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Professional Profile
Result-oriented professional with extensive experience in the healthcare industry. Goals-directed Revenue Cycle Manager with a consistent track record of increased practice revenue to include both front and back end. Skilled in clarifying issues, implementing solutions and complex decision making. Detail-oriented and organized with the ability to multi-task. Committed to professional interaction with staff from varying backgrounds while promoting team values. 
Key Accomplishments
  • Effectively managed all aspects of accounts receivable for a multi-specialty practice with multiple locations.
  • Initiated insurance verification policy to be implemented practice-wide.
  • Increased patient participation by 25% with credit card on file to resolve outstanding balances.
  • Educated and trained support staff to use insurance web sites to increase profitability. 
Experience Summary
Billing Manager, 07/1999 to 04/2017
Endocrine & Diabetes Center – Vienna, VA
  • Professionally and efficiently managed all aspects of medical billing for a multi-practitioner, multi-location specialty practice.
  • Effectively coordinated all claims processing functions, allocated payments, appealed denials, and processed adjustments.
  • Accurately and timely posted payments from all sources; paper checks, EFT's and credit cards
  • Researched insurance retractions and verified patient refunds for Accounts Payable in a timely manner.
  • Initiated and established insurance verification policies with major payers to be adopted and implemented by office staff.
  • Administrative contact managing insurance website registration and training front desk staff.
  • Responsible for daily financial operations including: accuracy of charge posting, electronic deposits, payment allocation and scanned bank check deposits.
  • Thoroughly performed insurance claim follow up and patient collection of approximately 900 accounts monthly.
  • Systematically printed and reviewed monthly patient aging reports and solicited overdue payments. Prepared accounts for electronic collection agency transfer.
  • Meticulously reconciled all charges and payments preparing accurate reports daily, month end closing and yearly summary for managing physician review.
  • Working knowledge of CPT codes, ICD-10 coding and HIPAA guidelines.
  • Well versed with all major payers such as Blue Cross, Medicare, Managed Care and commercial plans, etc.
  • Flagged all payments not paid in accordance with current contract rates, followed up with insurance representative for resolution of payment errors.
  • Resourcefully used various coding books, procedure manuals and on-line encoders to resolve billing and payment errors.
  • Maintained accurate patient registration and managed appointment scheduling.
Patient Services Coordinator, 04/1991 to 06/1996
INOVA Home Health – Springfield, VA
  • Responsible for primary intake and insurance verification for patients requiring home care services.
  • Coordinated with liaison nursing staff and RN team leaders conducting case management and ensured benefits for all ordered disciplines.
  • Initiated communications regarding home care benefit information to patients or family members prior to staffing.
  • Carefully completed entry of patient demographic and insurance information into data base prior to claim submission.
  • Promoted teamwork with billing team to ensure smooth reimbursement and collection process.
Billing Supervisor, 05/1990 to 03/1991
Northern Virginia Doctor's Hospital (Northern Virginia Community Hospital) – Arlington, VA
  • Managed Billing Department operation by daily submitting electronic claims to all major payers with a staff of three representatives
  • Consistently ensured accurate ICD-9 and CPT4 coding of outpatient and emergency room accounts.
  • Worked closely with Admissions, Medical Records, and the Business Office to ensure accuracy.
  • Well versed in Medicare, Medicaid, PPO and HMO guidelines in a hospital setting.

Medicare Specialist, 09/1989 to 04/1990
Southwestern Medical Center – Lawton, OK
  • Reliably billed both inpatient and outpatient Medicare accounts.
  • Responsible for computerized follow up and supplemental insurance billing. Professionally resolved errors to expedite payment.
  • Successfully received and allocated payments to patient accounts.
  • Worked cooperatively with patients and family members while making payment arrangements and performing financial counseling.
Patient Services Coordinator, 09/1986 to 05/1989
Abbey/Foster Home Health Care – Lawton, OK
  • Diligently obtained and verified insurance and diagnosis information for successful claims filing.
  • Filled orders for rental and/or purchase of durable medical equipment (DME).
  • Proficiently handled all areas of office operations including customer service, accounts payable, inventory, payroll and retail sales.
  • Mastered Medicare, Medicaid and CHAMPUS (Tricare) guidelines for home care equipment.
Education
Bachelor of Arts: Psychology, Wheaton College - Wheaton, IL
Certifications

Certified Medical Insurance Specialist, May 2012

Licensed AFLAC agent (life and health) 2014

This resume is created in 7 minutes.
Career Overview

A dedicated professional with a well respected track record in the Luxury Home Furnishings Industry. Successful at listening to the needs of the client and collaborating on a creative vision. Brings vast knowledge base of  business and customer service.

Core Strengths
  • Creative Interior Design skills
  • Courteous demeanor
  • Active listener/communicator
  • Goal oriented
  • Energetic work attitude
  • Seasoned in conflict resolution
  • Strong organizational skills
  • Sharp problem solver
Accomplishments
  • Worked within company guidelines to welcome, educate and assist in client decision making. Ability to achieve well thought out design projects, while maintaining customer confidence and comfort level.
  • Maintained an active client base by developing relationships that would result in repeat business. Ranked in the top 10 % of the sales force annually for showroom sales nationwide. 
  • Tracked orders through out the production process and updated clients regularly. Handled any and all issues and customer complaints  by listening and finding a solution to customer satisfaction.
Work Experience
05/2017 to Current
Showroom Associate Semihandmade － Palm Springs, CA
  • Provide a welcoming and inviting atmosphere in which to explore and solve problems related to Kitchen, Bath and Media projects.
  • Engage with and educate customers on the quality and benefits of using our products and services.
  • Follow up on customer shipments, and help resolve any issues related to shipping.
  • Provide feedback to marketing and Web master related to consumer needs and gaps in our product selection/offering. 
  • Maintain showroom appearance and assist with inventory and modify display when necessary. 
  • Provide daily accounting of potential business, walk ins and new leads for future follow up.
12/1994 to 05/2017
Sale Associate Baker Furniture (A Kohler Company) － Laguna Niguel, CA
  • Sell high end home furnishings for a major furniture manufacturer.
  • Maintain a high standard of professionalism with clients and their teams.
  • Develop relationships with designers and architects to create a client base for repeat business..
  • Successfully assist clients in choosing furnishings that are consistent with their preferences and budget.
  • Maintain accurate specifications for each project.
12/1992 to 12/1994
Visual Display Coordinator Baker Furniture (A Kohler Company) － Laguna Niguel, CA
  • Responsible for 18,000 square feet of showroom space.
  • Maintained visual standards developed by corporate design team.
  • Executed floor display moves and remodel changes.
03/1987 to 07/1991
Billing Supervisor Homedco － Ridgewood, NY
  • Supervised team of 13 in a third party billing department for a major home health care provider.
07/1984 to 06/1986
Assistant Market Research Director The NPD Group － Port Washington, NY
  • Responsible for market research projects from inception to completion, while providing technical support to clients in application of data.
Educational Background
Certificate, Interior Design Interior Designers Institute － Newport Beach, CA, USA
Bachelor of Science: Business Administration / Marketing Long Island University, C.W. Post College － Greenvale, NY, USA
Skills
  • Sales
  • Interior Design
  • Customer service
  • Merchandising
  • Billing
This resume is created in 7 minutes.
Highlights
  • Accounts receivable professional
  • Complex problem solving
  • Strong communication skills
  • Expert in customer relations
  • Effective time management
  • Excellent managerial techniques
  • Extensive knowledge of Florida Medicare/Advantage/Managed Care
  • MU/HEDIS/MRA/HIPAA
  • Strong computer skills
Summary

Highly experienced in all areas of Family Practice/Internal Medicine/Medical Billing/Coding and Front Office with sound judgment and decision-making skills

Experience
Sr Billing Coordinator Feb 2019 to Current
 Community Health Centers Of Pinellas Inc.
Billing/Office Manager Apr 2017 to Feb 2019
 Medi Clinics Primary Care LLC － Tampa, FL
  • Managed all daily billing processes including transmitting claims to insurance carriers, processing/correcting insurance rejects, processing rebills, verifying electronic acknowledgements were received. Applied all ERA payments
  • Corresponded with Medicare, Medicaid and private insurance providers to resolve billing issues
  • Headed onboarding process and trained staff in the implementation of Kareo EMR software

  • Generated and mailed patient statements
  • Assisted with referrals, eligibility and prepared medical records for patients
  • Registered patients and scheduled appointments
  • Reviewed and approved time cards for processing by the provider
  • Processed patient payments and scanned identification and insurance cards
  • Took messages from patients and relayed them to the appropriate staff
  • Entered patient information including insurance, demographic and health history into the system to ensure that all records were up-to-date
  • Regularly evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed
  • Jumped in to fill gaps in office when necessary
  • Ensured HIPAA compliance and patient confidentiality
  • Maintained all confidential personnel files, certification and CPR compliance records
  • Evaluated accuracy and compliance of all documentation
  • Delegated staff duties
  • Carefully selected as well as trained new staff
  • Supported staff by performing a wide range of clerical and administrative tasks
  • Coordinated all Internal Medicine clinical rotations for ARNP students coming to our office
Billing Manager Jun 2016 to Mar 2017
 Eduardo Palanca MD － Clearwater, FL
  • Reduced time and costs and increased efficiency by introducing new billing and accounts receivable procedures
  • Verified details of transactions, including funds received and total account balances
  • Suggested process improvements to secure prompt and regular payments
  • Researched and resolved billing and collection problems for the organization
  • Review and prepare daily physician, hospital, ALF/SNF charges to submit electronically 
  • Electronic/manual posting and adjusting of payments from insurances and patients
  • Reviewed denied claims, fixed, resubmitted and appealed when necessary
  • Processed patient statements electronically on a routine, scheduled basis
  • Provided telephone and in person support to patients as related to billing
  • Assisted front office staff with any questions/problems/training with billing and insurance matters
  • Billed for bi-monthly home health certification and re-certification
Billing Supervisor Feb 2002 to Jun 2016
 West Coast Family Medical Care － Clearwater, FL
  • Oversaw daily operations of billing office
  • Prepared daily physician charges and submission of electronic and paper claims
  • Resolved all file transfers and submission errors from clearinghouse
  • Performed electronic and manual posting and adjustments of payments from insurance carriers and patient payments
  • Reviewed EOBs for coding and billing issues and submitted corrected claims and appeals as needed in a timely fashion
  • Checked claim status online and by phone
  • Performed online insurance verification
  • Processed monthly patient statements
  • Provided telephone support to patients as related to billing matters and collection of outstanding balances
  • Prepared and submitted monthly accounts to outside collection agency
  • Acted as PM software manager with thorough understanding of the system, including set up, maintenance, and problem resolution
  • Trained front office staff in PM system
  • Faxed or mailed patient billing ledgers to attorney offices per request or subpoena and charged accordingly
  • Charged No Show/Returned check fees to patient
  • Performed monthly billing of Home Health certification and re-certification/Care Plan Oversight/Chronic Care management
  • Prepared accounts receivable deposit for bank
Accomplishments
  • Researched and resolved billing problems that had previously been missed
  • Established and implemented OSHA and HIPPA procedures and protocols for medical offices
  • Trained multiple office personnel for seamless ICD-10 transition
  • Set up, maintained, and performed maintenance and problem resolution of practice management software with thorough understanding of the system
  • Successful track record handling complicated assignments
  • Highly experienced in reconciling insurance/patient payments and resolving account disputes
Education
Medical Front Office Specialist Educational Training Center － Largo, Florida
Certified Medical Assistant Pinellas Technical Education Center － St Petersburg, Florida
This resume is created in 7 minutes.
Professional Summary
Customer-centered professional with a diverse financial service career in medical billing, training, and project management. Highly analytical, deadline-driven billing professional who completes accounting activities with accuracy and speed.
Skills
  • Front desk experience
  • Computer knowledge
  • Fluent in Spanish
  • Customer-oriented
  • Organized
  • Great with Numbers and math
  • Fast and efficient service worker
  • Invoice coding familiarity
  • Staff training/development
  • Deadline-oriented
Work History
Billing Supervisor , 12/2015 to Current
K-Bee Homecare Services LLC – Clovis, NM
  • Correctly coded and billed medical claims for various MCO\'s (managed care organizations)
  • Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in consumer IPOCs.
  • Verified consumers eligibility and claims status with insurance agencies.
  • Diligently filed and followed up on third party claims.
  • Assisted in the maintenance of electronic billing records (filing, billing, research, and authorization of hours).
  • Billed Molina, BCBS (blue cross blue shield), VA (veterans affairs) and workers compensation.
Assistant Manager, 05/2014 to 10/2015
Noble Finance – Clovis, NM
  • Promptly responded to inquiries and requests from prospective customers.
  • Trained staff on operating procedures and company services.
  • Cross-trained and backed up other customer service managers.
  • Investigated and resolved customer inquiries and complaints in an empathetic manner.
  • Reviewed collection reports to determine the status of collections and the amounts of outstanding balances.
  • Collected and reported monthly expense variances and explanations.
  • Supervised accounts receivables clerks, team of three.
Shift Manager, 09/2012 to 04/2014
McDonald\'s – Clovis, NM
  • Consistently provided friendly guest service and heartfelt hospitality.
  • Promptly and empathetically handled guest concerns and complaints.
  • Operated the drive-through window and sales register quickly and efficiently.
  • Maintained high standards of customer service during high-volume, fast-paced operations.
  • Cross-trained and coordinated scheduling with team members to ensure seamless service.
  • Oversaw cash for registers at end of employee shifts. 
Front Desk Agent, 11/2010 to 08/2012
Holiday Inn Express & Suites Clovis – Clovis, NM
  • Greeted and welcomed all hotel guests with a smile.
  • Reviewed account information and charges with guests during check-out.
  • Collaborated with maintenance and housekeeping to assure rooms were available for guest.
  • Verified that personal and payment information on guest accounts was accurate and complete.
Education
High School Diploma: 2010
Clovis High School - Clovis, NM

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