Medical Billing Data Entry

ANTOINETTE SPOSITO

518-***-**** • ***********@*****.*** • Troy, NY 12180

SUMMARY / PROFILE:

Medical Billing Specialist Analyst with extensive experience and knowledge in medical claims processing and medical billing. Work closely with clinical staff as well as hospital representatives to maintain positive relations ensuring goals are met. Seeking opportunities to use skills in on-site or remote role. Bilingual: English (native), Italian (conversational), and American Sign Language.

Billing: Customer Service, Data Entry, Medical Claims Processing, Insurance Eligibility & Benefits Verification, Healthcare Reimbursements, Appeals Submittals, and Patient, Provider and Payer Communication

Tools and Technology: MS Teams, MS Word, MS Excel, & MS Outlook, EPIC, Meditech, ePACES, and Athena EHR

EXPERIENCE:

Billing Analyst / Medical Biller / Accounts Receivable St. Peter’s Health Partners, Albany, NY 4/2006 – 12/2022

Billing Analyst

Monitor and correct claims daily for Front End, Referrals and Authorizations, and Clinical Workflow

Analyze billed charges, medical records and related documentation for missing, incorrect or late charges

Assist with daily review of charge items and revenue integrity reviews to ensure timely resolution

Identify problematic charges for further review to correct coding/billing issues

Document corrections, discrepancies, outstanding items and exceptions in appropriate systems

Ran monthly reports to identify outbound referrals and communicate improvement ideas to management

Review denials / rejections and write-off dashboards for trends and provide feedback to management, report outstanding claims to ensure timely billing and payment

Medical Biller and Cash Posting Representative

Perform daily activities of payment posting team that receives, posts, and reconciles cash payments

Learn Medicaid system, EPACES, then transferred to high need area to help with cash posting

Manage payment posting process for patient/resident accounts covering healthcare facilities

Handle payments from residents and insurance companies and enter data into banking system

Post payments and development of bank deposits including scanning, file retrieval and mail distribution

Accounts Receivable for Hospital Billing

Verify insurances, and help patient with health insurance billing discrepancies

Bill claims and contact insurance companies to monitor appeals, with high success rate of appeals

Resolve rejections, errors, denials and payment discrepancies in Excel and escalate as needed

Evaluate hospital charge capture practices to ensure accuracy, completeness and for payers’ compliance

Attend payer meetings to discuss claim issues and carrier updates that might impact claims

Work on special projects for other areas, supervisors, and management

EDUCATION:

Associates Degree (A.O.S.) in Advanced Paralegal Studies, Mildred Elley College, Albany, NY

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