinghouse to resolve file compatibility issues Retrieve
Electronic Remittance Advice (ERA's) Send secondary claims upon processing of
primary insurance
- Monthly processing of Patient statements
- Answer and resolve patient
billing inquires
- Follow up on Insurance and patient aging.
- Re-submit insurance claims as necessary Knowledgeable in timely
filing restrictions
- Insure office practices are in compliance with HIPAA regulations Interview patients obtained demographics medical insurance and
financial data
- Obtained authorizations from
insurance companies and care-core
Education
Diploma - Medical Billing and Coding
Hunter Business School
Levittown, NY2003
Skills
- Medical billing
- HIPAA compliance
- CMS-1500 billing forms
- Works well under pressure
- Microsoft Word
- Microsoft Excel
- Financial reporting
- Excellent communication skills
Timeline
Account Manager
Medical 360
02.2014 - Current
Billing Specialist
Progressive Urology
06.2013 - 01.2014
Billing Collections Specialist
21St Century Oncology/Urology
06.2012 - 05.2013
Senior Billing Collections Specialist
Premier Urology Associates
08.2008 - 06.2012
Diploma - Medical Billing and Coding
Hunter Business School