If you are a medical practice in need of quality assistance from a company that can provide the right support, MK Medical Consulting, INC is here to meet your needs. RESUME
Work Experience
Billing Manager
Florida Neurological Center, LLC - Ocala, FL
February 2018 to August 2021
*Started in February of 2018 and was promoted to billing manager by July of 2018
*Doubled the provider's revenue in th
e first year of becoming billing manager.
*Negotiated all provider contracts with insurance companies.
*Credentialed physician with all insurance carriers.
*Set up bank accounts for electronic funds transfer and electronic remittance advice with insurance companies and clearinghouse.
*Maintained all bank deposits.
*Applied payment explanation of benefits from insurance carriers.
*Maintained all billing for office visits, testing and MRI services.
*Managed authorizations.
*Negotiated payment plans with patients.
*After two years of employment I increased providers revenue by 400,000.
*Appealed denials with insurance companies.
*Managed all correspondence and appeals
Payment Poster
Florida Medical Reimbursement Services - Ocala, FL
July 2015 to February 2018
Payment Analysis- Posted adjustments, offsets, denials, charge entry, Overpayment requests. Anesthesia Billing Specialist/Credentialing Administrator
Pro-Medical Inc - Ocala, FL July 1999 to July 2015
*Provided billing services for over 300 anesthesia providers, bringing in revenue of $40 million.
*Prepared documents on maintenance of licensure reports, notifications, and follow ups on all expiring licenses.
*Performed timely interactions with the payer representatives, multi-section directors, physicians, office coordinators and medical staff to ensure credentialing and participation in carrier networks.
*Credentialed physicians with BCBS, Medicare, Medicaid, Champus, RR Medicare and all other Medicare products. Accounts Receivable
*Answered all patient or insurance telephone inquiries pertaining to assigned accounts and answered questions regarding contractual agreements, licensing and billing.
*Reviewed and researched problems with respect to established policies, billing, procedures, contractual agreements and licensing practices.
*Managed all incoming correspondence, appeals, reviews and worked accounts through to resolution.
*Documented current information on accounts to maintain quality customer service. Payment Analysis
*Posted adjustments, payment entry, and charge entry as needed and handled all insurance requests for refunds of overpayments per request.
*Applied offsets and corrections to payments on patient accounts and balanced daily posting figures.
*Perform data entry inputting the denials received from the insurance companies. Diploma
Vanguard High School - Ocala, FL
Central Florida Community College 2 Years
Skills
ANSI (10+ years), Excel (10+ years), MICROSOFT SHAREPOINT (10+ years), MS Word (10+ years), posting (10+ years), Caretracker (3 years)
Additional Information
I've enjoyed 25 years of progressively responsible employment working for as leader in the billing field. I consider myself a professional in the industry and uphold a personal standard of always delivering a high degree of accuracy. I am highly knowledgeable of ICD 10, CPT codes, medical terminology, modifiers, HIPAA and compliance standards. I possess an extensive background in support, accounts receivables, payment analysis, credentialing and all clerical functions. Core Strengths
*Organizational and strategic planning skills with a proven ability to overcome and solve problems.
*Capable of posting 70 explanations of benefits, correspondence and patient payments per hour with an error rate of less than 2%.
*Exceptional customer service skills managing negotiations with various "Payer" representatives to include Multi-Section Directors, *Physicians, Office Coordinators and related medical office staff
*A billing manager for high influx practice that was in trouble. I doubled their money and found the issues in their account receivable. *I am able to go into a system, and review what's lacking and overturn their money. I worked for a provider with over 5 million in accounts receivable and get it down to 600,000 outstanding in a matter of 2 years.
*Credentialed over 500 physicians.
*Marketing. Technical Proficiencies
Kredo, Care Tracker, Revcyle, Payment Posting and Credentialing SharePoint, E-Clinical Works
Microsoft, MS Word, Excel, Outlook, and Power Point
ANSI Formatting/835 Remits
