Experience

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  The home depot - auburn, ny

  Jun 2008 - Jul 2019

  Csr - customer service representative

   Interacted with customers by telephone or in-person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints. Kept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions, are taken. Resolved customers' service or billing complaints by performing activities such as exchanging merchandise, refunding money, or adjusting bills.

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  Medical call center

  Jun 2015 - Jun 2016

  Medical receptionist
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  Advanced motor drives

  Jun 2016 - Jun 2017

  Receptionist
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  Capturenet

  Jun 2017 - Oct 2018

  Patient billing representative

   Extracted and actioned hospital reports, identified non-Medicare patients and leveraged expertise in ICD and CPT diagnostic coding classification. Collected demographic details either by meeting patients face to face at the hospital or over the phone. Communicated with external stakeholders including domestic and international insurance companies, Medicare, and third-party financial counsellors Created new Patients and maintained accurate patient records into CRM/ Meditech system within required timeframes. Processed invoices within required timeframes, processed patient accounts, managed recoveries.  Undertaken inbound and outbound communications with Patients, including phone calls, letters and emails. Collected payments including upfront from Patients and undertaken financial assessment of debtors’ payment negotiations. Processed receipts, cash and credit card payments and prepared bank deposits, Allocated payments and process adjustments Resolved and clarified codes or diagnoses with conflicting, missing, or unclear information by consulting with the doctor’s office’s coding team. Skilled in-hospital patient accounting systems: Meditech, CPSI, HMS, MS4, Epic Paragon Show less

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  Coast physical therapy

  Jul 2019 - now

  Medical biller/ claims specialist

   Handling appeals and triages, Elig & benefits, A/R, paper claims, Secondary and TERT, and billing claims. Undertake inbound and outbound communications with Patients, including phone calls, letters and emails. Schedule and prepare invoices, performed data entry, check issuance tasks and general ledger coding.  Keep track of all medical billing, resolved inquiries/ billing complaints, record expenditures, and documentations. Reconcile medical billing files and processed work by verifying appeals and managing EMR software. Facilitate operations, maintained great customer and public relations and increased profit margins under the direction of upper management. Maintain confidential information relating to customers, following all policies and practices related to HIPPA. Manage Medicare, Medicaid, AARP, BCBS, Workers Compensation accounts. Manage 1500+ claims, and documentation to identify gaps or discrepancies in information on each unique work item. Working with all insurance companies that include Medicaid, Medicare, all commercial insurances, nys workers comp. and providing phone support to patients regarding inquiries. Recommend and develop the corrective action plans to remedy billing issues; posting claims & payments, manage Credentialing. Show less

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  Crouse hospital

  Nov 2021 - Oct 2022

  Medical records clerk

   Worked in Medent to send medical records, x-rays, scripts, and reports to a variety of providers/ specialists as well as their nurse team. Collected patient information, issuing medical files, and processing patient admissions.  Handled medical records (for hospitals, Drs. office, physical therapy, along with different specialties: Gastro, urology, dermatology, pain management, etc.) Worked with a small team to ensure all patient records are current and organized.  Distributed medical charts to the appropriate departments of the hospital. Maintained accurate records by following hospital procedures. Ensured patient charts, paperwork, and reports are completed in an accurate and timely manner Kept all medical records confidential and protected Supplied the nursing department with the appropriate documents and forms. Completed clerical duties including answering phones, responding to emails, and processing patient admission and discharge records. Show less

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  Maximus medical billing, llc

  Nov 2022 - now

  Appeals / triager

   Sending back triaging claims back to providers for appeal status with detailed breakdown of the claims and rejection reasons.  Sending claim appeals for closing and medical review after doing research and working codes for NCCI edits, modifiers, MUE edits.  Leverage expertise in inpatient, physician based, and outpatient physical therapy billing. Leverage decision making, time management & a high volume of research skills.  Consistently hit Daily & weekly productivity goals in this role; use critical thinking skills to analyze all information. Show less