Shannon Santos
Naugatuck,CT
Summary
Highly-motivated employee with desire to take on new challenges. Skilled in reconciling accounts, identifying discrepancies, and resolving billing issues promptly. Strong attention to detail and numerical accuracy, with a commitment to maintaining confidentiality and upholding the highest standards of integrity in financial transactions.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Revenue Integrity Analyst
Bristol Hospital and Multi-Specialty Group
Bristol, CT
03.2019 - Current
- Analyzed trends in billing denials and worked with departments to identify root causes.
- Reviewed charge capture accuracy and identified opportunities for improvement.
- Provided support in the development and implementation of revenue integrity processes, policies, and procedures.
- Identified discrepancies between charges billed versus payments received from insurance companies.
- Maintained current knowledge of Medicare and Medicaid reimbursement rules and regulations.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Checked claims coding for accuracy with ICD-10 standards.
- Reconciled codes against services rendered.
Medical Biller and Coder
Urology Specialists
Middlebury, CT
09.2010 - 03.2019
- Verified accuracy of patient information and insurance data in billing system.
- Submitted claims to insurance companies electronically or by mail.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Ensured timely filing of all claims within established guidelines.
- Obtained authorizations for in office procedures
Education
Health Claims Specialist Program - Medical Billing And Coding
Brantford Hall Career Institute
Southington, CT07-2010
Skills
- Healthcare billing
- Revenue optimization
- Insurance claims handling
- Billing documentation
- Reconciling charges
- Multitasking
- Time management abilities
- Deadline-oriented
- Billing reconciliation
- Excel
- Identifying errors
Certification
- Certified Profession Coder -7/2010
- Certified ICD-10 Proficiency- 12/2015
Timeline
Revenue Integrity Analyst
Bristol Hospital and Multi-Specialty Group
03.2019 - Current
Medical Biller and Coder
Urology Specialists
09.2010 - 03.2019
- Certified Profession Coder -7/2010
- Certified ICD-10 Proficiency- 12/2015
Health Claims Specialist Program - Medical Billing And Coding
Brantford Hall Career Institute
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