Sue Moore
Jenison ,MI
Summary
Accomplished Medical Billing Manager with a proven track record at Alger Pediatrics PC, enhancing revenue cycle management and patient satisfaction through expert claims processing and effective communication. Skilled in ICD-10 and HIPAA compliance, I significantly reduced claim denials and fostered strong insurance relationships, demonstrating a continuous learning attitude and a commitment to professionalism.
Personable and methodical, with thorough understanding of medical billing procedures and healthcare regulations, proficient in managing billing software and handling insurance claims. Possesses comprehensive knowledge of medical coding and compliance, coupled with strong analytical skills and attention to detail. Committed to improving billing processes and ensuring accurate financial management.
Developed skills in healthcare environment include managing complex billing systems and ensuring compliance with industry standards. Expertly handle sensitive patient information and resolve discrepancies with precision and efficiency. Seeking to leverage these transferable skills in new field to drive operational success and improve processes.
Competent medical billing professional manages busy medical office and delivers excellent customer service to patients.
Overview
25
25
years of professional experience
Work History
Medical Billing Manager
Alger Pediatrics PC
03.2012 - 12.2024
- Reviewed billing problems, researched issues, and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Increased patient satisfaction by addressing billing inquiries promptly and professionally.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
- Enhanced revenue cycle management by overseeing timely and accurate claims submission.
- Streamlined claim appeals process by creating clear documentation guidelines and templates for staff use.
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
- Implemented efficient workflows within the department that led to increased productivity levels among staff members while reducing errors in claim submissions.
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- Maintained patient confidentiality by adhering to strict HIPAA regulations during all aspects of the coding and billing processes.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Provided exceptional customer service to patients, addressing their concerns regarding insurance claims or billing issues with empathy and professionalism.
Billing Specialist
Partners In Family Health
03.2000 - 03.2012
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information.
- Prevented unnecessary loss of revenue due to late or incomplete billing by meticulously tracking all accounts and ensuring timely submission of accurate claim forms.
- Implemented efficient workflows within the department that led to increased productivity levels among staff members while reducing errors in claim submissions.
- Updated patient financial information to guarantee accuracy.
- Improved patient satisfaction by promptly addressing and resolving medical billing disputes.
- Reduced errors in medical billing by implementing standardized coding guidelines and best practices.
- Maintained compliance with federal regulations by keeping current on changes in the healthcare industry affecting medical billing practices.
- Maintained knowledge of standardized medical billing codes.
- Ensured compliance with industry regulations by staying updated on changing medical billing procedures and coding guidelines.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Researched and resolved billing discrepancies to enable accurate billing.
Education
Associate of Applied Science - Business Administration And Management
Davenport University
Grand Rapids, MI05-1985
Skills
- Claims processing proficiency
- HIPAA compliance
- Effective communication
- Patient confidentiality practices
- Electronic health records experience
- Accounts receivable management
- ICD-10 proficiency
- Professionalism and ethics
- CPT knowledge
- Continuous learning attitude
- Insurance verification
- Denial management
- Payment posting
- Claim submission
- Patient billing
Timeline
Medical Billing Manager
Alger Pediatrics PC
03.2012 - 12.2024
Billing Specialist
Partners In Family Health
03.2000 - 03.2012
Associate of Applied Science - Business Administration And Management
Davenport University