Michael D. Caira Email & Phone Number

Brookline, MA

Took care of billing for Blue Cross/Blue Shield - MA & Beacon Health Strategies via: paper claims, direct data entry, and electronic billing.Submitted denied or underpaid Beacon Health Strategies claims for adjustment online to obtain proper payment.Billed Secondary claims via paper & direct data entry.Posted payments from prior months that were never.

Greater Boston Area

Posted payments from Medicare B & Medicare A for 5 Mental Health Hospitals for the State of Michigan.Audited others work, and returned it to them for correction prior to posting.Removed $0.00 charge items from the database.

Charlestown, MA

Verified information on scanned invoices so that they could be paid.Printed & referred problem invoices so that they could be researched, and paid manually.

Waltham, MA

Did Monthly Aging Services Access Point (ASAP) billing using the Healthwyse billing system. * Did both paper and electronic Mental Health billing using Therapist Helper. * Used Claims Connect to bill Medicare B claims. I would then check the reports generated the next day to verify that all of the claims went through, and corrected any errors on rejected.

Did billing & follow-up for: Network Health, BMC HealthNet Plan, Neighborhood Health Plan, and Tricare/Champus. Used Meditech system to track payment progress.Transferred co-pays from insurance to self-pay.Referred claims for write-off to Billing Manager.Checked REV's system to verify: Medicaid Eligibility, Claim Status, and Primary Care Clinician.

Used Epic Medical Billing system to resolve behavioral health denials, usually by printing corrected paper claims for resubmission. * Went online to determine Eligibility Information, and claims information from the following carriers: BC/BS, CIGNA, United Behavioral Health/PacifiCare, Beacon Health Strategies, and Neighborhood Health Plan. * Sent a weekly.

Sent in Medicaid Applications to help qualified patients obtain Medicaid Benefits.Interviewed patients to obtain relevant information, and to have them sign the applications.Did follow-up phone calls to Insurance Companies on overdue accounts.

Print paper claims for: Early Intervention, Mental Health, and Lactation Education.Voided & Rekeyed charges that were billed to the wrong insurance carrier(s).Billed and did follow-up on Home Health & Group Adult Foster Care, (GAFC), claims.Trained new Biller in: Mental Health, Home Health, and GAFC claims.Handled special billing claims such as.

Did follow up phone calls on overdue accounts and adjustments. * Submitted electronic claims to MBHP, and did resubmissions of any outstanding claims. * Pulled backup on claims requiring adjustment or write off. * Filled in as necessary for other account representatives who were out on leave of absence. * Did projects as assigned by the Supervisor and.

High School Diploma, College/University Preparatory And Advanced High School/Secondary Diploma Program

Activities and Societies: Newton North Concert Choir Bacon House Council

Bachelor Of Science In Business Administration, Management

Activities and Societies: Northeastern University Chorus - Served as Concert Manager for 1 year.