Sherri Brainard
Wilmington,DE
Summary
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Astute Accounts Receivable Specialist with [Number] years' experience in accounting, auditing and cash management for [Type] sector organizations. Expert in accurately and efficiently executing time-sensitive processing and reporting of regulatory-compliant financial documentation. Adept team leader and employee trainer with outstanding communication abilities. Successful in aligning cross-functional objectives to facilitate productivity and deliver on-time project completion.
Overview
18
18
years of professional experience
Work History
Payment Processor
Delaware Orthopaedic Specialists P.A
Wilmington, DE
11.2023 - Current
- Processed payments for insurance company's in a timely manner, ensuring that all deadlines were met.
- Investigated insurance complaints about incorrect or delayed payments and resolved any issues quickly and efficiently.
- Processed credit card transactions in accordance with applicable regulations and security protocols.
- Reviewed customer payment requests to ensure accuracy and compliance with company policies.
- Collaborated with other departments within the organization to ensure proper communication regarding payment processes.
- Verified customer account information prior to processing payments.
- Generated detailed reports of payment activity for management review.
- Tracked changes in legislation related to electronic payments and updated company procedures accordingly.
- Prepared bank deposits by verifying that funds are available before posting them.
- Verified, classified, computed, posted and recorded accounts payable data and reconciled daily totals to confirm proper accounting.
- Performed various accounts receivable functions, handled cash receipts posting, updated cash flow reports and researched chargebacks and write-offs.
- Maintained accounting records by performing routine calculating, posting and verifying duties.
- Recorded debit, credit and account transactions in computer spreadsheets and databases.
Medical Billing Manager
Delaware Orthopaedic Specialists P.A
Wilmington, DE
01.2015 - 11.2023
- Oversaw daily activities related to the processing of electronic claims submissions.
- Reviewed appeals processes and assisted in preparing appeal letters when necessary.
- Developed training programs for new hires and existing staff in order to improve performance and efficiency.
- Maintained detailed records of all payments received from patients or third-party payers.
- Managed and reviewed medical billing staff to ensure accuracy of patient accounts.
- Resolved issues related to denied or rejected payments from insurance companies.
- Worked closely with clinical staff to ensure timely submission of claims and accurate coding practices.
- Identified areas of improvement within the medical billing process, implemented changes accordingly.
- Conducted audits on claims submitted by medical billing staff, ensuring compliance with all applicable laws and regulations.
- Assisted in developing policies and procedures related to medical billing operations.
- Prepared monthly financial statements detailing revenue generated by practice locations.
- Monitored accounts receivable aging reports and worked proactively to reduce outstanding balances due from patients or insurers.
- Created reports outlining trends in revenue cycle management, such as denials and rejections.
- Provided technical assistance regarding coding questions or other inquiries from internal teams.
- Collaborated with IT department on software upgrades or system enhancements that would improve overall efficiency.
- Attended industry conferences, seminars, and meetings to stay abreast of current trends in healthcare finance.
- Coordinated efforts between departments regarding patient follow up activities associated with denials or rejections.
- Negotiated contracts with payers to maximize reimbursement rates for services rendered.
- Analyzed financial data, identified discrepancies, and reported findings to senior leadership team.
- Developed strategies for improving collections performance across multiple sites.
- Tracked key metrics relating to patient satisfaction and customer service levels, providing regular updates on progress made towards goals set forth by the senior leadership team.
- Helped customers to bring accounts into good standing by implementing payment plans.
- Conducted insurance verification and pre-authorization, coded [Type] procedures and managed patient charts.
- Developed improved standard operating procedures to increase billing accuracy and cash flow.
- Led team of [Number] staff handling more than $[Amount] in monthly charges.
- Set up and maintained [Software] electronic billing system.
- Enforced operational compliance with state and federal laws and [Type] standards.
- Managed billing calendar and scheduled claims for payments.
- Built high-performance team by collaborating with new members on procedural, administrative, collections and compliance areas.
- Developed performance improvement plans based on deep reviews of current work.
- Resolved billing issues by applying knowledge and completing in-depth research.
- Coordinated preparation of external audit materials and external financial reporting.
- Maintained regular performance appraisals for subordinates through verbal, written and on-going review programs.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Created financial management mechanisms to minimize financial risk to business.
Medical Biller and Coder
Delaware Orthopaedic Specialists P.A
Wilmington, DE
10.2005 - 01.2015
- Ensured timely filing of all claims within established guidelines.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Filed and submitted insurance claims.
- Verified accuracy of patient information and insurance data in billing system.
- Submitted claims to insurance companies electronically or by mail.
- Adhered strictly to HIPAA guidelines when handling confidential patient information.
- Provided customer service support to patients regarding billing inquiries.
- Assessed medical codes on patient records for accuracy.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Monitored aging accounts receivable report weekly to identify unpaid balances due.
- Tracked details such as authorizations, pre-certifications or referrals required prior to service delivery.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Prepared financial statements that summarize account activity over a period of time.
- Expertly assigned charges and payments for medical procedures.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Reviewed received payments for accuracy and applied to intended patient accounts.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Documented and filed patient data and medical records.
- Interpreted physician orders, notes, lab results, radiology reports. for appropriate code assignment.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Assisted with the development of departmental policies related to charge capture processes and coding practices.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Performed daily audits on all bills submitted for accuracy and completeness.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Reviewed medical records to meet insurance company requirements.
- Performed routine quality assurance audits to promote data integrity.
- Compiled and maintained logs, and statistical or research records to locate requested health data.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Maintained high accuracy rate on daily production of completed reviews.
- Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
- Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
- Verified proper coding, sequencing of diagnoses and accuracy of [Type] procedures.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Received, organized and maintained all coding and reimbursement periodicals and updates.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Categorized health services and assigned specific [Type] code to each one.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Maintained positive working relationship with fellow staff and management.
- Compiled and coded patient data using standard classification systems.
- Handled incoming calls and directed callers to appropriate department or employee.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Transmitted information or documents to customers through email, mailings or facsimile machine.
- Verified record copies before handing each over to check for and remove unnecessary details.
- Mentored junior team members and managed employee relationships.
- Determined and implemented techniques to improve medical records retrieval process.
- Set up patient charts and documented information in various company software.
- Streamlined day-to-day office processes to meet long-term goals.
- Safeguarded medical records to maintain patient confidentiality.
- Pulled patient records and transferred information to appropriate parties.
- Located and retrieved files, assisting public with general information.
- Ordered and restocked supplies in line with budget limits and office needs.
- Purged inactive files and destroyed obsolete files following procedures.
- Assigned patients to diagnosis-related groups using appropriate computer software.
Education
Business Administration and Management
Delaware Technical And Community College
Newark, DESkills
- Transaction Processing
- Banking Operations
- Credit Card Processing
- Payment Reconciliation
- Bill Processing
- Billing Dispute Resolution
- Investigative Research
- Audit Procedures
- Payment Management
- Adjustment Posting
- Contract Reviewing
- Claims Processing
- Payment Posting
- Accounts Receivable
- Account Reconciliation
- Microsoft Excel
- Department Oversight
- Policy Development
- Financial Management
- Coding Proficiency
References
References available upon request.
Timeline
Payment Processor
Delaware Orthopaedic Specialists P.A
11.2023 - Current
Medical Billing Manager
Delaware Orthopaedic Specialists P.A
01.2015 - 11.2023
Medical Biller and Coder
Delaware Orthopaedic Specialists P.A
10.2005 - 01.2015
Business Administration and Management
Delaware Technical And Community College
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