Billing Operations & Denials Specialist

Objective

To work as part of an innovative team where my excellent multitasking skills, ability to schedule appointments, adaptable personality, and profound ability to give attention to detail will be applied.

Experience

The Salvation Army-Mid Town, St. Louis, MO

Billing Manager

September 2023-Present

Prepares and submits clean claims to various insurance companies, and state funders either electronically or by paper.

Processes payments from insurance companies

Oversees and complete the pre-authorizations for insurance companies

Responsible for updates to the HER systems, and inputs CPT,DSM, and ICD codes for behavioral health services.

Ensure that the billing staff receive supervision and assistance with job responsibilities as needed. Assures efficient time and resource utilization in the absence of staff, conducts all billing functions to insure continual operations.

Mercy DC Pratt Cancer Center, St Louis. MO

Specialty Account Coordinator

July 2022-September 2023

Insurance/benefit verification, rejection and denials management and collections

Utilize automated software application (EPIC) to process financial eligibility, authorization, billing, and denial follow-up transactions

Communicating with the patient/guarantor on payment status

Utilizing Word, Excel, and Outlook

Good understanding of funding guidelines, claims procedures and insurance company regulations, as well as oncology coding and billing

Mercy JFK Clinic, St Louis. MO

Clinic Financial Coordinator II

August 2018-July 2022

Managing a high volume of claims

Communicating with the patient/guarantor on payment status

Utilizing Word, Excel, and Outlook as appropriate to aid in the completion of daily tasks

Utilize automated software application (EPIC) to process financial eligibility, authorization, billing, and denial follow-up transactions

Follows HIPAA regulations to ensure patient’s privacy

Talk with patients’ who have billing questions

Perform or request adjustments and write offs as applicable

Good understanding of PPO, Medicare and Medicaid insurance companies

Mercy Clinic Women's Health, Des Peres

Financial Coordinator I & Medical Receptionist

January 2006- August 2018

Billed private insurance, Medicare, and Medicaid for OB/GYN and Delivery services

Assisted patients in scheduling meetings, including follow-up and reminder phone calls

Facilitated clear communication between patients, employees, and management

Follows HIPAA regulations to ensure patient’s privacy

Functioned as Office Manager assistant for 14 years

Madoksy Chiropractic and Acupuncture Center, St. Louis

Office Manager

Jan 2002- Feb 2006

Maintain office services by organizing office operations and procedures

Billed private insurance and automobile accident claims

Collected payments and managed financial tracking and banking deposits

Scheduled initial and follow-up appointments with patients

Initiated reminder calls to patients

Education

Job Corporation, St. Louis Missouri

GED

Certificate in Business Administration

Certificate in Clerical Administration

Epic Trained Super User

Skills

Proficient in Microsoft Teams, Outlook, Excel, Word and a trained Super User for EPIC programing. I have a strong ability to learn new electronic medical records systems. Knowledgeable and consistent in applying HIPPA regulations.

Multitasking, Collaboration, Attention to detail, Adaptability, Communication, Customer service, Positivity

Contact this candidate