Cayla Kline Email & Phone Number

Pittsburgh, Pennsylvania, United States

• Accurately retrieve and file documents (licenses, malpractice insurance, CAQH, NPI etc..)
• Consistent follow up to ensure providers are credentialed with vision and medical insuranceplans
• Work in multiple programs to ensure accurate information across all platforms
• Outstanding ability to work independently and within a team environment
• Lead credentialing meetings and create agendas

Pittsburgh, Pennsylvania, United States

• Efficiently resolve pharmacy claims or commercial and medicaid payers.
• Maintain a production rate of 12 claims per hour consistently meeting or exceedingperformance targets.
• Conducted outreach to insurance companies to ensure successful payment andreprocessing.
• Diligently studied EOB (explanation of benefits) to identify claim issues.

Pittsburgh, Pennsylvania, United States

• Reviewed the estimated patient financial responsibility on verification of benefits form toensure accuracy.
• Operated with guarantors on mutually agreeable payment plans when necessary forestimated patient financial responsibility.
• Worked with the UR department requesting prior authorizations and notifyingguarantors/clients of denials and approvals.
• Conducted necessary account processes with revenue cycle departments to complete andensure account balances are accurate in the billing system.
• Consistently met KPI targets.

Pittsburgh, Pennsylvania

• Understood insurance regulations and enrollments in various systems such as CAQH,Medicare And Medicaid.
• Oversaw processing of and preparation of new member enrollments.
• Maintained confidentiality and responsibility for all enrollment files through the process.
• Adhered to deadlines and enrollment schedules by tracking files through all stages AccountsReceivable Specialist

New Castle, PA

• Manage accounts payable functions to identify overdue accounts and initiate collection processes
• Prepare month end closing entries for detailed reporting and record keeping
• Perform various accounts receivable functions, including cash receipts posting, updating cash flow reports and researching chargebacks and write-offs
• Coordinate with clients and internal departments resolve account discrepancies

New Castle, PA

• Delivered exceptional customer service to all clients by effectively communicating information and actively listening to concerns
• Coordinated vendor services, including emergency repair, cleaning companies and contractors, to optimize handling of customer claims
• Explained loss coverage, assisted policyholder's with itemizing damages and coordinated alternative living arrangements

Wexford, PA

• Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records
• Performed insurance verification, pre-certification and pre-authorization
• Added modifiers, coded narrative diagnosis and verified diagnoses
• Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management

New Castle, PA

• Posted charges, payments and adjustments
• Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature
• Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials
• Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes
• Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements

New Castle, PA

• Analyzed patients' encounter forms diagnosis codes to validate accuracy, completeness and specificity
• Reviewed medical records to meet insurance company requirements
• Verified the accuracy and integrity of motor vehicle and workers' compensation claims
• Maintained 95% accuracy rate on daily production of 45 to 60 reviews per day