Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Regan Bucalo

Dover,PA

Summary

Results-driven Financial Receivable Coordinator with over a decade of experience in Revenue Cycle Management. Committed to elevating patient satisfaction levels and driving the success of healthcare facilities. Proficient in maintaining confidentiality, adhering to patient care standards, and navigating insurance claims procedures with precision. Skilled in discrepancy resolution, record-keeping accuracy, and adept use of accounting software. Recognized for a collaborative team approach, adaptability to evolving demands, and unwavering dependability in consistently delivering exceptional outcomes. A reliable team player dedicated to maximizing efficiency and effectiveness in achieving organizational objectives.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Accounts Receivable Representative

United Urology Group
07.2024 - Current
  • Experience with Allscripts PM and PayerPath systems.
  • Contributed to positive cash flow by identifying opportunities for improvement in the accounts receivable process.
  • Reviewed several high-dollar urology procedure accounts to ensure proper billing and appropriate carrier payments per contract.
  • Facilitated smooth audits through meticulous record-keeping and prompt provision of requested documentation.
  • Reconciled accounts receivable ledger to verify payments and resolve variances.
  • Regularly monitored accounts receivable aging reports, identifying trends that informed future collections strategies.
  • Assisted management with tracking and updating lockbox/ correspondence addresses with carriers to optimize cash flow.
  • Reduced outstanding accounts receivable balances through diligent follow-up and negotiation efforts.
  • Reconciled accounts receivable vouchers with outstanding customer balances and applied appropriate adjustments to optimize cash flow and reduce past due accounts.
  • Assisted management with auditing 3rd party company accounts to ensure accuracy and efficiency.
  • Ran reports and analyzed data to ensure proper workflow of daily duties and aged accounts, as well as analyzing denials by departments and carriers to locate trends.
  • Assisted in internal audits to identify areas of improvement within the payment posting process, resulting in increased accuracy rates.
  • Provided valuable insights during departmental meetings that led to continuous improvements in the accounts receiveable process.

Financial Receivable Coordinator

University Of Maryland Medical System
11.2018 - 07.2024
  • 5 years of Epic system experience.
  • Experience with OnBase correspondence system.
  • Currently working follow-up for 15 facilities, primarily with payer BlueCross BlueSheild.
  • Sufficient knowledge with provider based billing, professional and facility billing guidelines.
  • Kept high average of performance evaluations.
  • Organized spaces, materials and catering support for internal meetings.
  • Trained new team members and created various training manuals.
  • Follows HIPAA guidelines.
  • Experience with the HSCRC - Health Services Cost Review Commission in the state of Maryland.
  • Ability to look up ICD-10 diagnosis, CPT treatment codes and Hospital Revenue Codes from online service or using traditional coding references.
  • Periodically create insurance or patient aging reports using the medical practice billing software.
  • Submits UB-04/1500 insurance claim forms to clearinghouse or individual insurance companies electronically or via paper.
  • Verified discrepancies and resolved clients' billing issues.
  • Understands complex claim denials and how to properly appeal when not in agreement with the insurance carrier.
  • Prepares patient statements for charges not covered by insurance.
  • Posts insurance payments, adjustments and patient payments using medical claim billing software.
  • Knowledgeable with verifying patient benefits, eligibility, and demographics.
  • Contacting and notifying patients via phone or mail regarding their accounts.
  • Entered data, generated reports, and produced tracking documents.

Medical Billing Specialist

NextGen Healthcare
11.2013 - 11.2018
  • 5+ years of Nextgen RCM System Experience.
  • Insures claim information is complete and accurate before submitting to clearinghouse or individual insurance companies electronically or via paper.
  • CMS-1500 form or UB04 claim forms experience.
  • Prepares appeal letters to insurance carrier when not in agreement with claim denial.
  • Prepares patient statements for charges not covered by insurance.
  • Provides necessary information to collection agencies for delinquent or past due accounts.
  • Posts insurance and patient payments and adjustments using medical claim billing software.
  • May perform soft collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
  • For patients with coverage by more than one insurer, prepares and submits secondary and tertiary claims upon processing by primary insurer.
  • Periodically create insurance or patient aging reports using the medical practice billing software.
  • Understands managed care authorizations and limits to coverage.
  • Knowledgeable with verifying patient benefits, eligibility, and demographics.
  • Ability to look up ICD 10 diagnosis and CPT treatment codes from online service or using traditional coding references.

Education

High School Diploma -

Susquehannock High School
Glen Rock, PA
2011

Skills

  • Hospital Billing Experience (UB04 and 1500 Claim Forms)
  • Strong Work Ethic
  • Team Player with Positive Attitude
  • Complex Problem Solving
  • Team Leadership
  • Phone and Email Etiquette
  • Staff Development and Training
  • Motivational Leadership
  • ICD-9 and ICD-10
  • Strong Microsoft Office Skills
  • Data Entry
  • Detail Oriented
  • Proficient in NextGen RCM, EPIC and Allscripts PM systems
  • Data entry and management
  • Training material development
  • Flexible & Adaptable
  • Organization and Time management
  • Decision-making
  • Relationship building
  • Project management

Certification

HIPAA 2024-2025

HIPAA stands for the Health Insurance Portability and Accountability Act and is a U.S. federal law enacted in 1996 as an attempt at incremental healthcare reform. It was subsequently revised in 2009 with the ARRA/HITECH Act and again in 2013 with the Omnibus Rule. HIPAA's intent was to reform the healthcare industry by reducing costs, simplifying administrative processes and burdens, and improving the privacy and security of patients' health information. Today
HIPAA compliance mainly revolves around the last item: protecting the privacy and security of patients' health information.

Timeline

Accounts Receivable Representative

United Urology Group
07.2024 - Current

Financial Receivable Coordinator

University Of Maryland Medical System
11.2018 - 07.2024

Medical Billing Specialist

NextGen Healthcare
11.2013 - 11.2018

High School Diploma -

Susquehannock High School

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