Varina Falkner-Doss
Spartanburg,SC
Summary
Driven by a passion for excellence, leveraged medical coding and accounts receivable management and significantly reduced bad debt write-offs. Proactive approach and effective communication skills fostered strong client relationships and enhanced team productivity. Skilled in HIPAA compliance and customer engagement, consistently prioritize accuracy and efficiency in fast-paced environments. Successful at efficiently handling client inquiries, billing, and administrative tasks. Committed to leveraging these qualities to drive team success and contribute to organizational growth. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Medical AR Reimbursement Specialist III
Vizia Diagnostic (Formyl Boston Scientific)
01.2022 - 10.2024
- Improved overall efficiency by streamlining A/R processes and implementing new software tools XIFIN and Nova Path.
- Enhanced cash flow by promptly identifying and resolving billing discrepancies.
- Participated in regular meetings with cross-functional teams focused on process improvement initiatives, representing the A/R department and providing valuable insight into potential areas.
- Presented audit findings to the accounting manager after reviewing results and paperwork.
- Researched industry trends related to credit management strategies, recommending updates or enhancements as appropriate for continued improvement in A/R operations.
- Conducted periodic account reconciliations to identify potential errors or discrepancies in billing or payments received.
- Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Enhanced the overall financial performance of the organization by diligently monitoring outstanding claims and following up on overdue payments.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Followed up on 45-50 accounts daily, denial and unpaid claims to resolve problems and obtain payments.
- Assisted patients with understanding their benefits coverage, providing clear explanations regarding out-of-pocket expenses and reimbursements.
- Employed clinical and billing codes expertise to correct billing inconsistencies.
Certified Medical Coder
Suburban Hematology Oncology Associates
06.2019 - 01.2022
- Improved accuracy of medical coding by thoroughly reviewing patient records and assigning correct codes for diagnoses and procedures.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Coded medical charts at 80-100 per day.
- Maintained compliance with industry regulations by staying up-to-date on the latest changes in medical coding guidelines and conventions.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
- Supported continuous improvement initiatives within the coding department by actively participating in team meetings, training, and sharing best practices with colleagues.
- Verified, coded, and added modifiers to diagnoses.
- Protected patient confidentiality by adhering strictly to HIPAA regulations when handling sensitive information related to medical records, treatments, and diagnoses.
- Utilized advanced knowledge of anatomy, physiology, and medical terminology to accurately assign codes for complex or rare diagnoses and procedures.
- Reduced claim denials by consistently applying knowledge of payer-specific coding requirements while preparing claims for submission.
- Resourcefully used various coding books, procedure manuals, and online encoders.
- Communicated with insurance companies to research and resolved coding discrepancies.
Medical Billing and Collections Specialist
Suburban Hematology Oncology Associates
06.2015 - 06.2019
- Reduced claim denials by diligently reviewing patient records for correct coding and billing information at 60 accounts per day
- Provided essential support to the medical billing team, allowing for a more efficient and effective overall operation within the department
- Collaborated with team members to identify trends in unpaid claims and develop strategies for resolution.
- Facilitated effective communication between healthcare providers, patients, and insurance companies to resolve billing disputes promptly.
- Maintained excellent relationships with insurance representatives to expedite claims processing and secure timely reimbursements for services rendered.
- Contributed significantly towards reducing the number of denied claims by identifying potential issues upfront during the initial review phase of the process.
- Corrected, completed, and processed claims for multiple payer codes.
- Processed billing calls and answered questions from patients and third-party carriers.
Medical Verification Specialist
Vantage Oncology (Formyl ROSA)
04.2010 - 09.2014
- Improved overall efficiency by streamlining A/R processes and implementing new software tools XIFIN and Nova Path.
- Enhanced cash flow by promptly identifying and resolving billing discrepancies.
- Participated in regular meetings with cross-functional teams focused on process improvement initiatives, representing the A/R department and providing valuable insight into potential areas.
- Presented audit findings to the accounting manager after reviewing results and paperwork.
- Researched industry trends related to credit management strategies, recommending updates or enhancements as appropriate for continued improvement in A/R operations.
- Conducted periodic account reconciliations to identify potential errors or discrepancies in billing or payments received.
- Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Identified trends in reimbursement denials, recommending process improvements to minimize future occurrences.
- Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Enhanced the overall financial performance of the organization by diligently monitoring outstanding claims and following up on overdue payments.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Followed up on 45-50 accounts daily, denial and unpaid claims to resolve problems and obtain payments.
- Assisted patients with understanding their benefits coverage, providing clear explanations regarding out-of-pocket expenses and reimbursements.
- Employed clinical and billing codes expertise to correct billing inconsistencies.
Education
High School Diploma -
Holly Springs High School
Certification - Coder/Biller
Penn Foster Career School
Scranton, PA06.2021
Skills
- Medical billing
- Revenue cycle
- Denial management
- Claims resolution
- Payment disputes
- Medical coding
- Patient records
- EOB analysis
- Payment collections
- Insurance claims
- Billing issues
- Denial codes
- Claims follow-up
- Medical terminology
- Billing errors
Additional Information
Reference: Upon request
Certification
Certified Medical Financial Counselor (CFC)
Certified Billing/Coder(CBCS)
Timeline
Medical AR Reimbursement Specialist III
Vizia Diagnostic (Formyl Boston Scientific)
01.2022 - 10.2024
Certified Medical Coder
Suburban Hematology Oncology Associates
06.2019 - 01.2022
Medical Billing and Collections Specialist
Suburban Hematology Oncology Associates
06.2015 - 06.2019
Medical Verification Specialist
Vantage Oncology (Formyl ROSA)
04.2010 - 09.2014
High School Diploma -
Holly Springs High School
Certification - Coder/Biller
Penn Foster Career School
Certified Medical Financial Counselor (CFC)
Certified Billing/Coder(CBCS)
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