Amy Schmidt
Omaha,NE
Summary
I have a background of providing exceptional service to both patients and customers and being a dependable team player in every professional position I have held. Serving as a liaison to resolve billing issues for patients, maintaining confidentiality, and clearly communicating with patients as well as co-workers, have been key aspects of my work experience. I am articulate, self-motivated, very personable, and professional as I strive to provide high quality support for my employer and their office management staff.
Overview
13
13
years of professional experience
Work History
Medical Billing Representative
Ilumin
09.2019 - Current
- Downloaded and reviewed daily ERA remittances from the Trizetto clearinghouse and various provider portals such as UHC, Availity, Instamed, Tricare, Navinet, and Payspan.
- Examined finalized patients exams from the previous day and made any corrections to the posted charges as necessary. Reviewed testing, added appropriate modifiers, ensured CPT coding was correct, reviewed diagnoses, and attached any needed authorizations to the claims before submission to insurance payers. Requested that the physicians addend any charts that were incomplete.
- Reviewed operative reports and billed charges for surgical procedures done at ambulatory surgical centers. Answered questions from staff and physicians regarding appropriate CPT codes and diagnoses.
- Balanced the payments that were received in the office from patients and insurance companies the previous day to the corresponding practice management reports. Reviewed daily batches that were generated by office receptionists and opticians to make sure all payments were posted correctly. Prepared bank deposits and ran all reports related to daily balancing.
- Posted insurance EFTs and manual check and credit card payments. Submitted corrected claims or reconsideration requests and appeals on insurance portals for denied claims or made necessary calls to provider services for various insurance payers. I also uploaded medical records to payer portals as requested.
- Obtained prior authorizations for specialty pharmacy medication from provider portals or by phone as necessary. Met with and maintained contact with pharmaceutical representatives and stayed up-to-date regarding which payers required step therapy and/or required prior authorization for ten different specialty medications. Informed the medical technicians and physicians regarding what specialty medication would be allowed by specific patient's insurance plans when asked.
- Advised patients regarding specialty medication assistance programs. Submitted claims to and posted payments from these assistance programs and answered patients inquiries regarding program enrollment.
- Answered numerous patient inquiries regarding billing daily by phone or in person. Collected payments from patients over the phone by e-check or credit card as well as Alphaeon and Care Credit portals. Prepared patients statements and called patients regarding past due accounts. Prepared patients accounts for the collection agency after final notice calls. Refunded patients via credit card or by requesting checks for credits on patient accounts at the end of each month.
- Maintained up-to-date knowledge regarding Nebraska and Iowa Medicaid plans and portals as well as their corresponding vision plans. Maintained up-to-date knowledge regarding various insurance payers billing preferences. Submitted disability records along with physicians statements and medical records to various state agencies. Requested and obtained referrals from Tricare for patients that are active in US military. Attended the American Academy of Ophthalmology coding and billing conferences held in Omaha on a yearly basis.
Customer Service Representative
CommScope
02.2018 - 08.2019
- Managed shipments and orders for a five state region for one of CommScope's premier customers using SAP system.
- Learned, referenced, and applied product knowledge information and prepared quotes per customer's request.
- Received and managed calls to answer clients' questions, solve problems, inform customers regarding products, or direct calls to appropriate departments.
- Investigated and resolved customer inquiries and complaints in a timely and empathetic manner.
- Communicated with and supported sales, marketing, and administrative teams.
- Managed numerous emails per day from customers and co-workers regarding order status.
Medical Billing Representative
Ilumin
07.2014 - 02.2018
- Examined patient exams and correctly coded and submitted claims to insurance companies. Posted electronic and manual payments to patient accounts.
- Personally spoke with or answered numerous calls per day from customers and insurance representatives to address concerns or questions regarding billing statements, insurance benefits, or general inquiries.
- Corresponded daily with insurance companies, technical support representatives, and patients via e-mails, letters, and fax to solve problems and seek approval for upcoming procedures.
- Assisted patients in applying for and obtaining financial assistance through private foundations for specialized medical treatments.
- Attended off-site meetings and organized and maintained documentation for the practice regarding changes in insurance procedures that would directly affect payment received by our office.
- Effectively communicated with management regarding any customer service issues that needed to be addressed and ensured that patient satisfaction and privacy be carefully attended.
- Contacted insurance companies regarding unpaid claims and submitted relevant documentation within timely filing limits to receive payment.
Medical Office Receptionist
Ilumin
01.2011 - 06.2014
- Greeted patients and entered patient demographic information, insurance policies, and patient payments in a setting designed to ensure patient privacy.
- Contacted patients regarding upcoming appointments.
- Acted as a liaison between patients and physicians and medical technicians in the office regarding questions and concerns about patient care.
Education
Bachelor of Science - Education
University of Nebraska Omaha
Omaha, NE1993
Skills
- Exceptional oral and written communication skills
- Strong attention to detail
- Proficient with Microsoft Office
- Customer service-oriented
- Experienced in training and providing support to new employees
- Excellent organizational skills
- Familiarity with CPT coding and ICD-10 knowledge
- Familiarity with medical billing/prior authorization procedure and navigating insurance payer portals
- Experience with several different medical billing software programs including ModMed
Timeline
Medical Billing Representative
Ilumin
09.2019 - Current
Customer Service Representative
CommScope
02.2018 - 08.2019
Medical Billing Representative
Ilumin
07.2014 - 02.2018
Medical Office Receptionist
Ilumin
01.2011 - 06.2014
Bachelor of Science - Education
University of Nebraska Omaha
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