Michelle Fuksa
Andover,Ks
Summary
Results driven medical biller with several years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrates leadership skills to guide teams towards success, optimize performance and sustain organizational success.
Overview
33
33
years of professional experience
Work History
Reimbursement Specialist
Kansas Gastroenterology
09.2014 - Current
- Adheres to HIPAA regulations when handling confidential information.
- Analyze data trends in order to identify areas of improvement in reimbursement processes.
- Trains new team members on company policies and accounting systems to keep team operations productive and efficient.
- Responds promptly to inquiries from insurance companies regarding claim disputes.
- Corrects, completes and processes claims.
- Coordinates with outside vendors such as providers, labs, and copay programs for biologic infusions.
- Interprets complex medical codes related to billing procedures.
- Acts as a liaison between insurance companies and healthcare providers.
- Expedites payments by verifying accuracy and currency of patient and insurance information.
- Collaborates with internal teams such as finance, accounting, and legal departments.
- Monitors customer account details for non-payments, delayed payments, and other irregularities.
- Monitors past due accounts and pursued collections on outstanding invoices.
- Generates and distributes month-end statements for customers and resolved related concerns.
- Processes refund requests and reconciled deposit and patient collections.
- Maintains detailed records of all communications related to claim processing activities.
- Checks claims coding for accuracy with ICD-10 standards.
- Enters procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Collects, posts, and manages patient account payments.
- Performs insurance verification, pre-certification and pre-authorization.
- Processes claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
- Generates detailed financial reports for management review.
- Assists patients with filing appeals for denied claims.
- Creates reports detailing the status of outstanding medical claims.
- Oversees daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
- Researches discrepancies in patient accounts to resolve payment issues.
- Codes and submits complex infusion claims
- Coordinates patient enrollment, claims submission, and payment posting for multiple biologic assistance programs.
Billing
CMB Medical Billing, Inc
10.1999 - 09.2014
- Managed billing operations for a small agency.
- Directed all billing activities such as claims management, payment postings, and physician payroll.
- Resolved customer inquiries regarding billing information.
- Assisted customers with payment issues and billing inquiries.
- Resolved billing disputes with customers promptly.
- Maintained accurate records of billing transactions.
- Prepared invoices for customers using billing software.
- Verified accuracy of invoices and billing statements.
- Managed billing process for insurance companies when necessary.
- Coordinated with billing department to clarify billing issues related to coding.
Front Desk Receptionist
Lakepoint Psychiatry
Wichita, KS
01.1992 - 09.1999
- Completed basic bookkeeping and document filing.
- Handled cash transactions accurately, balancing the register at the end of each shift.
- Performed data entry into computer systems to maintain accurate records of customer information.
- Greeted visitors entering establishment to determine nature and purpose of visit.
- Maintained client accounts by obtaining, recording and updating personal and financial information.
- Reconciled daily financial transactions against cash receipts at the end of each day's business activity.
- Monitored reception area to provide consistently safe, hazard-free environment for customers.
- Assisted with scheduling appointments for clients and visitors.
- Assisted with preparing reports, presentations and other documents as requested by management staff.
- Answered multi-line phone system and managed calls by routing to proper extensions or taking messages.
- Processed payments from customers using a variety of payment methods including credit cards, checks and money orders.
- Answered incoming calls, directed them to appropriate personnel and took messages.
- Handled sensitive information in a confidential manner.
Billing/Front Desk
Charter Hospital
Wichita, Ks
- Billing/payroll Manager
- Billing department for hospital and clinic
- Responsible for claims, payment posting, doctor payroll, etc for both hospital and clinic.
- Processed customer refunds promptly upon request.
- Managed daily cash postings from lockbox or other electronic methods of payment processing.
- Oversaw the preparation of monthly billing reports and analysis to track billing efficiency and accuracy.
- Worked with customers to resolve billing disputes in a timely manner.
- Helped customers to bring accounts into good standing by implementing payment plans.
- Monitored customer account details for non-payments, delayed payments, and other irregularities.
- Monitored delinquent accounts and worked with collections department if necessary.
Education
High school -
Southeast Highschool
Wichita, Ks06-1993
Skills
Proficient in Microsoft Word and Excel
- Consistent Performer
- Charge posting/coding
- Payment Posting
- Effective Communication Skills
- Customer Service
- EMR and Billing Software
- Positive attitude
- Good communication skills
- Good organizational skills
- Adaptable Learner
- ICD-10 coding
- Claims processing
- Payment posting
- HIPAA compliance
- Microsoft office
- Medical billing
- Copay collection
- Eligibility verification
- Team collaboration
- Account reconciliation
- Multitasking and organization
- Month-end closing procedures
- Denial management
- Time management
- Collection practices
- Attention to detail
- Problem-solving
- Billing dispute resolution
- Customer engagement
- Financial reporting
- Collaborative Team Member
References
References available upon request.
Timeline
Reimbursement Specialist
Kansas Gastroenterology
09.2014 - Current
Billing
CMB Medical Billing, Inc
10.1999 - 09.2014
Front Desk Receptionist
Lakepoint Psychiatry
01.1992 - 09.1999
Billing/Front Desk
Charter Hospital
High school -
Southeast Highschool
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