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Click here or scroll down to respond to this candidateCandidate's Name
Health insurance benefits, Medical billing and Claims professionalStreet Address
CPHONE NUMBER AVAILABLE, EMAIL AVAILABLEPROFILE: Quality and results orientated achiever seeking a position within your company; quick learner and efficient multitasker; Organized, accurate, and focused; Strong analytical, problem solving and attention to detail abilities; Ten plus years of medical billing experience. Known for strong technical skills. Knowledgeable in Accounts Receivable and Collections, Commercial/Private payers, Medicare/Medicaid, Workers Compensation, FMLA claims, and third party insurance. Self-motivated, dedicated, personable team player with great communication skills. Proficient in MS 365 Suite, PeopleSoft, Credible, CorCentric, Change Healthcare, Procentive, MNits and many other billing software platforms. CPT and ICD 10 coding. Knowledge of R and SQL.EDUCATION: Associate in Applied Science Degree, Data Analyst Program May 2018Hennepin Technical College, Brooklyn Park, MNPhi Theta Kappa Honor Society member since August 2012WORK EXPERIENCE:AR/AP Manager {January 2024 to July 2024}MGC Diagnostics CorporationManaging accounts payable and accounts receivable functions to ensure compliance with internal controls and accounting policiesSupervision of TeamEnsuring accurate and timely processing of invoicesCoordinating with other department heads within companyMonitoring the accounts aging reports to identify delinquent accountsResponsible for reporting monthly and quarterly to be provided to controllerLead Billing and Collections Specialist {May 2020 to December 2023}AvivoBilling all programs which include Mental Health, Chemical Addiction and Housing services for Nonprofit.Collections of these programs which require strong follow up skills along with organizational skills.Reviewing all Service Authorizations required by payers and documenting those requirements in ERM system.Billing DHS, PMAPS and commercial insurance companies.Billing Liaison (Oct 2019 to March 2020Global Kinetics CorporationGathering required billing documentation Reaching out to clinics.Prior authorization process.Working within AdvancedMD for the billing process.Account Receivable Lead (Jan 2018 to Sept 2019)Starkey Hearing FoundationProcessing and collecting high dollar claims for multiple payers. Included submitting appeals and collecting additional information needed.Running reporting and working aging according to that reporting.Working with new hires for their training on systems and processes.Billing Supervisor (Jun 2016 to Jan 2018)Minnesota International MedicineSupervision of Billing SpecialistsManages billing and claim submission to all payersWork with department supervisors to resolve payment related issuesResponsible for designing and implementing policies and procedures across multiple locationsBilling Specialist (Feb 2016 to June 2016)Fraser Child and Family/Robert HalfProcessed incoming payments from clients after insurance processes.Collections, aging, researched and addressed escalated accounts and other payment issues.Accounts Receivable Facility/Third Party Coordinator (March 2014 to July 2015)Thrifty White Pharmacy CorporateIdentified areas to drive improvement and efficiency within the Facility/Third Party Insurance team.Partnered with specialists and leadership to coordinate and implement improvements to these processes.Assisted the specialists with researching and addressing escalated account / payment issues.FMLA Leave Manager (March 2013 to Dec 2013)Cigna Leave Solutions, Eden Prairie, MNDetermined employee eligibility for FMLA benefits.Assessed if claim meets state and federal regulations and compliance standards.Administered claims and track progress with internal partners.Broker Services Analyst/Contractor, Agent On-Boarding (July 2012 to Dec 2012)United Healthcare via Volt Staffing Agency, Minnetonka, MNHandled processes new and renewing agents selling UHC Medicare products.Scrutinized documentation to ensure completeness, accuracy and compliance.Processed agent applications for licensing, appointment and contracting credentialsNavigated successfully in technical applications including: SharePoint, Access, Sircon Producer Manager, Oracle, Adobe Acrobat and DCM.Bill Review Manager (January 1999 to June 2011)Bill Review SupervisorBill Review AnalystCorvel Corporation, Minneapolis, MNManaged, evaluated and trained staff of 27 in processes and procedures.Reviewed hospital audits, state fee schedule regulations and electronic billing.Appeared for hirings at Dept. of Labor for provider appeals with the State of MN.Administered Workers Compensation claims applying correct rules and state statutes.Entered managed care authorizations and utilization revisions.Monitored financial budgets and revenue(up to $700,000) and assessed staffing workflow needs.Emphasized maintaining high quality, maximizing savings and excellent customer service.Claims Examiner (October 2001 to April 2002)Metropolitan Health PlanAnalyzed claims data using CPT, HCPCs, ICD9 coding.Processed Medical Assistance, General Assistance, MNCare and County claims. |
