Maryam Boone seeks a professional position that require a proactive team leader with a hands-on managerial experience, and a solid track record for delivering results, where she can utilize her 10 years of experience and education, and excellent customer relations skills. She is goal-driven, experienced, and dedicated Medical Billing professional soon to complete a B.A. with an emphasis in Healthcare administration and a A.S. Degree as a certified RHIT; with more than 11-years related, hands-on experience in fast-paced and time sensitive healthcare industry. Adaptable leader and administrator accustomed to managing numerous employees, staff training initiatives, restructuring of work, and keeping abreast of increasingly complex regulatory environment.
Coordinate timely, accurate billing of all commercial payers, including pharmacy and patient billing; track and collect outstanding accounts receivable. Conducts routine claim audits for accurate coding prior to claim submission and assign appropriate modifiers to enforce accurate payment. Coordinate with clinicians and medical staff on appropriate code usage. Promptly post charges via the practice management system within 5 days of payment. Manage commercial payer contracts, payer relations and rate negotiations. Research, develop and negotiate new contracts for medical and pharmacy services. Determine billing requirements of new HMO contracts while maintaining clinician credentialing on CAQH. Train and oversee billing staff and front desk leads .Including knowledge of EHR Medicare and Medicaid incentives and meaningful use reporting.
Ensured high-quality customer service, monitored, evaluated the quality of in/out bound telephone calls, used coaching and monitoring techniques, calls calibration sessions, to regulate standards within the area and to maintain consistency and continue improvement.
Assisted in with maintaining hospital census, coordinate nurse liaisons in preparation of prospective patients through referrals and community resources, provided benefit assessment and obtain pre-authorization from insurance provider to maximize payment of services, informed patients of deductibles and co-payment. Toured potential patients and/or family to the rehab units and programs offering educational material and information as needed.
Medical billing, payment posting, collections, reconciliation, accounts receivable, reporting and tracking, appeals and follow-up handle all inquires, process claims, ensures completeness and correctness of all claim information and, facilitates maximum reimbursement in a timely and efficient manner. Analyzing, updating and correcting claims data according CMS and third-party payers' claims requirements. Evaluate patient’s financial status and establish budget payment plans.
Evaluated and respond to all aspects of written billing inquiries from the patients or their representative in order to resolve billing issues. Maintained patient indigence and bankruptcy claims, completed refunds and adjustments to customer's accounts
Provided administrative support to Vice President of Human Resource and Director of Operations, maintained calendar coordination, preparation of documents and reports using MS Office software, expense reporting, travel coordination, prepared power point presentations and distribute reports. Assist with recruiting, training, and evaluation of staff. Provided administration of employee health benefits and executed bi-weekly payroll.
Responsible for record keeping procedures and storage of all clinical records in a manner consistent with facility policy and procedures, supervised department of eight employees, established and implemented policies to ensure that records are complete, accurately documented, accessible and systematically organized. Act as department resource in resolving medical records issues, identify medical records for documentation deficiencies, responded to pharmacists’ inquiries regarding required medical record documentation, analyze and report new documents in charts.