Experienced billing specialist with a strong background in software implementation and team management at Faith Healthcare. Proven ability to streamline billing processes and resolve disputes effectively, leading to increased customer satisfaction. Expertise in medical coding compliance and staff training, contributing to enhanced operational efficiency.
Overview
30
30
years of professional experience
1
1
Certification
Work History
Director of Billing
Faith Healthcare
Somerset
12.2019 - Current
Managed billing processes for client accounts and inquiries.
Assisted in implementing billing software and training staff on its use.
Coordinated with the finance team to resolve discrepancies promptly.
Maintained organized records of all billing transactions and communications.
Communicated effectively with clients regarding payment terms and issues.
Developed standard operating procedures for efficient billing operations.
Analyzed customer accounts and identified discrepancies in invoices, payments, credits, and deductions.
Researched complex billing issues using internal resources and external sources as needed.
Resolved billing issues by applying knowledge and completing in-depth research.
Participated in process improvement initiatives to increase efficiency within the department.
Processed customer refunds promptly upon request.
Worked with customers to resolve billing disputes in a timely manner.
Investigated unapplied payments or credits to determine appropriate application method.
Assisted auditors with required documentation related to accounts receivable audits.
Provided support to Accounts Payable department when needed regarding vendor inquiries or dispute resolution.
Conducted insurance verification and pre-authorization, coded medical procedures and managed patient charts.
Provided expert advice on billing optimization strategies, leading to a reduction in outstanding accounts receivables.
Collaborated with IT department to troubleshoot and resolve billing system issues promptly.
Analyzed billing processes and recommended improvements to minimize cycle time and enhance customer satisfaction.
Implemented new billing system software, resulting in an increase in productivity.
Managed and supervised billing department staff, including training, evaluation, and workflow distribution.
Release of Information Specialist/Medical Coder
Wayne County Hopital
Monticello
06.2002 - 05.2008
Processed patient requests for medical records and information access.
Ensured compliance with HIPAA regulations in all information releases.
Coordinated with healthcare providers to gather necessary documentation.
Reviewed and verified authenticity of identification for record requests.
Educated staff on proper release of information procedures and guidelines.
Maintained organized records of released information and requests received.
Resolved issues relating to incomplete or inaccurate authorizations.
Compiled and coded patient data using standard classification systems.
Analyzed patient records to ensure accurate coding and compliance with regulations.
Reviewed medical documentation for completeness and coding accuracy.
Utilized coding software to assign appropriate codes for diagnoses and procedures.
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
Communicated with healthcare personnel, including practitioners to promote accuracy.
Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
Office Manager/Billing Specialist
Rolling Hills Medical Center
Monticello
01.1999 - 05.2002
Coordinated daily office operations and maintained workflow efficiency.
Maintained filing system for records, correspondence and other documents.
Managed front desk operations including greeting visitors, answering questions or directing them to appropriate personnel.
Supervised staff members, organized schedules and delegated tasks.
Developed and implemented office policies and procedures.
Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
Processed patient billing inquiries and resolved discrepancies efficiently.
Maintained accurate patient accounts by updating billing information regularly.
Trained new staff on billing procedures and software systems effectively.
Worked closely with patients to discuss payment arrangements when needed.
Inpatient/Outpatient Medical Coder
Lake Cumberland Regional Hospital
Somerset
05.1995 - 01.1999
Reviewed medical records for accurate coding and compliance with regulations.
Assigned procedure codes using ICD-10 and CPT coding systems.
Collaborated with healthcare providers to clarify documentation and ensure precision.
Updated coding knowledge through continuous education on industry changes.
Communicated with billing departments to resolve coding discrepancies effectively.
Maintained confidentiality of patient information in accordance with HIPAA regulations.
Collaborated with physicians, nurses and other healthcare professionals regarding coding issues or questions.
Actively participated in continuing education courses related to outpatient medical coding practices.
Coded patient information using ICD-10, CPT, HCPCS codes according to established guidelines.
Assigned appropriate modifiers to accurately reflect services rendered.
Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.