Paula Khoenle
Medical Billing Manager
Eustis,FL
Summary
Medical Billing Manager familiar with all Medical billing requirements. Offering an organized and quality-oriented mindset along with 35 years of experience in administrative, customer service and leadership positions. Eager to leverage abilities and experience in dynamic new position with room for growth and advancement.
Overview
27
27
years of professional experience
Work History
A/R Billing Specialist
Mid-Florida Pathology, LLC
06.2023 - Current
- .Improved A/R billing accuracy by diligently reviewing invoices and resolving discrepancies.
- Researched and resolved billing discrepancies to enable accurate billing.
- Implemented process improvements reducing billing errors and enhancing workflow efficiency.
- Monitored aging accounts and initiated collection processes to optimize cash flow.
- Enhanced cash flow by expediting the collection of overdue accounts through persistent followup.
- Provided exceptional customer service while managing high-volume client inquiries regarding billing matters.
- Conducted thorough account reconciliations, accurately identifying and resolving discrepancies.
- Assist with posting payments to accounts
- Handle billing issues from both insureds as well as medical practices, correcting issues and rebilling insurance carriers
Medical Billing Manager
Cardiovascular Associates of lake County
07.2021 - 06.2023
- Oversee billing dept (5 employees)
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Resolve billing issues by applying knowledge and completing in-depth research.
- Help customers bring accounts into good standing by implementing payment plans.
- Set up workflows to ensure team goals are met.
- Supervise and Conduct insurance verification and pre-authorization, updated charts reflecting the updated information
- Developed and update Insurance Fee Schedules to insure front office has accurate information
- Monitor AR issues and open tasks to insure prompt handling
- Handle issues with our billing company to obtain continual flow of income to the practice.
- Review Collection Pre-List before sending to outside agency, attempt to settle account or set up payment plan.
- Review medical records to ensure proper coding for testing ordered as well as appeals.
- Attended workshops to keep updated and learn new processes to improve office proficiency
- Contact and set up participation in Insurance plans.
- Hire and train billing staff
Medical Billing Specialist
The Cardiovascular Center
05.2020 - 07.2021
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Posted charges and payments
- Completed appeals, filed and submitted claims
- Posted and adjusted payments from insurance companies
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Reviewed and verified benefits and eligibility with speed and precision.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Prepared and attached referrals, and other required correspondence to reduce incidence of denials.
- Set patients up on payment plans who were having testing done or had large account balances and maintained the payment plans monthly
- Submitted refund requests for claims paid in error.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Consistently informed patients of financial responsibilities prior to services being rendered.
- Reviewed patient bills for accuracy, identifying discrepancies and resolving issues promptly.
Medical Billing Specialist
Premier Infectious Disease
05.2017 - 05.2020
- Posted charges, payments and adjustments.
- Use PMD to bill out charges for hospital visits for 4 Physicians as well as a nurse practitioner.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Completed appeals and filed and submitted claims.
- Posted and adjusted payments from insurance companies.
- Reviewed and verified benefits and eligibility with speed and precision.
- Applied payments, adjustments and denials into medical manager system.
- Submitted refund requests for claims paid in error.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.
- Answered phones and handled all patient issues
Medical Biller and Coder
Dr Charles Kohler MD and Dr. Norma Kusnetz MD
02.2015 - 05.2017
- Filed and submitted insurance claims for commercial, medicare, medicaid and workers comp
- Reviewed received payments both electronic and paper for accuracy and applied to intended patient accounts
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Assigned procedure and diagnosis codes for insurance billing using Intergy software.
- Interpreted medical reports to apply appropriate ICD-9, ICD-10, CPT-4 and HCPCS codes.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Submitted and accurately processed insurance claims with related medical code verifications and assessments.
- Responsible for lowering AR-both patient as well as insurance for both the Family Practice as well as the Surgical Practice.
- Responsible for all aspect for Family Practice from verifying benefits to posting charges, adjustments and payments.
- Responsible for appeals to insurances and all aspects of A/R
- Handle all patients calls to their satisfaction
- Implemented payment plans for patients with balances to avoid collection on accounts.
- Process and send out patient statements monthly
- Responsible for both daily and monthly balancing/closing
- Responsible for ordering supplies
- Responsible for HIPPA training and office compliance
- Maintaining the log for security policies in the office, keeping it accurate and up to date.
Medical Billing Specialist/Assistant Manager
Dr. Andrew Scoma MD
02.2004 - 02.2015
- Communicated with patients with compassion while keeping medical information private.
- Post all charges and payments, both electronic and paper.
- Process and send out patient statements monthly.
- Handle collections on patient balances, as well as all collection agency issues.
- Confirm eligibility and copays/coins for patients
- Handle all patient phone calls regarding accounts from both patients as well as insurance companies and vendors.
- Copy and scan records to patients charts.
- Set up and maintain phone tree to contact patients to confirm upcoming appointments.
- Fax reports, forms etc to both physicians as well as patients electronically via secured portal and UPDOX.
- Responsible for A/R including all appeals to insurance companies
- Assist front office with phone calls, scheduling and anything else needed
- Schedule labs and testing for patients
- Check out patients, make follow up appointments.
- Order office supplies
- Handle HIPPA Compliance for office
- Responsible to balance end of day close, end of month close as well end of year close
- Assist Office Manager wherever needed
- Responsible for smooth running of office in Office Managers absence.
Office Manager/Medical Billing Specialist
Dr. Larry M. Marcus M.D
02.1999 - 03.2004
- Oversee 2 Offices-1 ENT and 1 facial Plastics and 3 employees
- Interview, hire and train new employees.
- Run monthly patient statements.
- Responsible for all aspects of billing to include posting all charges, payments, AR reconciliation, and appeals.
- Handle all office issues that arise-from patient complaints, billing issues from insurance companies, other medical offices, and patients.
- Maintain appointments for office visits as well as surgeries both in office as well as hospital setting.
- Answer phones, set up new patient charts, as well as charts for follow up visits, verify insurance, schedule X-rays and labs.
- Speak to Radiologists to obtain wet reads on tests, and pharmacy orders, writing precise messages for the Physician.
- Set up Pharmaceutical Rep appointments and keep record of office medication samples.
- Run and verify all pre-billing to ensure clean claims and run billing on daily basis.
- Responsible to order all office supplies and reconcile statements from vendors.
- Work closely with the nurse to ensure offices run smoothly day to day.
- Implemented scheduling systems to optimize patient appointments and reduce wait times.
- Coordinated all aspects of the move when combining the 2 offices into one, including setting up new phone lines, charting system and streamlining workflows.
Education
Certificate - Medical Billing And Coding
Educational Training of Wethersfield
Wethersfield, CT05.1999
Certificate - Paralegal
National Academy of Paralegal Studies
Yalesville Ct.06.1990
Skills
- Strong Work Ethic
- Accounts Payable and Receivable Proficient
- Decision Making
- Quality Assurance
- Time Management/Multitasking
- Customer Service
- Quality-Oriented Team Player
- CPT, HCPCS, ICD-9 and ICD-10 Proficient
- INTERGY Software Applications Proficiency
- AMAZING CHARTS Software Applications Proficiency
- MEDISOFT Software Applications Proficiency
- GATEWAY Software Applications Proficiency
- NextGen Software Applications Proficiency
- RXNT Software Applications Proficiency
- UPDOX
- PMD
- HIPAA Compliance
- Cardiology (inc Interventional), Endocrinology, ENT, Facial Plastics, Infectious Disease, Surgical, Family Practice and Pediatric and Pathology Experience
- Verbal and written communication
- Month-end closing procedures
- Medical billing expertise
- Accounts receivable management
- Claim submission and Payment posting
- Appeals processing
- Relationship Building
- Microsoft Office
- Team management
Languages
English
Full Professional
Education and Training
other,other
Timeline
A/R Billing Specialist
Mid-Florida Pathology, LLC
06.2023 - Current
Medical Billing Manager
Cardiovascular Associates of lake County
07.2021 - 06.2023
Medical Billing Specialist
The Cardiovascular Center
05.2020 - 07.2021
Medical Billing Specialist
Premier Infectious Disease
05.2017 - 05.2020
Medical Biller and Coder
Dr Charles Kohler MD and Dr. Norma Kusnetz MD
02.2015 - 05.2017
Medical Billing Specialist/Assistant Manager
Dr. Andrew Scoma MD
02.2004 - 02.2015
Office Manager/Medical Billing Specialist
Dr. Larry M. Marcus M.D
02.1999 - 03.2004
Certificate - Paralegal
National Academy of Paralegal Studies
Certificate - Medical Billing And Coding
Educational Training of Wethersfield