Oversaw medical billing and revenue cycle function for a Pain Management specialist in Melbourne Florida.Analyzed account receivables and reported outstanding claims, submission errors, denial trends, and submission errors to billing team to address.Guided the practice with strategies that would increase their patient volume, productivity, and revenue; adjusted payer mix and assisted with credentialing.Acted as interim office manager while provider filled the role of a permanent in-house office manager. Monitored and mentored all employees during the adjustment process keeping morale high while ensuring their roles and functions were met on a daily basis.

Assisted the neurosurgery department with timely claim submissions by ensuring medical documentation for procedures and office visits was completed in a timely manner.Submitted all CPT and ICD-10 coding to the professional coding team for review. Once the review was completed, prepared claims for submission process through a variety of systems.Established a more streamlined protocol for collecting medical reports from a variety of systems while ensuring all were billed and accounted for. In addition, streamlined processes would ensure providers were completing their medical notes and addendums so claims would be billed timely.

Monitored internal and external billing team workflows. Implemented procedures to ensure daily and monthly revenue goals were met.Conducted departmental reviews to identify holes in revenue cycle. Developed highly effective workflows to streamline processes, prevent loss and maintain maximum revenue integrity.Provided billing and coding guidance and education to clinical and non-clinical departments.Reviewed revenue analytical data and provided financial reports to CFO as needed.Trained new employees and strengthened team relationships with hands-on and motivational approach.

Managed off-site billing company for quality control.Analyzed financial data related to revenue cycle and created in-depth reports for supervisor.Monitored and analyzed insurance reimbursement data through comparative reports. Identified potential underpayments and denial trends requiring immediate attention.Provided patients with explanations of their balances and offered variety of payment options. Assisted patients with billing questions and concerns.Assisted external billing company in resolving charge capture discrepancies, missing/lack of provider documentation and denials requiring provider assistance.Mastered out-of-network billing and collections. Recovered over $200K in paid-to-patient reimbursements within two-month timeframe.Assisted practice manager in coordinating promotional events, team building and staff gatherings.

Delivered timely and accurate charge submissions.Managed Empire Blue Cross Blue Shield account receivables for both in and out of network physicians.Prepared and performed submission of claims.Communicated with insurance providers to follow-up or expedite claim payment. Resolved denied claims via claim reprocessing or appeal submission.Liaised between patients and insurance companies.Posted payments and collections on regular basis and maintained deposit and receivables spreadsheet.Maintained 0% error rate with payment posting.

Managed office operations. Maximized employee performance by monitoring daily activities, training and mentoring team members.Verified patient insurance coverage and benefits for both in and out of network therapists. Provided patients with summary of anticipated cost share.Obtained and monitored therapy pre-authorizations to ensure patient visits were within allotted quantity and time frame.Filed Workers Compensation, No Fault and Commercial insurance claims. Posted and adjusted payments from insurance companies. Followed up on outstanding / denied claims and filed appeals as necessary.Implemented and maintained new electronic billing system. Managed social media sites to maintain regular presence. Designed marketing and educational materials for practice.Managed credentialing for providers renting space within office. Enrolled providers and Medicaid, Medicare and private insurance plans.Networked with physicians in area to promote practice.Organized and participated in promotional events for community. Increased daily patient flow by 20%.

Billed ophthalmology claims for Dr. Vincent Giovinazzo, who ran the retina clinic at Staten Island University Hospital North.Delivered timely and accurate charge submissions and posted insurance payments.Verified patient benefits.Followed up on outstanding / underpaid claims and appeals.Provided support to the medical receptionist. Pulled and filed patient charts, scheduled patient appointments, answered incoming calls and prepared charts for following day.

Managed Emblem HIP, Palladian, Health Care Partners and 1199 accounts receivable for large orthopedic practice.Communicated with insurance providers to resolve denied claims for orthopedic, pain-management, neurosurgery and neurology specialties.Initiated and followed up on insurance prior- authorizations.Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.Prepared corrected claim submissions and drafted compelling medical necessity appeals. Maintained over 95% denial overturn rate.Assisted patients calling with billing inquiries.Provided training to new employees.