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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.
Bachelor of Arts: Psychology, Wheaton College - Wheaton, IL

Certified Medical Insurance Specialist, May 2012

Licensed AFLAC agent (life and health) 2014

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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
  • 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
  • Sales
  • Interior Design
  • Customer service
  • Merchandising
  • Billing
This resume is created in 7 minutes.
  • 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
  • Strong computer skills

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

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
  • 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
Medical Front Office Specialist Educational Training Center Largo, Florida
Certified Medical Assistant Pinellas Technical Education Center St Petersburg, Florida
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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.
  • 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.
High School Diploma: 2010
Clovis High School - Clovis, NM