Medical Billing Customer Service

Lisa Kariwiec

c: 224-***-**** e: ************@*****.*** LinkedIn Profile

Summary

Results-driven professional experienced in Medical Collections and A/R Billing. Proven track record of success in optimizing revenue cycles, ensuring accurate billing, and streamlining collections processes. Strong time management, communication, and teamwork skills, with a commitment to delivering exceptional results in fast-paced healthcare environments.

Skills & Expertise

• Medical Billing & Collections – Extensive experience in A/R billing, claims processing, denials management, and insurance verification.

• Insurance & Patient Advocacy – Skilled in contacting insurance carriers and patients to resolve claim denials, verify benefits, and maximize reimbursement.

• Revenue Cycle Management – Strong knowledge of A/R processes, reconciliation of carrier submissions, and resolution of outstanding balances.

• Claims Appeals & Conflict Resolution – Proven ability to research and appeal denied claims while addressing disputes with insurance providers and patients.

• Medical Record-Keeping & Compliance – Experience maintaining accurate financial records, processing EDI transactions, and ensuring compliance with healthcare regulations.

• Patient Scheduling & Customer Service – Adept at scheduling appointments, managing patient inquiries, and coordinating with healthcare providers.

• Technical Proficiency – Proficient in Microsoft Excel, Outlook, Global Messaging, and electronic health records

(EHR) systems.

• Organizational & Time Management Skills – Ability to handle high-volume workloads efficiently, prioritize tasks, and meet key performance indicators (KPIs).

Professional Experience

Medical Billing Specialist November 2024 - present ENT Illinois – Park Ridge, IL

• Scrub claims to ensure accuracy and compliance before submission to insurance providers.

• Post insurance and patient payments, reconciling accounts for accurate financial records.

• Conduct claims follow-up, identifying and resolving denials or discrepancies to maximize reimbursement.

• Communicate with insurance carriers and patients regarding claim statuses, payment issues, and eligibility verification.

• Answer incoming calls, assisting patients with billing inquiries, payment options, and insurance-related concerns.

• Maintain detailed records of transactions, payments, and claim resolutions in compliance with industry regulations.

Collections Specialist – AM&D November 2019 – October 2024 Philips (formerly Biotel Heart) – Chicago, IL

• Contact patients and insurance carriers to resolve claim denials related to demographic discrepancies or coverage issues.

• Verify patient eligibility and benefits for durable medical equipment (DME) to ensure accurate billing and reimbursement.

• Review and correct clerical errors on patient claims, ensuring up-to-date insurance coverage based on weekly work logs.

Senior A/R Representative August 2008 – October 2019 Change Healthcare/McKesson – Wheeling, IL

• Manage insurance verification and medical record-keeping to ensure accurate claim submissions.

• Oversee A/R billing procedures, including resolution of denied claims and conflict resolution with insurance carriers.

• Conduct follow-ups on outstanding A/R across all payers, ensuring timely reimbursement and account resolution.

• Handle all insurance correspondence, working closely with carriers and patients to maximize payments and identify potential account issues.

• Process EDI transactions and ERA files, reconciling carrier submissions, edits, and rejection reports.

• Research and resolve accounts listed on Delinquent Insurance Reports, Collection Ledgers, and Government Payer reports, making informed decisions to optimize reimbursement.

• Consistently meet productivity standards and KPI goals while identifying trends and reporting them to management.

• Work on special projects as assigned, demonstrating strong analytical and problem-solving skills.

• Proficient in healthcare and insurance billing, with expertise in customer service and financial reconciliation.

• Highly organized, detail-oriented, and able to multitask in a fast-paced environment.

• Strong written and verbal communication skills, with a proven ability to collaborate effectively across teams. References available upon request

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