Medical billing specialist

L INDA R ODE LL I

***A Ruth Place Eatontown, New Jersey 07724

732-***-**** ************@*****.***

SUMMARY QUALIFICATIONS

OF

Dedicated Financial Counselor ~ Know ledge of Commercial & Private Insurance ~ Administrative Skills

Highly-accomplished, solutions-driven leader and dedicated financial counselor with unique background of clinical,

administrative, financial, insurance, medical billing, coding, technical and patient support skills and experience

acquired in fields of infertility and gynecology. More than 18 years of achievements managing financial operations

and helping patients understand their coverage and costs, as well as explore options to pay for treatments. Possess

strong work ethic and outstanding communication and collaborative relationship-building attributes.

CORE COMPETENCIES

Patient-Focused Care Healthcare/Organizational Management Patient Financial Counseling Accounts Payable/

Accounts Receivable Daily Reconciliations Medical Billing CPT & ICD-9 Coding Clinical/Administrative

Leadership Knowledge of Commercial and Private Insurance Time Management Skills Strategic Planning

Problem Solving Policy/Procedure Development Team Leadership Communications Relationship-Building

PROFESSIONAL EXPERIENCE

2007 – Present

IVF NEW JERSEY, Somerset, NJ

Financial Counselor / Manager

Commanded superior financial and clinical leadership as co-manager of billing department for infertility practice,

overseeing all financial aspects of practice comprised of 6 doctors and 10 billing representatives in 6 different offices.

Provided expert oversight of $12 Million annual revenue with 10-15% generated by the Donor Egg Program and the

remainder from other treatments, such as artificial insemination and 500 cycles/year of In Vitro Fertilization (IVF).

Coordinated 150 cycles/year of third-party reproduction, including shared and non-shared egg donor cycles, by

staying in close contact with patients and donors, nationally and internationally.

Devised and organized an effective means of presenting treatment costs to patients by developing and managing new treatment

cost sheets with fee structure, as well as informing patients of their out-of pocket financial responsibilities to eliminate confusion.

Contributed to greater revenue generation and improved patient satisfaction by working directly with patients and

2 loan companies, Springstone Financing and CapexMD, to help more patients obtain financing for treatment.

Valued as trusted manager and advisor, served as point of contact and developed productive collaborative relationships

with all IVF NJ personnel, including billing reps, receptionists, nurses and medical techs, for insurance and financial inquiries.

Ensured high degree of accuracy by analyzing/interpreting patients’ medical records and evaluating diagnosis and procedure

codes to determine billable services. Meticulously tracked and resolved over/underpayments by reconciling with daily receipts.

Increased operational efficiency and minimized costs through assessment of billing policies, identifying/resolving all

problems related to billing and addressing ongoing issues within the organization. Trained staff in processes/procedures.

Managed all important medical billing functions, including benefit verifications and pre-authorizations, as well as

patient and insurance accounts receivable. Reconciled all monies collected and charges entered on a daily basis.

Elevated financial and operational performance by remaining up to date with all insurance requirements and adeptly

verifying, pre-certifying and pre-authorizing patients’ insurance benefits.

Optimized achievement of organizational objectives by creating a framework and processes for documentation and

presentation of revisions to patient medical policies and fee structures. Posted daily charges, insurance and patient payments.

Facilitated a smoothly-run clinical operation by answering patient calls and emails in fast-paced infertility office,

as well as scheduling patient appointments, MRIs, HSGs and other procedures.

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PROFESSIONAL EXPERIENCE

(Continued)

2006 – 2007

CHARLOTTE SPORTS MEDICINE INSTITUTE, Huntersville, NC

Front Desk Medical Receptionist / Scheduler

Fulfilled a key administrative role answering high volume of patient calls and emails in busy orthopedic surgeon’s

office, in addition to scheduling patient appointments, surgeries, CAT scans, MRIs and physical therapy.

Delivered significant improvements in clinical performance by working with outside facilities, including radiology

sites and hospitals, to ensure patients received procedures needed to diagnose, treat or correct their medical issues.

Minimized costs and maximized revenue by efficiently managing office, overseeing accounts receivable/payable, posting

daily charges and reconciling daily income. Reduced accounts receivable by establishing new credit criteria for patients.

Worked closely with providers of commercial, private and Medicare insurance to verify coverage, file claims, post

insurance payments, identify/resolve billing errors and refile denied or rejected claims.

1998 – 2006

IVF NEW JERSEY, Somerset, NJ

Financial Counselor

Enhanced financial and clinical performance by verifying insurance coverage and confirming patient information to

coordinate patients’ insurance benefits and collect co-payments. Refiled denied and rejected claims.

Eliminated errors by carefully preparing, reviewing and submitting patient statements with accurately entered

procedure codes, diagnosis codes and patient demographics. Answered patient calls and billing questions.

1996 – 1998

PRUDENTIAL HEALTH INSURANCE COMPANY, Cranbury, NJ

Customer Service Representative

Recognized for outstanding performance and selected to serve as an exclusive IBM Team Customer Service

Representative. Effectively managed high volumes of customer calls, including inquiries and complaints.

Demonstrated advanced technical and analytical skills, including computer knowledge and problem-solving

abilities, as well as interpersonal customer service skills, as a member of cross-functional team.

TRAINING

Plan to take advanced Excel Course and complete Coding Specialist Certification in near future.

Representative Training: Medical Billing Software, EMR (Electronic Medical Records) Software, In-service

Training for Pharmaceutical Discount Plans, Shared-risk Programs (including Refunds and Multi-cycle Discounts),

Financial Loan Programs.

COMPUTER SKILLS

eIVF and ArtSys Medical Charting Software, Ridgemark and Oncall Medical Billing Software, Microsoft

Office including Word, Excel and Outlook.

EDUCATION

WEST VIRGINIA UNIVERSITY

General Studies

BROOKDALE COMMUNITY COLLEGE

General Studies

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