Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Michelle Guzman

Roselle Park,NJ

Summary

Motivated professional who is Bilingual in English and Spanish. Experienced in managing and motivating staff to meet daily and monthly expectations. Strong customer service skills and capable of handling sensitive and confidential information with care. Excellent understanding of reimbursement methodologies.

Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.

Overview

19
19
years of professional experience

Work History

Medical Office Associate

Atlantic Imaging Services
01.2023 - Current
  • Answered multi-lined phone, scheduled patients’ appointments, and greeted patients.
  • Updated patient charts and handled data entry
  • Confirm patient eligibility with insurance company
  • Create authorizations for procedures (MRI and CT scans)
  • Assist with setting up patient rooms and assist with patient and family education
  • Offer direct assistance to Spanish-speaking patients by translating information, explaining check-in procedures, and addressing any questions to ensure a smooth and efficient experience
  • Develop a workflow to ensure a smooth process for mammogram patients

Revenue Cycle Supervisor

Vistec Partners
01.2023 - 01.2025
  • Supervising, managing and motivating staff to complete monthly deadlines
  • Recommending account adjustments as appropriate
  • Assuring claims are going out in a timely fashion and as accurately as possible
  • Helped develop strategies to maintain proper and timely filing
  • Created and maintained spreadsheets with common billing issues to resolve for proper reimbursement
  • Assist upper management with solutions to recurring issues as seen in work queues and workflow

Charge Entry Biller Specialist

New You Bariatric Group
01.2021 - 01.2023
  • Manage ICD-10 coding and billing for services rendered in hospital and office (such as office and surgical procedures)
  • Superb multitasking and organizational skills while entering patient encounters
  • Provide optimal customer service while addressing inquiries regarding patient balance, account concerns, and setting up courtesy accounts
  • Data entry and retrieval system
  • Was able to decrease the lag time for home sleep studies

Revenue Cycle Specialist

RIVERSIDE MEDICAL GROUP, Part of Optum
01.2021 - 01.2021
  • Exporting data from system (Epic) to ensure proper billing was met
  • Resubmitting COVID vaccines to HRSA COVID assistance fund
  • Review insurance policies to ensure proper and up to date billing
  • Help gather and set up new edits in Epic in order to make sure claims are going out correctly
  • Provide spreadsheets with useful information regarding payments received (per payor, CPT and/or diagnosis)
  • Complete monthly total patients seen per provider and office/department for multi-specialty group
  • Assist team with knowledge regarding billing and claims corrections from a charge entry point of view
  • Assist new management with possible solutions to reoccurring issues as seen in work-quos
  • Provide guidance to other team members as needed (charge entry, account receivable as well other team members of the revenue cycle team)

Charge Entry Supervisor

RIVERSIDE MEDICAL GROUP, Part of Optum
01.2019 - 01.2021
  • Supervising, managing and motivating staff in the charge entry team
  • Recommending account adjustments as appropriate
  • Assuring claims are going out in a timely fashion and as accurately as possible for over 16 specialties, over 100 locations
  • Running daily open encounter reports and reaching out to district mangers along with office managers to ensure proper closure of such in order to send out claims
  • Helped develop strategies to close open encounters for all offices and specialties
  • Created and maintained spreadsheets with daily and monthly numbers for all specialties
  • Helped create guidelines to ensure Epic support team built for Go-live Pediatric locations
  • Assist other departments with coding questions as well as with insurance follow up to ensure correct processing of claims
  • Reviewed and released charges along the side of the charge entry team to make sure weekly and monthly quota were met
  • Reviewed and corrected (as needed) claims from account receivable team as well as customer service team
  • Assisted with the transition for our Radiology department as well to help establish a workflow that was manageable
  • Assist with coding audits per specialty
  • Was able to increase charges from 2019 to 2020 by 13% and for 2020 to May 2021 increase charges to 78% (from Jan-May; only five months and numbers are larger due to seeing less patients during the pandemic for 2020 compared to 2021 increase for same months)

Billing/Collections

RIVERSIDE MEDICAL GROUP, Part of Optum
01.2010 - 01.2019
  • Manage ICD-10 coding and billing for services rendered in hospital and office. (Such as newborn charges, preventative care visits, etc.)
  • Superb multitasking and organizational skills while entering up to 450-500 patient encounters per day, multiple lines
  • Collection of patient balances, set up and follow up on payment arrangements. Adjusting balances (such as bankruptcy, charge errors, etc.)
  • Provide optimal customer service while addressing inquiries regarding patient balance, account concerns, and setting up courtesy accounts
  • Data entry and retrieval in Epic
  • Handled health insurance payments and reimbursements

Medical Office Assistant

RIVERSIDE PEDIATRIC GROUP
01.2007 - 01.2010
  • Answered multi-line phone, scheduled patients’ appointments and greeted patients.
  • Updated patient charts and handled data entry
  • Confirm patient eligibility with insurance company
  • Create authorizations for procedures or medications for patient and Issue referrals
  • Cover for immediate supervisor in her absence and train new employees
  • Maintain and set up patient rooms and assist with patient and family education
  • Enter and retrieve information from New Jersey Immunization Information System (NJIIS)

Education

Bachelor of Science - Technical Management, Health Information Management

DeVry University
North Brunswick, NJ

Certificate - Medical Billing & Coding

DeVry University
North Brunswick, NJ

HIPAA Training Certificate - undefined

North American Learning Institute

Skills

  • Adaptable in high-stress situations
  • Ability to work easily and cooperatively with other departments
  • Excellent analytical and problem-solving skills
  • Reimbursement methodologies
  • Health Information Statistics
  • Detail-oriented decision maker
  • Proficient task management
  • Ensures compliance with HIPAA regulations
  • Microsoft Office (Word, Excel and Outlook)
  • Office administration
  • Patient scheduling
  • Insurance verification
  • Appointment management
  • Medical office software
  • Attention to detail
  • Patient care
  • Patient registration
  • Insurance authorizations
  • Managing patient records

Languages

Spanish
Native or Bilingual

Timeline

Medical Office Associate

Atlantic Imaging Services
01.2023 - Current

Revenue Cycle Supervisor

Vistec Partners
01.2023 - 01.2025

Charge Entry Biller Specialist

New You Bariatric Group
01.2021 - 01.2023

Revenue Cycle Specialist

RIVERSIDE MEDICAL GROUP, Part of Optum
01.2021 - 01.2021

Charge Entry Supervisor

RIVERSIDE MEDICAL GROUP, Part of Optum
01.2019 - 01.2021

Billing/Collections

RIVERSIDE MEDICAL GROUP, Part of Optum
01.2010 - 01.2019

Medical Office Assistant

RIVERSIDE PEDIATRIC GROUP
01.2007 - 01.2010

Certificate - Medical Billing & Coding

DeVry University

HIPAA Training Certificate - undefined

North American Learning Institute

Bachelor of Science - Technical Management, Health Information Management

DeVry University

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Michelle Guzman