Medical Administration 15+years.Ins. Auths.Business Mgr, Specialist

Karen Strauss

HealthCare Administration

Scottsdale, AZ

Authorized to work in the US for any employer

Work Experience

Business Office Manager

Orthopedics & Sports Medicine - Paradise Valley, AZ February 2021 to Present

• Handle all daily bank deposits

• Opening, closing office procedures

• Schedule all outpatient surgeries

• Initiate-complete all prior authorizations

• Initiate-complete all levels of appeals

• Reconciliation

• Responsible for work comp and liens

• Review patient charts, including patient history, progress notes, diagnostic reports, operative and pathology reports, workers compensation,discharge summaries prior to release of records

• Insurance verification for new and established patients prior to scheduled appointment.

• Communicate patients benefits including deductibles, coinsurance and copays

• Ordered office supplies,

• Reviewed and tracked claims staus

• Disseminated inquiries to appropriate departments

• Kept track of all incoming and outgoing mail, faxes

• Manage all meetings, schedules for physician.

• Maintained communication and supported patient concerns within timely manner and professionalism. Patient Care Coordinator/Front office

Internal Medicine Associates - Paradise Valley, AZ May 2020 to February 2021

• Advanced MD

• Check in/check out patients

• Patient scheduling

• Communicate to meet patients needs

• New patient registration

• Insurance verifications, authorizations and referrals

• Chart prep., review

• Refill requests placed

• Review/collect aging report

• Process payor payments

Clinical and Administrative Assistant

Your Veins- Permanently closed due to Covid 19 3/2020 - Scottsdale, AZ July 2019 to March 2020

• Advanced M.D.

• Prior Authorizations

• Insurance verifications in office specialists visits, in office procedures, diagnostics.

• Register all new patients

• Complete all new referrals

• Communicate effectively with referring physicians and clinics

• End of day balancing

• Explain procedures and consents to patients prior to appointments

• Schedule new and existing patients

• Confirm patient appointments

• Collect copays, past due balances, no show fees

• Check in/ check out patients

• Rooming patients

• Sanitization of procedure and consult rooms

• Vitals

• Sales

Billing & Insurance Coordinator

Medical Billing Group West - Scottsdale, AZ

December 2017 to July 2019

• Specializing in review E.O.B. Medicaid payor follow up. Commercial payor follow up.

• Answering phone call inquiries on patient accounts/insurance companies/lawyer's.

• Maintain and grows provider relations and ensures optimal billing processes.

• Identifies specific trends or denials, creates appeal letters, advocates for patients, continues to minimize lost revenue. Research clearinghouse.

• Correction on billing end to get claim paid in timely manner. Medical Billing Specialist II

Arizona Pain Specialists - Scottsdale, AZ

February 2015 to December 2016

• Specialty, multi physician, large practice, full cycle billing.

• Procedure charge entry in and out patient, office new, established charge entry.

• Follow up with physicians, practice managers as needed to correct, inform, update notes,dictation related to patient billing, Investigate, resolve denials, partially paid and rejected claims, troubleshooting.

• Contacted patients to resolve any and all insurance clarifications needed to submit claim.

• Reviewed patient charts, including patient history, progress notes, diagnostic reports, operative and pathology reports, workers compensation adjuster notes and discharge summaries to ensure accurate charge entry.

• Sequenced codes correctly, initiated revised billing as needed.Identified reasons for denials and coding delays to ensure timely filling.

Production Specialist

CVS Caremark - Scottsdale, AZ

July 2014 to January 2015

Contract position

• Establish a positive working relationship with internal and external customers by providing accurate, reliable and timely file submissions and error resolution.

• Based high volume call in and out environment. This is accomplished through Quality Validation, timely efficient and excelling in member satisfaction – not limited to review images of Med D beneficiary documents for correct letter and enrollment grids in daily management . Reimbursement Operations Patient Advocate

MCKESSON Specialty Pharmacy - Scottsdale, AZ

October 2010 to January 2013

• Responsible for addressing escalated reimbursement questions from patients, insurance companies, providers, and clients specific to pharmaceutical products.

• Interacts with both internal and external business partners to achieve optimal coverage and reimbursement for pharmaceutical products

Medical Billing Specialist

SOUTHWEST SPINE AND SPORTS - Scottsdale, AZ

February 2003 to September 2010

• Responsible for multi provider billing

• Entering in office established and new patients consults/evals, injections and treatments.As well as out patient hospital billing.

• Review physicians dictated patient visit to ensure maximum reimbursement.

• Review ERA

• Communicate with W.C. adjusters, ins. Companies

• Post and adjust insurance payments.

• Manage accounts receivables

• Maintain patient acct balances to not exceed 30 60 days. Sending statements monthly, contacting patient via phone as well as noting account.

• Contact commercial insurance to resolve unpaid claims, denials of request prior auth. Education

Associate in Aesthetics

Artistic school of Beauty - Phoenix, AZ

February 2003 to May 2003

Graduate in Medical

Anthem College-Sacramento - Sacramento, CA

April 1997 to May 1999

Skills

• CPT-10,ICD-9, Instamed, Kareo, Web PT, Claimtrak.,MACPractice, Cenpatico, SPSI, Practice Management Software, PrimeSuite, Salesforce,PCN, AdvancedMD, Carecloud, Intergy, Nextgen,Allscripts,Myway/Aprima,Mckesson Star, Epic,E Clinical, Online multiple insurance portals, Auditing, Accounts Receivable, Accounts Payable, Claims Processing,HCPCS., CMS 1500., MS Word,Outlook, MS Office, Citrix, Emdeon software.

• Insurance Verification

• Medical Billing

• Medical Records

• Medical Scheduling

• Time Management

• Medical Receptionist

• Medical Coding

• Medical Terminology

• Athenahealth

• HIPAA

• Phone Etiquette

• Anatomy Knowledge

• Sage

• Leadership

• Administrative experience

• Office Management

• Clerical Experience

• Customer service

• Communication skills

• Organizational skills

• Windows

• Microsoft Office

• Microsoft Word

• Computer skills

• Management

• ICD-10

• Medical office experience

• Basic math

• Sales

• CPT coding

• Filing

• Front desk

• EMR systems

• AdvancedMD

Assessments

Verbal Communication — Highly Proficient

June 2019

Measures a candidate's ability to effectively convey information when speaking. Full results: Highly Proficient

Customer Service — Highly Proficient

June 2020

Identifying and resolving common customer issues

Full results: Highly Proficient

Medical Terminology — Proficient

June 2019

Understanding and using medical terminology

Full results: Proficient

Customer Focus & Orientation — Highly Proficient

July 2020

Responding to customer situations with sensitivity Full results: Highly Proficient

Attention to Detail — Proficient

July 2020

Identifying differences in materials, following instructions, and detecting details among distracting information.

Full results: Proficient

Medical Receptionist Skills — Highly Proficient

July 2020

Managing physician schedules and maintaining accurate patient records Full results: Highly Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

Contact this candidate