Administrative Professional experienced in optimizing productivity, efficiency and service quality across various environments. Highly dependable, ethical and reliable expert coordinator that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence.
Overview
11
11
years of professional experience
Work History
Billing Coordinator
Universal Healthcare MSO, LLC
09.2022 - Current
Coordinated, managed and implemented auditing procedures for Enhanced Care Management encounters
Communicated with case managers and administrative staff to obtain necessary information for audits
Assigned Admin over several systems
Performed billing and coding procedures for Enhanced Care Management services
Processed insurance company denials by auditing member files, investigating denial reason to determine proper reimbursement
Documented and maintained claim status for each claim throughout billing process
Tracked and reported on claims processing metrics to aid senior management in making informed decisions
Utilized specialized software to process incoming claims, enter data and generate reports
Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards
Maintained strong knowledge of basic medical terminology to better understand services and needed HCPC and ICD-10 coding
Input and processed checks into EMR system
Submit authorization requests to applicable insurance for Enhanced Care Management Services
Submit Enhanced Care Management member referral requests to health plan
Managed workload and priorities to meet claims processing deadlines
Maintained strict confidentiality when handling sensitive client information, adhering to HIPAA or other privacy guidelines as required in specific industries.