Steve Kramer
Charleston,SC
Summary
Dedicated and highly motivated team player who enjoys the challenges of a fast-paced work environment while consistently meeting the demands of a heavy workload. Eager to utilize expertise and contribute to the success of a high reliable organization. Many years of experience working for the largest academic healthcare system in SC specialized in revenue cycle management, credit analyst, and quality assurance. Stellar history of a high work performance and exceeding yearly goals for financial achievements. Possess a strong desire to develop new knowledge and skills in a professional setting.
Overview
20
20
years of professional experience
13
13
years of post-secondary education
Work History
E-Commerce Retailer
Owner
Charleston, SC
11.2021 - Current
- 99% customer satisfaction rating
- Procurement & validation of goods on-line sales
- Forecasting sales trends
- Creating listings including detailed item descriptions
- Logistics of merchandise packing
- Handling customer enquiries and issues
- Recording of all transactions, cost, and deposits
- Internet based research of items
- Inventory management
- Knowledgeable in global shipping options
- Managed insurance claims and fraud
- High level of familiarity with competitors for other online marketplaces
Credit Processor
The Medical University Of South Carolina
Charleston , SC
04.2016 - 11.2021
- Analyze and resolve credits found on guarantor, client, third party liability, workers’ compensation, and clearing accounts using department established workflows and resources.
- Post and transfer payments according to remittance advices both electronically through 835 transactions and those received by mail.
- Process and deny carrier refund requests and recoupments for medical services provided by physicians.
- Ensure claims are accurately billed and paid accordingly on patient accounts.
- Review registration accounts for discrepancies in coverage plans and demographic data
- Collaborate with department contacts, coding staff, and revenue cycle support on issues pertaining to charge entry, claim appeals, and proper claim reimbursement.
Quality Assurance Specialist
The Medical University Of South Carolina
Charleston, SC
05.2012 - 04.2016
- Provided comprehensive monthly audits of revenue cycle personnel to ensure accuracy, understanding and adherence to all policy and procedures concerning the handling of patient accounts for MUSC Physicians.
- Identified integrity and quality employee data by reviewing transaction details, claim processes, account notation, scanned documentation, and system audit trails.
- Tested and reported on department workflows and applications pertaining to claim billing, coding denials, payment discrepancies, system edits, and trending employee errors.
Paralegal
The Medical University Of South Carolina
Charleston, SC
09.2006 - 05.2012
- Received and provided legal correspondence involving patient billing requests, disputes, subpoenas, payments, and settlements.
- Communicated with patient and university attorneys on a daily basis concerning physician billing issues.
- Managed Bankruptcy and Estate cases by filing creditor claims, applying adjustments, posting payments, and maintaining custom built system interfaces for identified patient accounts.
- Processed and resolved claims involving traditional health insurance carriers along with Workers’ Compensation and third-party liability.
Administrative Specialist
ATC Healthcare Services
Charleston, SC
01.2006 - 09.2006
- Assistant to Practice Manager and Physicians. Responsible for record keeping, statistics compilation, meeting coordination related to medical home activities, and correspondence. Scanned radiology and lab reports, consultation, medical histories, and insurance forms into Practice Partner.
- Designed and created in Microsoft Access a demographic, statistical, and medical insurance database for two clinics to support Medical Grant funding activities.
- Interpreted clients' needs and introduced services to fit specific requirements.
- Attended training programs to deepen professional skillset and assisted in training fellow store associates on existing and new training programs.
- Followed all company policies and procedures to deliver quality work.
- Listened and responded to customer requests and forwarded necessary information to superiors.
Customer Service Representative
The Medical University Of South Carolina
Charleston, SC
09.2005 - 09.2006
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Responded to customer concerns with friendly and knowledgeable service and remedied issues promptly and effectively.
- Resolved inbound and outbound communication regarding medical billing, coding and documentation.
- Prepared insurance claim and patient correspondence, financial assistance applications, budget plans, and departmental requests.
- Received and posted payments from patients, insurance carriers, grants, and governmental/collection agencies.
- Provided excellent Customer Service by preserving HIPAA Compliance Standards.
Medical Billing Associate
ATC Healthcare Services
Charleston, SC
01.2004 - 12.2004
- Responsible for calculating daily reconciliation reports and trial balances for entire practice; posting charges and patient payments in CompuSystems; creating instant router slips; preparing deposit slips; issuing fees for diagnosis, chemotherapy, IV therapy, oral and injected drugs; and filing medical records.
- Partnered with billing analyst department to investigate and remedy any gross margin trend issues.
- Reviewed full history of past due accounts and contacted client or attorney regarding collection, implementation of payment plan or pursuit of legal remedies on unpaid accounts.
- Verified daily coupon extraction process to enable correct execution of process.
- Evaluated aging reports to identify members to be included in monthly outbound collection calls.
Onsite Medical Coding Internships
Coding Certification Program
09.2003 - 12.2003
- Inpatient / Outpatient Internships at the Medical University of South Carolina, Trident Medical Center, and Roper Hospital.
- Responsible for written and system database entry of diagnostic, procedural, and Emergency Room information for insurance reimbursement.
- Responsible for medical record compilation and associated statistical analysis.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Verified signatures and checked medical charts for accuracy and completion.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Education
Paralegal Certificate At The Legal Studies Insti - Paralegal Studies
Florida International University
Miami, FL 01.2007 - 12.2007
Medical Coding Specialist Certification Program - Medical Insurance Coding
Trident Technical College
Charleston, SC 01.2002 - 12.2003
3 Year Studies - No Degree Awarded - Computer Science
College of Charleston
Charleston 01.1998 - 12.2001
Bachelor of Science - Biology
George Mason University
Fairfax, VA 09.1995 - 05.1997
Bachelor of Science - Marine Science
University of South Carolina
Columbia, SC 08.1990 - 05.1995
Skills
Credit & Financial Data Analyst (healthcare)
Quality Assurance – Financial Integrity
On-line Sales Specialist
Superior Customer Service
Outstanding Communication Skills
Inventory Management
Cost Reductions
Bankruptcy and Estate - Creditor Claims Management
Revenue Cycle Auditor (multi-million-dollar academic center)
Insurance Claims Specialist (payment processing/reimbursement)
Report Reconciliations
Workers Compensation
Paralegal Experience (financial/healthcare)
Medical Coding/Billing
EPIC experience – Super User
Timeline
E-Commerce Retailer
Owner
11.2021 - Current
Credit Processor
The Medical University Of South Carolina
04.2016 - 11.2021
Quality Assurance Specialist
The Medical University Of South Carolina
05.2012 - 04.2016
Paralegal Certificate At The Legal Studies Insti - Paralegal Studies
Florida International University
01.2007 - 12.2007
Paralegal
The Medical University Of South Carolina
09.2006 - 05.2012
Administrative Specialist
ATC Healthcare Services
01.2006 - 09.2006
Customer Service Representative
The Medical University Of South Carolina
09.2005 - 09.2006
Medical Billing Associate
ATC Healthcare Services
01.2004 - 12.2004
Onsite Medical Coding Internships
Coding Certification Program
09.2003 - 12.2003
Medical Coding Specialist Certification Program - Medical Insurance Coding
Trident Technical College
01.2002 - 12.2003
3 Year Studies - No Degree Awarded - Computer Science
College of Charleston
01.1998 - 12.2001
Bachelor of Science - Biology
George Mason University
09.1995 - 05.1997
Bachelor of Science - Marine Science
University of South Carolina
08.1990 - 05.1995