Melanie Humpert
San Bernardino,CA
Summary
Reliable Billing Manager with background in overseeing billing operations within fast-paced environments. Known for effectively managing teams, optimizing billing processes and reducing errors. Strengths include strong leadership skills, problem-solving abilities and commitment to achieving company goals.
Overview
21
21
years of professional experience
Work History
Billing Manager
Primary Care Medical Group of Inland Empire, Inc
San Bernardino, CA
08.2016 - 10.2020
- Daily collaboration and supervision of a high functioning Medical Office including a Primary Physician Office, Pediatric. Specialty of Internal Medicine, Pulmonary and Sleep Medicine, Sleep Clinic. Hospice.
- Resolved complex appeals involving denied claims with accuracy.
- Coordinated timely scheduling for patients referred to specialty office.
- Completed insurance verification and authorization before patient visits.
- Requested authorization and medical imaging post-visit, including coding for medical procedures.
- Scheduled referred patients promptly.
- Assisted medical billing and administrative staff with policy clarifications.
- Offered guidance on policy matters to medical billing and admin staff.
- Clarified policy details, aiding both billing personnel and administrative employees in their tasks.
- Trained and evaluated new staff
- Oversaw completion of monthly aeging audits.
- Generated monthly statements for patients.
- Ensured timely submission of claims through close cooperation with administrative assistants in billing
- Managed implementation of HEDIS and quality measures for Medicare, Medi-Cal, Private, PPO insurances involving 12 IPA groups.
- Managed outreach efforts to ensure timely scheduling of both new and yearly appointments.
- Developed improved standard operating procedures to increase billing accuracy and patient time.
- Identified areas of improvement within the medical billing process, implemented changes accordingly.
- Conducted audits on claims submitted by medical billing staff, ensuring compliance with all applicable laws and regulations.
- Managed and supervised billing department staff, including training, evaluation, and workflow distribution.
- Resolved issues related to denied or rejected payments from insurance companies.
- Enhanced billing efficiency ensuring prompt and precise output.
- Monitored accounts receivable aging reports and worked proactively to reduce outstanding balances due from patients or insurers.
- Supervised activities of administrative assistants, medical assistants, and other staff.
- Managed and reviewed medical billing staff to ensure accuracy of patient accounts.
- Created reports to support appeals such as denials and rejections.
- Negotiated contracts with payers to maximize reimbursement rates for services rendered.
- Completed day-to-day duties accurately and efficiently.
- Worked with cross-functional teams to achieve goals.
- Credentialing for Physicians, Nurse Practitioner, Physician Assistant
- Contracting and licensing for Medical Practices
- Ensured necessary materials were on hand by managing Hospice and Primary Care inventory.
- Processed daily submissions for timely claim handling.
- Posted daily insurance payments
- Daily claim generation
- Daily authorization requesting
- Answering phones
Medical Biller and Coder
Daniel Gorenberg, MD
San Bernardino, CA
08.2004 - 12.2010
- Generated accounts receivable and profit-loss reports.
- Accounting Management Audits perform computer backups.
- Data entry on various accounting software.
- Mailing patient statements, collecting payments.
- Submitting insurance claims, follow up on remittances.
- Requesting, submitting, and obtaining authorizations.
- Cash accountability, conduct cash, check, ATM, and credit card transactions.
- Prepare accurate weekly deposits.
- Open and close the facility daily.
- Maintained multiple job duties of receptionist, office manager, medical referrals authorization clerk, as well as my duties for the job title of medical biller.
Externship - Medical Biller
Agape Medical Management
Riverside, CA
05.2004 - 07.2004
- Medical Biller Externship.
- CPT and ICD-9 coding.
- Utilized Encoder Pro computer software, enhancing operational efficiency.
- Conducted efficient tasks using Lytec Billing software for accurate transaction management.
- Verified and cross-checked data within spreadsheets for consistency.
- filing
- Data entry.
- Answering phones.
- HCFA 1500 forms.
- Electronic billing.
Shift Leader
Hollywood Video
San Bernardino, CA
12.1999 - 05.2002
- Opened and/or closed store daily.
- Cash accountability
- Conducted deposit preparation each day.
- Educated customers about offerings, promotions and pricing to boost sales.
- Positioned skilled staff in key areas throughout shift to optimize department productivity.
- Operated cash registers and balanced cash drawers to ensure accuracy in transactions.
- Developed promotional strategies to attract more customers during slow periods.
- Provided exceptional customer service and maintained a positive attitude throughout the shift.
- Inventory receiving auditing and restocking.
- Ensured staff was properly trained on all aspects of their job duties, including safety protocols.
- Maintained cleanliness and organization of the work area to uphold company standards.
- Managed daily workflow and scheduled staff for adequate coverage.
Education
Medical Biller Course - Health & Human Services
Universal Schools & Colleges of Health & Human Srv
Riverside, CA05-2004
Skills
- Management
- Collections experience
- Healthcare management
- Claims processing
- Training and mentoring
- Billing review
- Worksite organization
- Workplace organization
- File organization
- Clinic organization
- Medical billing technology
- Medicare and medicaid process
- Data entry
- HIPAA compliance
- Insurance verification
- Submission of medical claims
- Patient collections
- Insurance precertification processes
- Multi-line telephone operation
- Scheduling software
- Outbound calls
- Referral tracking
Timeline
Billing Manager
Primary Care Medical Group of Inland Empire, Inc
08.2016 - 10.2020
Medical Biller and Coder
Daniel Gorenberg, MD
08.2004 - 12.2010
Externship - Medical Biller
Agape Medical Management
05.2004 - 07.2004
Shift Leader
Hollywood Video
12.1999 - 05.2002
Medical Biller Course - Health & Human Services
Universal Schools & Colleges of Health & Human Srv
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