Susan Pehm

Assign appropriate diagnosis codes using CPT, ICD-10, and HCPCS codes to daily encounters

• Process surgical, and clinical charges promptly
• Review and process claim rejections for accuracy as well as insurance and coding compliance
• Perform collection activities, such as working aged accounts, AR reports to ensure timely filing

Accurately posts insurance payments received in the mail or through ERA

• Communicated with insurance providers to resolve denied claims and resubmitted.
• Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
• Accurately entered patient demographic and billing information in the billing system to enable tracking history and maintain accurate records.

• Manage the schedules and calendars of the patients and the 15 doctors on staff along with communicating patient arrivals or delays
• Obtain personal, medical, and insurance information from patients, and refer patients for appointments with secondary care providers
• Use EMR software to manage patient records and files, post payments to patient accounts; reinforce and uphold patient confidentiality as required by HIPAA and the clinic
• Manage office and medical supply inventories; receive deliveries and organize supplies in stockrooms and exam rooms.
• Increased patient retention through timely follow-up on appointment reminders and inquiries.
• Collaborated with practitioners to develop customized treatment plans tailored to individual patient needs, resulting in higher satisfaction rates.
• Developed strong rapport with patients through attentive listening skills and empathetic interactions during their visits.
• Reduced wait times for appointments by effectively coordinating schedules between patients and practitioners.

• Facilitated daily administrative functions, including customer service, patient scheduling, filing, and maintaining records, policy/contract renewals, answering calls, providing information, taking messages, scheduling appointments, and inventory management
• Collected patient copayments and recorded payment transactions; obtained third-party payer authorization for services provided and communicated outstanding balances to insurance companies and patients
• Monitor claims to ensure claims are settled equitably for both the client and the insurer
• Resolve customer complaints or answer customers' questions regarding claims, policies, and procedures, compile and prepare reports, templates, correspondence, or other information required by insurance or governmental agencies.
• Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
• Processed eligibility and benefits verification and authorization requests.
• Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
• Followed up on denials, late payments, extensions, and other special circumstances.
• Reduced claims processing time by effectively collaborating with adjusters, claimants, and internal departments.

• Receive payments and post amounts paid to customer accounts
• Reduced outstanding balances by diligently following up on overdue invoices and negotiating payment plans with clients.
• Supported audit processes by maintaining organized documentation and providing timely responses to inquiries from auditors.
• Locate and monitor overdue accounts, using EHR software, computer programs, and a variety of automated systems
• Advise customers of delinquent accounts by mail, or telephone to review with the customers the necessary actions and strategies for debt repayment
• Contact insurance companies to check on the status of claims payments and write appeal letters for denial of claims.

• Submit Medicare claims and follow up on unpaid, bundled & denied claims
• Apply appropriate Medicare guidelines to coding claims
• Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
• Work denials, appeals & referrals
• Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
• Post insurance payments according to contractual amounts
• Use EMR software to manage multiple patient records and files, post payments to patient accounts; reinforce and uphold patient confidentiality as required by HIPAA and the clinic
• Manage office and medical supply inventories; receive deliveries and organize supplies in stockrooms and exam rooms.

• Review and analyze patient accounts to ensure accurate billing & reimbursement
• Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
• Submit claims to insurance companies
• Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
• Resolve billing discrepancies and answer patient inquiries regarding billing
• Followed up on denied and unpaid claims to resolve problems and obtain payments.
• Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.