Sharon L. Kamnik
North Wales,PA
Summary
I am a dedicated and experienced Medical Coding and Billing Manager. I have successfully managed and improved billing processes, implemented new systems, and trained staff to enhance efficiency and revenue cycles. My expertise in medical coding, billing, and patient care coordination makes me a valuable asset to any healthcare organization.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Medical Coding and Billing Manager
Brewer Eye Associates
Doylestown, PA
06.2021 - Current
- Created the medical billing department by bringing all medical billing in house for a large 10 location medical optometry practice.
- Implemented TriZetto clearinghouse for claims processing, and claims management electronically.
- Developed and implemented a process with comanaging practices for postoperative care for patients who have had cataract surgery and laser eye surgery.
- Implemented a new point of service and invoicing system for timely patient billing.
- Established a relationship with a new collections’ agency and developed a process for collecting outstanding debt.
- Assisted in the creation of a Standard of Operations manual for training new employees.
- Created new processes and policies to improve the revenue cycle.
- Responsible for ongoing management of enrollments in clearing house for new locations and new payers with EFT/ ERA/claims.
- Responsible for answering questions, advising and training physicians and staff on medical coding and billing policies and guidelines
- Perform patient chart audits and provide coding feedback and education to clinical team as needed
- Educate Physicians on documentation guidelines.
- Stay up to date with LCDs and NCDs.
- In charge of all accounts receivables including collecting, posting and managing patient account payments.
- Prepare, review, submit, clean claims to various insurance companies including Medicare, Managed care and Commercial insurance companies.
- Investigate rejected claims and take the necessary steps to rectify the issue.
- Provide timely and professional customer service, verify discrepancies and resolve patient billing issues, answer questions from the patients, facility, staff, and payers.
- Stay up to date with payer rules and regulations regarding Ophthalmology billing and coding.
- Proficient in navigating payer portals and websites to obtain patient eligibility, benefits and claims.
- Train new employees in all matters pertaining to medical billing and coding.
- Review account receivable reports for patient and payer outstanding balances and take appropriate action.
- Hold weekly Teams meetings with lead staff members to review goals for the week, go over housekeeping topics and introduce any new policies to be implemented.
- Participate in monthly doctors’ meetings to update and educate physicians in any guidelines and policies changes regarding coding and billing.
- Accomplishments:
- Tasks:
Ophthalmic Technician and Scribe/ Patient Care Coordinator
Lafayette Eye Associates
Lafayette Hill, PA
02.2019 - 06.2021
- Responsible to apply correct CPT-4 codes and modifiers along with the appropriate ICD 10 diagnosis codes to patient’s encounter
- Responsible for accurately reporting all findings as per the Physician in patient’s EMR.
- Perform comprehensive eye examinations
- Perform a variety of routine testing using ophthalmic instruments including, Goldman applanation tonometry and tonopen, fundus photos using Optos, automated refractions, visual field testing, corneal pachymetry, OCT testing, osmolarity testing.
- Assist the physician during diagnostic and minor surgical procedures.
- Assist the physician with patient education pertaining to the treatment prescribed.
- Responsible for preparing procedure and exam rooms; inventory equipment and supplies; replenish supplies and inventory.
- Review patients’ charts to extract clinical information to assign the appropriate ICD-10 and CPT-4 codes to the patient's EMR for appropriate reimbursement.
- Responsible to calculate total charge amount according to patient’s insurance coverage; collect co-pays and deductibles at the time of check-out
- Register all patients at time of check-in and enter data in the EMR system.
- Ensures all established patients have updated and accurate demographic information.
- Requests copay and coinsurance from patients at time of arrival.
- Provide support for all in-coming calls to the office.
- Prepare charts/paperwork for the next day’s patients.
- Examine and submit claims to appropriate insurance companies
- Review denied claims, correct and resubmit claims in a timely fashion.
- Ophthalmic Technician and Scribe
- Patient Care Coordinator
Surgical Scheduler /Ophthalmic Scribe /Technician
Ophthalmology Physicians and Surgeons
Hatboro, PA
12.2010 - 11.2018
- Reviewed patient’s operative reports and extracted clinical information to assign the appropriate ICD-10 and CPT-4 codes, along with the correct modifiers to the encounter, for appropriate reimbursement.
- Responsible for scheduling all surgeries for multiple locations and multiple Doctors, including pre operative appointments, any testing the patient may need prior to surgery, post operative appointments, and the surgery appointment.
- Council the patients on various requirements and instructions, pre operatively and post operatively.
- Proficient in the use of Navinet and other insurance web sites to obtain information such as eligibility, benefits, fee schedules and precertification requirements
- Obtain precertification from insurance companies requiring authorization for various surgeries. Prepare and send clinical information to insurance companies required for review of surgical cases.
- Gather information from the patient’s medical plan and inform the patient of their benefits, surgical copays and out of pocket financial responsibilities.
- Prepare charts by ensuring all necessary paperwork is completed and on file, then submit the proper paperwork to the surgical facility.
- Keep all doctors informed as to their schedule and any issues within their schedule.
- Strong knowledge of EMR systems and separate scheduling systems.
- As the Lead Scribe, responsible for examining all patient charges, applying the correct CPT codes and ICD10 diagnosis codes for the billing department.
- Responsible for accurately reporting all findings as per the Physician in the EMR system
- Perform a variety of routine testing using ophthalmic instruments including, Goldman applanation tonometry and tonopen, fundus photos using Optos, automated refractions, visual field testing, corneal pachymetry, OCT testing, osmolarity testing.
- Scribe for retinal specialist and general ophthalmologist.
- Assist the physician during diagnostic and minor surgical procedures.
- Assist with intravitreal injections and retinal lasers
- Assist with Yag Capsulotomy and PI lasers
- Assist the physician with patient education pertaining to the treatment prescribed.
- Responsible for preparing procedure and exam rooms; inventory equipment and supplies; replenish supplies and inventory.
- Performed basic phone triage
- Ophthalmic Scribe/Technician
Per Diem Surgical Technician
Various Ambulatory Surgical Centers
02.2008 - 12.2010
- Assist Surgeons in a variety of surgical procedures in Ophthalmology, Ocular Plastics, Gynecology, Urology, General Surgery, ENT, Orthopedics, Plastic surgery and Endoscopy.
- Extensive knowledge of medical terminology and anatomy
Skills
- Proficient in Microsoft Outlook, Word, Excel and PowerPoint
- Effective written and verbal communication
- Ability to balance multiple priorities
- Strong organizational skills
- Thrive in team environments
Certification
- AAPC RCMS Certificate (completed course, Certification Exam scheduled)
- AAPC Certificate: CPC, Certified Professional Coder
- Certificate Ophthalmic Scribe
Timeline
Medical Coding and Billing Manager
Brewer Eye Associates
06.2021 - Current
Ophthalmic Technician and Scribe/ Patient Care Coordinator
Lafayette Eye Associates
02.2019 - 06.2021
Surgical Scheduler /Ophthalmic Scribe /Technician
Ophthalmology Physicians and Surgeons
12.2010 - 11.2018
Per Diem Surgical Technician
Various Ambulatory Surgical Centers
02.2008 - 12.2010