Monique Caines
Vancouver,WA
Summary
Detail-oriented professional with strong ICD-10 proficiency and E and M coding experience. Proven ability to resolve billing discrepancies and ensure compliance, contributing to improved revenue outcomes.
Overview
23
23
years of professional experience
Work History
Insurance Follow Up Specialist
Compass Oncology
Vancouver, WA
12.2023 - Current
- Managed insurance follow-up processes to ensure timely resolution of claims.
- Collaborated with healthcare providers to resolve billing discrepancies efficiently.
- Utilized electronic health record systems for accurate documentation and tracking of claims.
- Managed multiple priorities effectively while working within timely filing deadlines, ensuring optimal outcomes for both patients and the organization as a whole.
- Stayed current on industry regulations and trends to ensure compliance and optimize insurance follow-up strategies.
- Provided exceptional customer support to patients and insurance companies, fostering positive relationships.
- Participated in regular staff meetings to discuss and strategize action plans for problematic accounts, resulting in improved collections performance.
- Resolved patient disputes promptly regarding insurance coverage or billing matters.
- Investigated and resolved patient inquiries and complaints quickly.
Medical Biller and Coder
Head And Neck Surgical Associates
Portland, OR
03.2016 - 07.2023
- Used Epic to assign procedure and diagnostic codes to patient records for billing purposes.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
- Communicated with insurance providers to resolve denied claims and resubmit corrected claims for payment.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Guarded against fraud and abuse by verifying coded data accurately reflected services
Lead Medical Biller
Olson Memorial Clinic
Lake Oswego, OR
12.2003 - 01.2014
- Communicated with insurance providers to resolve denied claims.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Managed billing calendar and scheduled claims for payments.
- Delivered timely and accurate charge Education submissions.
- Set up and maintained new electronic billing system.
- Posted payments and collections on regular basis.
- Collected payments and applied to patient accounts.
Education
Certified Professional Coder - Medical Coding
AAPC
Portland, OR07-2022
Certified Dental Assistant - Dental
Carrington College
Portland08-2001
Skills
- ICD-10 proficiency
- Documentation review expertise
- Electronic health records navigation
- Radiology coding knowledge
- Dental coding expertise
- Medical billing procedures
- E and M coding proficiency
- Telehealth coding experience
- Oncology coding abilities
Timeline
Insurance Follow Up Specialist
Compass Oncology
12.2023 - Current
Medical Biller and Coder
Head And Neck Surgical Associates
03.2016 - 07.2023
Lead Medical Biller
Olson Memorial Clinic
12.2003 - 01.2014
Certified Professional Coder - Medical Coding
AAPC
Certified Dental Assistant - Dental
Carrington College