Randiann Stalter
Hackettstown,NJ
Summary
Detail-oriented Medical Billing Specialist/Medical Assistant with almost 20 years of experience in the healthcare field of which the last 9 years as a billing specialist include cycle management, insurance claims processing, payment posting, and accounts receivable follow-up. Skilled in ICD-10, CPT, and HCPCS coding review, insurance verification, claim submission, denial resolution, and maintaining HIPAA compliance. Proven ability to improve reimbursement rates and ensure accurate billing practices in fast-paced healthcare environments.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Medical Billing Specialist
MEG Business Management (A Provana Company)
Homosassa, GA
02.2018 - Current
- Prepare, review, and submit insurance claims accurately and timely.
- Verify patient insurance eligibility and benefits prior to services.
- Follow up on unpaid, denied, or rejected claims to maximize reimbursement.
- Post insurance and patient payments to accounts.
- Research and resolve billing discrepancies and claim denials.
- Maintain compliance with HIPAA regulations and payer guidelines.
- Communicate with insurance companies, providers, and patients regarding billing issues.
- Processed and submitted medical claims to insurance providers, ensuring compliance with regulations.
- Reviewed patient accounts for accuracy, resolving discrepancies promptly to maintain data integrity.
- Coordinated with healthcare providers to gather necessary documentation for claim approval.
- Verified accuracy of accounts payable payments, resulting in 60% reduction in payment errors and check reissues.
Medical Billing Clerk
Suncoast Skin Dermatology
Ocala, FL
05.2015 - 06.2018
- Registered patients and updated demographic information.
- Assisted with appointment scheduling and referral processing.
- Verified insurance coverage and collected required documentation.
- Managed incoming calls and directed patients to appropriate departments.
- Maintained confidentiality of patient information.
- Verified accuracy of accounts payable payments, resulting in 50% reduction in payment errors and check reissues.
Customer Service Representative
Tri County Orthopedics
Cedar Knolls, NJ
09.2003 - 10.2013
- Handled high-volume customer inquiries via phone and email.
- Resolved concerns while maintaining a positive customer experience.
- Entered and updated records with a high degree of accuracy.
- Collaborated with team members to improve workflow efficiency.
- Obtained authorization for in office procedures.
- Managed patient inquiries and resolved issues, ensuring high levels of customer satisfaction.
- Coordinated scheduling for appointments, optimizing clinic workflow and reducing wait times.
- Implemented feedback mechanisms to identify areas for service improvement and increase efficiency.
Education
Medical Assistant Certificate -
Anthem Institute
Parsippany, NJ01-2011
High School Diploma - undefined
North Warren Regional High School
Blairstown, NJ01-2002
Skills
- Medical Billing & Claims Processing
- Revenue Cycle Management
- Accounts Receivable Follow-Up
- Payment Posting
- Denial Management & Appeals
- ICD-10, CPT & HCPCS Codes
- Electronic Health Records (EHR/EMR)
- HIPAA Compliance
- Medicare & Medicaid Billing
- Commercial Insurance Billing
- Data Entry & Record Accuracy
- Customer Service
- Microsoft Office Suite
- Medical Billing Software: Theraoffice, Therabill, Fusion, A2C, PTEverywhere, Web PT
- Microsoft Excel, Word, Outlook
- Insurance Portals
- Electronic Claims Submission System
- Claim submission
- Insurance verification
- Patient billing
Certification
- Medical Assistant Certificate
- HIPAA Certification
Timeline
Medical Billing Specialist
MEG Business Management (A Provana Company)
02.2018 - Current
Medical Billing Clerk
Suncoast Skin Dermatology
05.2015 - 06.2018
Customer Service Representative
Tri County Orthopedics
09.2003 - 10.2013
High School Diploma - undefined
North Warren Regional High School
Medical Assistant Certificate -
Anthem Institute