Susan Lees
Pittsburgh,PA
Summary
Dynamic Medical Billing Supervisor with extensive experience at Suburban Urologic Associates, excelling in revenue cycle management and team leadership. Proven track record in optimizing billing workflows and ensuring compliance with Medicare regulations. Adept at resolving denied claims while fostering collaboration and delivering exceptional customer service.
Overview
28
28
years of professional experience
Work History
Medical Billing Supervisor
Suburban Urologic Associates
04.1997 - Current
- Verified proper ICD-10 coding on claims.
- Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
- Enforced operational compliance with state and federal laws and Joint Commission standards.
- Oversaw billing for Medicaid PCA, waiver and skilled claims, commercial insurance and private pay clients.
- Assisted patients by determining financial assistance available and setting up payment plans.
- Analyzed medical records to satisfy insurance company mandates.
- Reviewed services rendered and completed to reconcile codes.
- Submitted electronic and paper claims to insurance companies, Medicare and Medicaid to collect medical payments.
- Complied with HIPAA privacy and security regulations to protect patients' medical records and information.
- Confirmed backup and proper storage of sensitive information in event of data breach or outage.
- Scheduled patients in Medical Manager System.
- Followed up on legal claims.
- Reviewed outgoing bills for eligibility and accurateness.
- Maintained current accounts through aged revenue reporting.
- Devised new methods to improve billing workflows.
- Delivered timely and accurate charge submissions.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Collected payments and applied to patient accounts.
Education
Certified Medical Coder - Health Administration
Western School of Health And Business
Monroeville, PA03-1997
Skills
- Accounts receivable management
- Medicare and medicaid regulations
- Performance metrics analysis
- HIPAA compliance
- Team leadership and supervision
- Revenue cycle management
- Staff training and development
- Payment posting
- CPT coding
- Financial reporting
- Claims review
- Balance reconciliation
- Information requests
- Operations support
- Submission of medical claims
- Procedure coding
- Multitasking and organization
- Chart auditing
- Insurance verification
- Collections management
- Teamwork and collaboration
- Electronic claims
- Patient collections
- CPT code modifiers
- Insurance claims processing
- HIPAA compliance certification
- Payer contracts
- Customer service
- ICD-10 coding
- Collection calls
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Medical Billing Supervisor
Suburban Urologic Associates
04.1997 - Current
Certified Medical Coder - Health Administration
Western School of Health And Business
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