Neals Maxilin
Coral spring
Summary
Experienced Billing Manager with 9+ years of expertise in medical billing and claims management. Improved billing processes resulting in a 95% clean claim rate. Proficient in Medicaid, Medicare, and private insurance, collaborating with insurance providers to ensure HIPAA compliance. Utilizes analytical skills to enhance financial transparency and cash flow management, fostering a cooperative work environment. Skilled in handling complex billing issues, ensuring accuracy, and meeting deadlines. Strong focus on team collaboration and adaptability. Reliable communicator and problem-solver with proficiency in billing software, customer service, and financial reconciliation. Prepared to deliver results and contribute effectively in a fast-paced environment.
Overview
9
9
years of professional experience
2
2
years of post-secondary education
Work History
Billing Rep III/ Account Receivable
NYU LANGONE
02.2024 - Current
- Manage billing processes, ensuring prompt payments and reducing outstanding balances
- Streamline account receivables, achieving noticeable improvement in cash flow management
- Analyze financial data to identify discrepancies, enhancing accuracy in billing operations
- Collaborate with departments to resolve billing issues, fostering a cooperative work environment
- Optimize billing processes, reducing outstanding balances and enhancing cash flow through streamlined account receivables management
- Implement new strategies for managing account receivables, resulting in measurable improvements in cash flow and financial stability
- Meticulously oversee billing operations, ensuring timely payments and maintaining high standards of accuracy in financial transaction
- Conduct thorough financial data analysis to pinpoint discrepancies, enhancing billing accuracy and operational efficiency in healthcare finance
- Cross-trained in EPIC systems to enhance billing and accounts receivable processes.
- Utilized EPIC software to manage and process billing and accounts receivable.
- Processed claim appeals to resolve billing discrepancies.
- Processed and submitted claim appeals to ensure timely resolution.
- Handled reconsideration submissions to facilitate the resolution of denied claims.
- Handled authorization appeal processes, maintaining accuracy and adherence to guidelines.
- Monitored claim status to ensure timely updates.
- Resourcefully used various coding books, procedure manuals, and online encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied EncoderPro to enhance efficiency in medical billing and maintain precise coding.
MEDICAL BILLING SUPERVISOR
CHIROCARE OF FLORIDA
11.2021 - 02.2024
- Supervised billing operations across 5 locations, ensuring accuracy and efficiency.
- Lead billing operations for $5M+ annually, ensuring a95% clean claim rate
- Verify insurance eligibility for correct billing and patient satisfaction
- Analyze EOBs for precise insurance billing, enhancing financial transparency
- Coordinate with patients, insurers, and the billing office to streamline processes
- Streamlined denied claims process, achieving a95% clean claim rate and enhancing billing accuracy, while managing operations exceeding $5 million annually
- Facilitated seamless communication between patients, insurers, and the billing office, ensuring accurate coding and fostering a collaborative environment
- Meticulously reviewed patient diagnosis codes, processed insurance denials, and audited files to maximize reimbursement and improve financial clarity
- Implemented efficient processes for insurance verification and payment collection, developing strategies to improve claim submission accuracy
- Optimized account accuracy through efficient management of patient payments and thorough analysis of complex EOBs, ensuring correct insurance billing
- Supervised medical billing processes to ensure accuracy and compliance.
- Managed billing staff and workflows to optimize efficiency and reduce errors.
- Resolved billing discrepancies and worked with insurance companies to facilitate prompt payment.
- Worked closely with offshore counterparts to optimize medical billing workflows.
- Oversaw the accurate application of medical coding to ensure compliance with healthcare regulations.
- Managed appeal processes to ensure timely and accurate resolutions.
- Ensured timely submission of billing documents.
- Developed and implemented training programs for offshore staff to optimize billing operations.
Billing Manager
MEDTECH WORLDWIDE
03.2018 - 11.2021
- Assigned diagnostic codes, achieving a95% clean claim rate, and ensuring compliance and accuracy
- Resolved code discrepancies through effective communication with insurance firms
- Conducted on-site audits, enhancing accuracy and adherence to coding standards
- Conducted on-site coding audits, implementing strategic improvements that significantly elevated coding accuracy and compliance standards across departments
- Facilitated seamless communication between the coding team and insurance firms, effectively resolving discrepancies and improving claim accuracy
- Spearheaded on-site audits, implementing strategic improvements that significantly elevated coding accuracy and compliance standards
- Developed and implemented new coding protocols, streamlining processes and reducing error rates in diagnostic code assignments
- Conducted comprehensive reviews of coding practices, identifying areas for improvement and ensuring adherence to industry standards
- Optimized diagnostic coding processes, achieving a95% clean claim rate and enhancing overall accuracy in medical billing procedures
- Bridged communication gaps between the coding team and insurers, swiftly resolving discrepancies and boosting claim precision
- Managed durable medical equipment (DME) billing processes to ensure accurate and timely claims submission.
- Conducted training sessions to improve staff proficiency in billing operations.
- Guided new hires through onboarding, focusing on billing systems and compliance.
- Worked closely with nurses to review and correct coding edits.
Ambulatory Service Representative
Broward Health
11.2015 - 03.2018
- Informed patients of self-pay balances owed to the facility
- Reviewed account information and explained charges and other related inquiries from patients and insurance carriers in person or via telephone
- Documented actions in the system to maintain patient history and billing files
- Established payment arrangements according to policies, referring issues to the collection manager
- Trained new staff on filing, phone etiquette, and other office duties
- Processed payments using cash and credit cards, maintaining accurate records of transactions
- Greeted and assisted patients with check-in procedures
- Answered incoming calls, scheduled appointments, and filed medical records
- Verified patient insurance eligibility and entered patient information into the system
- Referred patients and guarantors to sources of outside funding
- Responded to inquiries by directing calls to appropriate personnel
- Engaged with patients to provide critical information
- Delivered support to medical staff in completion of patient paperwork
- Provided excellent customer service to patients and medical staff
- Process over 500 ACA Applications per year
- Streamlined patient check-in and billing processes, enhancing efficiency and reducing wait times
Education
Bachelor of Science - Health Administration
University of Phoenix-Arizona
08.2022 - Current
Certificate - Medical Coding
Atlantic Technical College
Pompano Beach, FL05.2015
High School Diploma - undefined
Palm Beach Central High School
Wellington, FL05.2012
Skills
- HIPAA Compliance Experienced
- Account Reconciliation
- Payer Contracts
- Workflow Management
- Medicaid
- Medicare
- Worker's comp
- PIP
- Claim Denial Management
- Team Leadership
- Customer relations skills
- Microsoft office
- Clinical workflow analysis
- Team leadership
- Epic software proficiency
- NextGen systems
- Appeals process proficiency
Internships
Jan2015 - May2015 Medical Record Intern, Broward Health Lauderdale Lakes Florida
Timeline
Billing Rep III/ Account Receivable
NYU LANGONE
02.2024 - Current
Bachelor of Science - Health Administration
University of Phoenix-Arizona
08.2022 - Current
MEDICAL BILLING SUPERVISOR
CHIROCARE OF FLORIDA
11.2021 - 02.2024
Billing Manager
MEDTECH WORLDWIDE
03.2018 - 11.2021
Ambulatory Service Representative
Broward Health
11.2015 - 03.2018
Certificate - Medical Coding
Atlantic Technical College
High School Diploma - undefined
Palm Beach Central High School
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