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