Medical Billing Specialist
Resume:
Kristal Buchanan
Altamonte Springs, FL *****
***********@*****.***
Hardworking Billing Manager proficient in overseeing team operations, implementing improvements and reducing delinquency. Offering 30 years of experience in Healthcare. Authorized to work in the US for any employer
Work Experience
Medical Billing Specialist
DocGo-New York, NY
October 2020 to November 2024
• Post insurance and patient payments
• Bill all medical claims to insurance companies utilizing billing software and medical clearing houses to ensure clean claims.
• Manage insurance denials by filing appeals or reconsiderations
• Answer phone calls and resolve any insurance or patient issues. Medical Billing Manager
Premier Cardiology And Vascular Associates-Maitland, FL October 2012 to July 2020
Worked with customers to develop payment plans and bring accounts current. Trained and mentored staff on procedures, compliance requirements and collections techniques. Conducted performance reviews and implemented improvement plans. Directed operations in busy 13-person billing group managing $400 000.00in monthly funds. Created new standard operating procedures improving billing accuracy and cash flow. Established efficient workflow processes, monitored daily productivity and implemented modifications to improve overall effectiveness of personnel and activities. Assessed personnel performance and implemented incentives and team-building events to boost morale. Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
Medical Billing Specialist
Emery Medical Solutions-Apopka, FL
May 2009 to August 2012
Posted and adjusted payments from insurance companies. Located errors and promptly refiled rejected claims. Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy. Pre-certified medical and radiology procedures, surgeries and echocardiograms. Printed and reviewed monthly patient aging report and solicited overdue payments. Precisely evaluated and verified benefits and eligibility. Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
Accurately posted and sent out all medical claims. Precisely completed appropriate claims paperwork, documentation and system entry. Transferred balances to correct payers.
Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
Researched and followed up on denied insurance claims. Medical Biller
Orlando Heart Specialists-Altamonte Springs, FL
August 1995 to March 2009
Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
Filed and updated patient information and medical records. Reviewed patient records, identified medical codes and created invoices for billing purposes. Maintained current accounts through aged revenue reporting. Collected payments and applied to patient accounts. Posted charges, payments and write-ups for cardiovascular procedures. Posted payments and collections on regular basis.
Researched and followed up on denied insurance claims. Set up and maintained new electronic billing system. Communicated with insurance providers to resolve any denied claims and resubmit. Education
Medical Office Administration
University of Central Florida - Orlando, FL
May 1999
Diploma
Tyrone Area High School - Tyrone, PA
June 1985
Skills
• Payment processing (10+ years)
• Process improvements (10+ years)
• Team Building
• Collections understanding
• Workflow planning
• Staff Management
• CPT Coding
• EMR Systems
• ICD-10
• Medical Billing
• Medical Coding
• Training and mentoring
• Medical Records
• Accounts Receivable
• Insurance Verification
• Medical Terminology
• ICD-9
• Managed care
• Customer service
• Microsoft Office
• Medical Scheduling
• Transcription
• Chairside Assisting
• Anatomy Knowledge
• Medical Imaging
• Infection Control Training
• Clerical Experience
• HIPAA
• Phone Etiquette
• Practice Management
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