Summary
Overview
Work History
Education
Skills
Timeline
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Taylor Kratochvil

Ambridge,PA

Summary

Accomplished Lead Billing Operations Specialist with a proven track record at Pantherx Rare Pharmacy, enhancing operational efficiency and customer satisfaction through expert project management and cross-functional communication. Skilled in medical billing and coordination, demonstrated success in managing multiple projects and improving workflows. Achieves results by leveraging a blend of technical proficiency and team collaboration.

Overview

18
18
years of professional experience

Work History

Lead Billing Operations Specialist

Pantherx Rare Pharmacy
Pittsburgh, PA
05.2023 - Current
  • Oversaw day-to-day operations, delegating tasks appropriately to ensure smooth workflow and timely completion of projects.
  • Boosted satisfaction, addressing concerns in a timely and professional manner.
  • Successfully managed multiple projects simultaneously while adhering to deadlines
  • Collected, arranged, and input information into database system.
  • Provided training for new hires, fostering a supportive learning environment conducive to success in their roles.
  • Enhanced team productivity with effective communication strategies.
  • Motivated and trained employees to maximize team productivity.

Billing Operations Specialist

Pantherx Rare Pharmacy
Pittsburgh, PA
11.2018 - 05.2023

Pharmacy and medical billing, UCF, 1500 forms and EDI. Keep updated on insurance policies and billing guidelines, Work claim denials, Aging reports, ICD-10, CPT, HCPCS Codes. In and outbound calls, data entry. Insurance verification, HIPPA compliant, Work with multiple payers, Blue cross blue shield Illinois, Texas, Texas Star Kids, Tricare. Strensiq medically billed. Understanding Contracts and Single Case Agreements.

Medical Billing Clerk

Heritage Valley Health System
Baden, PA
07.2018 - 11.2018
  • Updated patient financial information to guarantee accuracy.
  • Collected payments and applied to patient accounts.
  • Posted payments and collections on regular basis.
  • Filed and updated patient information and medical records.
  • Bill medical claims - via EDI Change Healthcare, Mail paper CMS 1500 claims. File appeals and resolve denials, send in medical records. In and outbound calls - patients and payers.

Billing & Authorization Coordinator

Heritage Valley Health System - Cardiology Office
Beaver
06.2012 - 07.2018
  • Collaborated with multidisciplinary teams to ensure timely submission of documentation required for insurance approval.
  • Improved patient care by efficiently coordinating authorizations for medical procedures and treatment plans.
  • Facilitated timely renewals of ongoing authorizations by closely monitoring expiration dates and initiating renewal processes proactively.
  • Calculated estimated copay based on current insurance benefits.
  • Authorizations and referrals to all major insurance companies, Data entry, CPT/ HCPS codes. ICD9 - 10, obtain Insurance policies and guidelines, insurance and benefit verification.

Receptionist

Heritage Valley Health System
Coraopolis, PA
06.2006 - 07.2012
  • Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
  • Confirmed appointments, communicated with clients, and updated client records.
  • Kept reception area clean and neat to give visitors positive first impression.
  • Registration, Appointment scheduling, in and outbound phone calls, Insurance verification, Data entry, obtain authorizations/referrals for testing, office visits, and new prescriptions.

Education

No Degree - Liberal Arts And General Studies

Community College Beaver County
Beaver

High School Diploma -

Ambridge Area High School
Ambridge, PA
06.2006

Skills

  • Operational Efficiency
  • Planning and coordination
  • Cross-Functional Communication
  • Project Management
  • Improvement plan knowledge
  • Process Improvement
  • Issue Research
  • Idea Development and Brainstorming
  • Process Documentation

Timeline

Lead Billing Operations Specialist

Pantherx Rare Pharmacy
05.2023 - Current

Billing Operations Specialist

Pantherx Rare Pharmacy
11.2018 - 05.2023

Medical Billing Clerk

Heritage Valley Health System
07.2018 - 11.2018

Billing & Authorization Coordinator

Heritage Valley Health System - Cardiology Office
06.2012 - 07.2018

Receptionist

Heritage Valley Health System
06.2006 - 07.2012

No Degree - Liberal Arts And General Studies

Community College Beaver County

High School Diploma -

Ambridge Area High School
Taylor Kratochvil