Reliable Manager demonstrating high level of ownership and initiative. Possessing exceptional work ethic and desire to go above and beyond to exceed company expectations. Offering knack for building productive working relationships. Successful in fast-paced, deadline-driven environments to manage goals and team development. History of thriving in team-oriented environments.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Medical Billing Specialist
Edwards Electronic Processing
Orlando, Florida
01.2025 - Current
Managed insurance claims processing for accurate reimbursement.
Contacted insurance providers to verify insurance information and obtain billing authorization.
Adhered to HIPAA regulations when handling confidential patient information.
Posted charges, payments and adjustments.
Completed appeals and filed and submitted claims.
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Applied payments, adjustments, and denials into medical manager system.
Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
Collaborated closely with other departments to resolve claims issues.
Maintained timely and accurate charge submission through electronic charge capture, including billing, and account receivables (BAR) system and clearing house.
Communicated with insurance representatives to complete claims processing or resolve problem claims.
Submitted appeals using provider portals and phone communication.
Submitted claims to insurance companies.
Reviewed and verified benefits and eligibility with speed and precision.
Reviewed patient records for accuracy and completeness of information in medical billing system.
Practice Manager II
Adventhealth Medical Group Primary Care
Lake Mary, FL
01.2019 - 12.2024
Managed a staff of 26 employees and 10 providers to ensure all duties are completed efficiently, making sure the office runs smoothly and effectively.
Collaborated with leadership and physicians to develop and implement strategic growth plans, addressing staffing, services, equipment, and facility needs.
Oversaw financial management, including cash control, bank reconciliations, deposits, and payments.
Led office staff in hiring, coaching, evaluating, and applying progressive discipline policies when necessary.
Ensured effective communication with all staff and providers regarding policies, procedures, and changes.
Assisted team with check-in, check-out processes, referrals, medical records management, and appointment scheduling.
Conducted regular meetings to address operational issues and enhance interdepartmental communication.
Ordered supplies and monitored inventory levels to maintain adequate stock.
Developed training programs for staff, promoting skill development and compliance.
Supervisor
Orlando Health Neurology Group/WOPG
Ocoee, FL
01.2017 - 01.2019
Manage a staff of 4 employees in a medical office setting, ensuring all duties are completed, efficient in making sure the practice runs smoothly and effective
Assist the physician in coordinating and manage the ALS clinic in the office started in July 2018, in this clinic I manage 5 employees
Arrange and conduct interviews, arrange meetings with insurance representatives, update physician credentials and malpractice, handle billing and coding measures, post patient payments, and oversee collections, Account Receivables aging details, balances due, deductibles, co-payments, and co-insurances
Clear TES edits, work lists, tasks, charges, order supplies, sign off on the bank charges when using the P-card, keep track of employees’ time in Kronos, faxed, typed, copied, write letters and email, scanned, print documents and office general administration
Verify patients’ eligibility, schedule appointments, assist team member with Crimson, referrals, medical records and Phytel
Budget planning, review scorecards with manager and physician, manage effectively through conflict, strong organizational skills, coach, mentor and help others
Senior Front Office Assistant
Orlando Health Central Maguire Family Medicine WOPG
Ocoee, FL
01.2015 - 01.2017
Greet patients upon arrival, checking in/out patients, verify patients’ insurance eligibility, confirmed and scheduled patient appointments, answered multi-line phone system, faxed, typed, copied, write letters and email, scanned and print documents
Collects deductibles, co-pays and coinsurance amounts from patients at checking in/out, operate credit card machine, enter medical records and no-show fee in GE, and daily deposits
Clear TES edits, work lists, tasks, charges, order supplies, send invoice to finance department, and knowledgeable with Kronos time, prepare daily bank bags and reconciliation form, and posting payments into patients’ accounts
Enter all new patient information into data systems, assist patient with billing and account issues
Request patient medical chart from vital records, submit subpoenas to risk management, medical records/ invoice send to third parties and attorneys
Coordinate the referrals for patients by making sure the HMO referrals are being submitted online through the appropriate insurance company, keeping track of the patient referrals by obtaining office notes from specialist, calling insurance company for prior Authorization for MRI/CT scans and medical surgery procedures
Assist the manager with different projects/tasks, conducted interviews, created a workflow for the referral process and no-show, communicates with staff regarding office goals
Trained new employees for their role as Front Office Assistant in GE and Allscripts, Interim for two months while the office manager was out on vacation
Maintains security and confidentiality regulations for record access and review. Consults with manager of any unusual request, and general office administration
Physician Office Clerk
Orlando Health Central OB/GYN WOPG
Ocoee, FL
01.2014 - 01.2015
Greet patients upon arrival, checking in/out patients, verify patients’ insurance eligibility, confirmed and scheduled patient appointments, answered multi-line phone system, faxed, typed, copied, write letters and email, scanned and print documents
Collects deductibles, co-pays and coinsurance amounts from patients at check in, operate credit card machine
Clear TES edits, work lists, tasks, charges, complete FMLA, AFLAC disability certification forms, and keep track of the patient annual visit in Phytel outreach by keeping a log in excel
Enter all new patient information into data systems, readies patient charts for back office upon arrival in the office, patient referrals, coordinates the release of medical information to all requestors
Maintains security and confidentiality regulations for record access and review. Consults with manager of any unusual request, and general office administration
Rehab Coordinator
Browning’s Pharmacy and Health Care
Orlando, FL
01.2013 - 01.2014
Verify patients’ eligibility, confirm and schedule appointments, answered a multi-line phone system, faxed, typed, copied, write letters and email, assist with coordinating sales, inventory and assembly of rehab equipment and supplies
Review all paperwork from repair technicians to make sure it is properly completed, determined what paperwork is needed for authorization, prepares delivery paperwork, re-verifies insurance and complete quotes for technicians and managers
Prepares CMN/LMN requests in a timely and accurate manner, review for completeness, prepare authorizations for Medicaid and other funding agencies to assure proper paperwork is included in the request
Review in process files at least weekly to make sure authorizations are being obtained as quickly as possible, sends follow up request, and maintain patient charts
Consistently record notes in computer regarding all conversations and work completed, reviews all returned CMN/LMN and authorizations to determine that the paperwork is complete to be paid appropriately
Assist the Billing Manager with daily billing with ICD-9-CM and HCPC codes as needed and general office administration
Office Manager/Biller
Kirkman Medical Center
Orlando, FL
01.2013 - 01.2013
Manage a staff of 4 employees in a medical-office setting, ensuring all duties are completed, while training new employees and externship students for assigned duties
Arrange and conduct interviews, arrange meetings with insurance representatives, update physician credentials and malpractice, handle billing and coding measures, post EOB and patient payments, and oversee collections, Account Receivables aging details, balances due, deductibles, co-payments, co-insurances and ICD-9-CM and CPT
Maintain proficiencies in HEDIS measures, Medicare Adjustment Risk, HMO plans, and Medicare/Medicaid claims, handles sleep study authorization request, follow up on denial and unpaid claims, and prepare appeal letters
Greet patients upon arrival, checking in/out patients, verify patients’ insurance eligibility, confirmed and scheduled patient appointments, answered multi-line phone system, faxed, typed, copied, wrote letters and email, scanned and print documents
Comprehensive Orthopedic
St. Thomas Neurology
Christiansted, St. Croix
01.2012 - 01.2012
Greet patients upon arrival, confirmed and scheduled patient appointments, answered a multi-line phone system, faxed, typed, copied and wrote letters and e-mail, scanned documents, printed and transcribed dictations
Handled the checking in/out of patients, daily deposits, and inventory, collects deductibles, co-pays and coinsurance amounts, calling patients’ insurance companies for pre-certifications and conveying key information to patients concerning billing issues and accounts
Complete FMLA, AFLAC disability certificate forms, workers compensation claims, order supplies, send invoice to accounting department, and assist the manager with general office administration
Comprehensive Orthopedic
Virgin Island Eye Institute
Christiansted, St. Croix
01.2007 - 01.2010
Greet patients upon arrival, confirmed and scheduled patient appointments, answered a multi-line phone system, faxed, typed, copied and wrote letters and e-mail, scanned documents, printed and transcribed dictations
Handled the checking in/out of patients, daily deposits, and inventory, collects deductibles, co-pays and coinsurance amounts, calling patients’ insurance companies for pre-certifications and conveying key information to patients concerning billing issues and accounts
Complete FMLA, AFLAC disability certificate forms, workers compensation claims, order supplies, send invoice to accounting department, and assist the manager with general office administration
Earned “Employee of the Year” honors from management in recognition of consistently superior productivity.
Seamlessly handled a plethora of daily administrative duties, including answering phones, scheduling patient appointments, filing key documents, assisting with billing documents and posting payments
Dental Assistant/Chair-Side Assistant
Fabio Dental Office
Sunny Isles, St. Croix
01.2003 - 01.2004
Took patient tooth X-rays, completed patient denture models, prepared patients for surgery, drew syringes and instructed patients on proper medication usage
Greet patients upon arrival, checking in/out patients, verify patients’ insurance eligibility, confirmed and scheduled patient appointments, answered multi-line phone system, faxed, typed, copied, wrote letters and email, scanned and print documents
Completed numerous administrative duties in support of personnel, helping to drive organizational goals
Education
Medical Billing & Coding Diploma -
Ultimate Medical Academy
Tampa, FL
06.2013
Master’s Degree - Bus. Admin. Healthcare Mgmt.
American Intercontinental University
Chicago, IL
01.2011
Extensive Certificate - Computer Applications
LBDC Professional Institute
Sunny Isles, St. Croix
01.2004
Skills
Leadership
Customer service
Conflict resolution
Empathy
Integrity
Constructive feedback
Process improvement
Coaching and mentoring
Adaptability
Problem solver
Team building and development
Training
Effective communication
Operations management
Certification
Practice management Institute
Certified Medical Office Manager /Sept, 2018
Languages
English
Professional
Spanish
Professional
References
References available upon request.
Timeline
Medical Billing Specialist
Edwards Electronic Processing
01.2025 - Current
Practice Manager II
Adventhealth Medical Group Primary Care
01.2019 - 12.2024
Supervisor
Orlando Health Neurology Group/WOPG
01.2017 - 01.2019
Senior Front Office Assistant
Orlando Health Central Maguire Family Medicine WOPG
Fund Administration Supervisor-Trade capturing at HDPL (HSBC Electronic Data Processing)Fund Administration Supervisor-Trade capturing at HDPL (HSBC Electronic Data Processing)
General Manager / Executive Manager at Feddon Automotive Group – Valley Chevrolet, GMC, CDJR, MitsubishiGeneral Manager / Executive Manager at Feddon Automotive Group – Valley Chevrolet, GMC, CDJR, Mitsubishi