Senior Medical Billing & Revenue Cycle Specialist

Ana Lamaire

Woonsocket, RI, ***** 401-***-****

*******@*****.***

SUMMARY OF

QUALIFICATIONS

Knowledge of Microsoft Excel, Word, Outlook, TPMS, QuickBooks, Waystar, Payerpath Syteline, Fundware, MIP, JobBoss, ABRA, Rumba, Microsoft Access,

EClinical10, All Scripts, Athena, EPIC

100% Remote position preferred

Fully Bi-Lingual in Spanish/English

Excellent organizational skills

Ability to work in a fast paced, high-pressure environment- work from home preferred

EDUCATION

High School Diploma Sep 1982 - Jun 1986

CARL SCHURZ HIGH SCHOOL, CHICAGO, IL

EXPERIENCE

SENIOR REVENUE CYCLE ASSOCIATE 2021 – 2025

VERADIGM HEALTH CARE ASSOCIATES CHICAGO, IL

Work with various Multi Specialty billing

Meet Monthly and Quarterly with providers regarding their aging reports

Responsible for the financial health of the client's revenue cycle

Monitor insurance claims by running appropriate reports, and efficiently contact insurance companies to resolve claims that are not paid in a timely manner

Identify coding or billing issues from EOBs/EFTs & work to correct errors in a timely manner

Identify and analyze denial trends

Ability to think critically to eliminate denials prior to claim submission & improve processes

Work clearinghouse rejections

Identify problem accounts and escalate as appropriate

Update the patient account record to identify actions taken on the account

Work with and meet with clients and colleagues to explain and obtain necessary information to get claims processed

Write appeals and include supporting documentation

Respond to and process insurance refunds

Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information

Train new employees on various medical billing software

BILLING ASSOCIATE 2017 – 2021

OCEAN STATE URGENT CARE, WOONSOCKET, RI

Researching billing discrepancies for medical insurances associated with Ocean State

Resubmitting claims to Third Party carriers

Correcting Navicare issues and rejections for all the Urgent Care/Primary Care Facilities

Extensive research and correction of claims for various insurances

Research payer requirements for accurate submission of claims for paper and electronic claims

ACCOUNTS RECEIVABLE ASSOCIATE 2015 - 2017

GARELICK FARMS/DEAN FOODS, FRANKLIN, MA

Researching billing discrepancies for various customers within Garelick Farms/Dean Foods

Extensive research and correction of invoices/ purchase orders for various customers

Worked within various web portals for billing discrepancies and submission of claims

Handle Invoicing for Dean Foods East/Northeast region for Accounts Receivable department

Assist department with various projects and billing assignments

3rd PARTY BILLING ASSOCIATE 2008 - 2015

CVS CAREMARK, WOONSOCKET, RI

Researching billing discrepancies for Medicaid agencies associated with CVS/Caremark

Resubmitting claims to Third Party carriers

Complete billing work assignments according to Third Party guidelines for productivity

Extensive research and correction of claims for various agencies

Research payer requirements for accurate submission of claims for paper,

Batch electronic and payer specific NCPDP 5.1 formats

Work extensively with the 837 billings for all the Medicaid agencies

Contacting stores and agencies to update information

SECRETARY II 2007 - 2008

JEWISH UNITED FUND, CHICAGO, IL

Report directly to the Vice President of organization

Managed heavy mail distribution

Organization of various meetings and events

Performed general clerical functions

CUSTOMER SERVICE/ACCOUNTING ASSISTANT/PURCHASING 2005 - 2007

SYMMETRY PRODUCTS GROUP, LINCOLN, RI

Input all incoming orders for company

Maintain all vendor files

Process credit requests/invoicing

Assist CFO with various accounting duties

Input and maintain all purchase orders

SECRETARY/ACCOUNTING ASSISTANT 2004 - 2004

NEWGRANGE GROUP LLC, NORTH SMITHFIELD, RI

Report directly to the President and Chief Financial Officer of company

Answer phones and greet people

Data entry using appropriate accounting software

Accounts Payable and Accounts Receivable for 5 offices

Bank Reconciliation's

Data entry of Journal entries on a monthly basis

Spanish/English Translations

ADMINISTRATIVE ASSISTANT/ACCOUNTING ASSISTANT 1991 – 2001

LEGAL ASSISTANCE FOUNDATION OF METROPOLITAN CHICAGO, CHICAGO, IL

Fluent Spanish/English translation

Handled 10 line Rolm Phone System

Managed heavy mail distribution

Typed letters and briefs WP60

Extensive client contact and referral

Assume sole responsibility for all check requests, printing checks and performing

Data entry using appropriate accounting software

Maintain time registers, vacation and sick time for all employees

Prepare data entry of cash receipts and bank deposits

Data entry of journal entries on a monthly basis

RECEPTIONIST/SECRETARY 1990 - 1991

CASA CENTRAL SOCIAL SERVICE AGENCY, CHICAGO, IL

Fluent Spanish/English translation

Handled 10 line AT & T System 25

Performed general clerical functions, including filling and mass mailings

SALES ASSOCIATES/ ASSISTANT MANAGER 1986 - 1990

HANOVER HALLMARK CARDS & GIFTS, CHICAGO, IL

Handled light accounting and bank deposits

Delegated work to employees

Managed daily activities including opening and closing of store

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