Rebecca Racicot
Cumberland,RI
Summary
Dedicated, motivated, and thoroughly organized individual who is extremely detail oriented. Highly effective problem solver that strives to help others and is extremely compassionate and friendly. Enthusiastic and a quick-learner, committed, and always eager to learn more. Work positively and professionally at all times and provides exceptional patient relation skills. Extremely experienced with healthcare systems and passionate about seeing tasks from start to finish.
Overview
14
14
years of professional experience
Work History
MASSAGE THERAPIST
SYNERGY WELLNESS CENTER
09.2023 - Current
CLAIMS SPECIALIST
COMPLETE STAFFING SOLUTIONS
10.2023 - 03.2024
- Obtained claim information from insurance carriers, patients, employers, and various websites for liability and workman's compensation claims
- Ensured all claim information was entered and billed claims accordingly
- Followed up on outstanding bills with the insurance carriers and worked accordingly (obtained payment, submitted reconsideration, or adjusted off)
MEDICAL BILLING SPECIALIST
UNIVERSITY ORTHOPEDICS
01.2019 - 09.2023
- Verify insurance eligibility and determine patient’s financial responsibility for upcoming office visits, surgeries, and various procedures
- Calculate and collect patient financial responsibility for upcoming procedures based on individual's benefits
- Ensure proper referrals and authorizations are in place
- Interact with doctors and medical staff accordingly to ensure claims are coded properly and correct documentation is in order
- Properly code and submit claims for multiple orthopedic doctors and physician’s assistants
- Resolve and make proper adjustments to unpaid or denied claims in a timely manner
- Liaison to the assigned office and medical staff for all billing and insurance questions
- Available to the patients to answer questions relating to claims, account balances, insurance requirements, and benefit explanations
- Knowledge of the Athena health system and associated hospital databases
MEDICAL BILLING SPECIALIST
CENTER FOR ORTHOPAEDICS
01.2010 - 01.2019
- Verify insurance eligibility and determine patient financial responsibilities for upcoming office visits, surgeries, procedures, and MRIs
- Obtain authorizations for surgeries, MRIs, and various medical procedures
- Communicate with the front desk regarding insurance and authorization issues as well as patient balances
- Collect patient payments and enter into the accounts
- Front desk coverage for the MRI facility owned by the company, as needed
- Properly code and submit claims for MRIs, office visits, surgeries, and procedures for 5 orthopedics doctors and 2 physical therapists
- Follow up with insurance companies to work and make adjustments on unpaid and denied claims for all accepted health insurance plans in a timely manner
- Enter insurance payments from Tufts and Cigna
- Verify the physical therapy department’s daily deposit and close out daily journal
- Verify the physical therapy department’s daily deposit and close out daily journal
- Create a guide for the physical therapy department on procedure code entry, obtaining authorizations, and list insurance specific requirements for DME and therapy billing
- Stay up to date with all insurance and code requirements and changes
- Create spreadsheet for office to reflect ICD-9 to ICD-10 diagnosis code conversion
- Create spreadsheet for all procedure codes and associated allowed amounts
- Create spreadsheet to track productivity for spinal injection codes as well as the reimbursement rate according to insurance plans
- Track and report surgery code productivity
- Given various special reports and projects for all doctors and office manager
- Train employees on procedure code entry and obtaining authorizations
- Knowledge of Intergy software and MRI database
Education
Certification - Massage Therapy
Spa Tech Institute - Westboro
Westborough, MA03.2022
Bachelor of Science - Athletic Training
Bridgewater State College
Bridgewater, MASkills
- Interpersonal skills
- Customer service
- Critical thinking
- Communication
- Fast learner
- Time management
- Detail oriented
- Health insurance navigation
- Healthcare software systems
Timeline
CLAIMS SPECIALIST
COMPLETE STAFFING SOLUTIONS
10.2023 - 03.2024
MASSAGE THERAPIST
SYNERGY WELLNESS CENTER
09.2023 - Current
MEDICAL BILLING SPECIALIST
UNIVERSITY ORTHOPEDICS
01.2019 - 09.2023
MEDICAL BILLING SPECIALIST
CENTER FOR ORTHOPAEDICS
01.2010 - 01.2019
Certification - Massage Therapy
Spa Tech Institute - Westboro
Bachelor of Science - Athletic Training
Bridgewater State College
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