Medical Billing Customer Service
Resume:
Dorothy Maimone
*** ****** ****, *******, ** ****6
*********@*****.***
PROFESSIONAL SUMMARY
I have over 35 years of expertise as a medical billing service-provider, delivering dependable and timely services for all my customers, including patient-facing providers, internal business leaders, and patients. I specialize in collections and credentialing, working diligently and efficiently to maximize revenue. I am a dedicated and independent worker, and I hold myself to high quality standards of work. On a weekly basis, I analyze revenue and accounts receivable data to evaluate my work performance towards my goal to maintain all collections under 60 days from billing. I proactively reach out to insurance carriers to initiate and manage appeals and resolve Explanation of Benefits (EOB) denials. I collaborate closely with providers to clarify payable services, using my expert knowledge of current procedural terminology
(CPT) codes and insurance-carrier-specific local coverage determinations (LCDs) to ensure accurate and timely payment. I am also able to manage high volumes of work. For example, from 2013 through 2015, I personally handled billing for three practices: Arcadia HomeCare, CRNP, and a private practice run by a local podiatrist, Dr. Luther Bond. For the past 13 years, I have maintained this high level of productively while working as a remote employee.
SKILLS
• Expert knowledge of coding (CPT, ICD-9,
and ICD-10) and insurance-carrier-specific
local coverage determinations (LCDs)
• Exceptional customer service with patients,
providers, insurance carriers, and business
leaders
• Provider credentialing with insurance carriers
• Weekly, monthly, and annual revenue and
accounts receivable reporting
• Posting charges and payments and claims
processing
• Appeals management and EOB denial resolution
• Highly productive remote employee
WORK EXPERIENCE
Senior Collection Specialist (remote employee)
Community Resource Nurse Practitioners, Stroudsburg, PA 2009 – Present
• Processes claims, verifies patients’ insurance coverage, posts charges and payments, maintains accounts receivable, contacts patients on delinquent accounts, and collects EOB denials across 15 facilities and home care patients, including billing for at-home patient monitoring services
• Credentials the practice with insurance carriers to become in-network
• Manages a daily report of patient caseloads across facilities and daily billing and collection activities to support business owner supervision of clinical services and revenue
• Schedules patients for appointments, handles patient calls to answer questions about their bills, and ensures up-to-date prescription lists for patients prior to receipt of clinical services Senior Collection Specialist (remote employee)
Dr. Luther Bond, Podiatrist, Pen Argyl, PA
2013 – Present
• Credentials Dr. Bond with insurance carriers to become in-network
• Processes claims, verifies patients’ insurance coverage, posts charges and payments, maintains accounts receivable, contacts patients on delinquent accounts, and collects EOB denials Senior Collection Specialist (remote employee)
Arcadia HomeCare, Allentown, PA
2015 – 2017
• Processed claims, verified patients’ insurance coverage, posted charges and payments, maintained accounts receivable, contacted patients on delinquent accounts, and collected EOB denials Therapist Collection Specialist
Weston Group, Easton, PA
2004 – 2009
• Credentialed the practice with insurance carriers to become in-network
• Processed claims for physical, occupational, and speech therapy, verified patients’ insurance coverage, posted charges and payments, maintained accounts receivable, contacted patients on delinquent accounts, and collected EOB denials
Billing Manager
Hunterdon Radiology, Flemington, NJ
1988 – 2003
• Supervisor for the billing department of eight employees, responsible for delegation of practice workload, onboarding and on-the-job training, annual performance reviews, and responding to questions and concerns regarding their daily work
• Produced monthly and year-end reports for management and met with practice owners monthly to discuss revenue, accounts receivable, LCD reports, and opportunities for improvement across the billing department
• Took a certified course for diagnostic coding, earned title as “certified coder”
• Continued to perform billing and collection duties
• Expert knowledge of CPT codes and diagnostic coding (ICD-9 and ICD-10) Collection Specialist
Hunterdon Radiology, Flemington, NJ
1986 – 1988
• Processed claims, verified patients’ insurance coverage, posted charges and payments, maintained accounts receivables, contacted patients on delinquent accounts, and collected EOB denials for five radiologists
OTHER WORK EXPERIENCE
Cashier and Deli Clerk
Deber’s Deli, Martin’s Creek, PA
2009 – 2019
• Responsible for helping customers, stocking and organizing display cases, slicing deli meat and making sandwiches, while ensuring prompt service and high level of customer satisfaction
• Responsible for store closing, including cleaning, restocking, end-of-day reports, and end-of-day accounting
EDUCATION
South Hunterdon Regional High School
Lambertville, NJ
GPA: 3.5
Class of 1978
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