Medical Billing Specialist
Resume:
Sheila Finley
Medical Billing Specialist
With over 13 years of experience in medical billing and a strong background in revenue cycle management, I am adept at ensuring accuracy in billing processes and compliance with healthcare regulations. My expertise in electronic health records and billing software, combined with my ability to work collaboratively with healthcare providers and insurance companies, positions me as a valuable asset in streamlining billing operations and enhancing financial performance. Work History
2016-06
- 2023-07
Billing Specialist
The New York Foundling
Submitted claims to insurance companies, including Medicaid Managed Care Plans (MM-CPs), ensuring compliance with healthcare regulations. In charge of revenue cycle for varies payers
Resolved denials and reviewed explanations of benefits, enhancing customer satisfaction through timely responses
Worked effectively with medical payers such as Medicare, Medicaid, and commercial in- surances to secure accurate payments Verified accuracy of accounts payable payments, achieving an 85% reduction in payment errors and check reissues.
2015-11
- 2016-06
Data Analyst
United Bronx Parents
Maintained confidentiality of sensitive client or company information, adhering to HIPAA and other healthcare regulations Analyzed data to identify root causes of problems and recommend corrective actions, improving operational efficiency Documented effective and replicable methods for extracting data and organizing data sources, enhancing data management processes Participated in requirements meetings to understand business needs, facilitating collabo- rative problem-solving.
2012-10
- 2015-06
Medical Biller
AHRC, Access Community Health Center
Prepared and submitted medical claims electronically to governmental, private pay, and commercial insurance carriers, including MMCPs Responded to customer concerns and questions daily, demonstrating strong communica- tion and problem-solving skills
Communicated with insurance provider relations to resolve denied claims, ensuring max- imum reimbursement for services provided Verified patient insurance eligibility, contributing to the accuracy of billing processes.
2010-10
- 2012-09
Medical Biller
Betances Health Center
Delivered timely and accurate charge submissions, including managing detailed, specifi- cally coded information for patient records Posted payments and collections on a regular basis, ensuring a steady funding stream
Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers, demonstrating attention to detail Personal Info
ad30hw@r.postjobfree.com
Phone
Skills
Languages
Billing systems and software,
Netsmart(myevlov), Nextgen, ECW,
Sage, Simple Practice, Counsol,
Accumedic.
Enhancing billing accuracy and
efficiency.
Strong knowledge of ICD-10, ICD-9,
and DRG coding systems, ensuring
compliance with
Coding guidelines and regulations.
Excellent communication skills,
facilitating effective collaboration with
healthcare
Providers and insurance companies.
Knowledgeable in revenue cycle
management, contributing to the
financial performance of healthcare
facilities.
English
Education
Certificates
Verified patient insurance eligibility, enhancing the efficiency of the billing process.
1994-09
- 1996-02
Accounting, Associate
Hostos Community, Bronx
2009-09
- 2010-10
Medical Billing and Coding, Certificate
Sanford Brown Institute, NewYork
2007-09
- 2009-02
Medical Office Systems Management, Associate
The College of Westchester, White Plains
2023-02 Certified Billing and Coding Specialist
Certification# A2N6K6P4. Exp. date 2025-02
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