Insurance Billing Specialist at Noran Neurological Clinic PA (2026-02 – Present)
Review and reprocessing claim denials for an established neurology practice with 3 locations. Including but not limited to office visits, MRI/CT, sleep studies, behavioral health claims, neurotoxin injections, and neuropsychiatric services. Experience working with a broad range of carriers including commercial, Medicare/Medicaid, and TriCare.
- Viewing and responding to medical record requests from insurance providers and TPAs, maintaining records of claim denials, appeals, policy changes and payer trends
- Reviewing upcoming appointments for non covered services on a per plan basis, issuing waivers of liability as needed for non covered services
- Maintaining and monitoring the fax inbox for incoming urgent insurance requests, and responding within a timely manner
- Confirming patient insurance eligibility and ensuring claims go to the correct payer
- Extensive experience filing appeals with supporting documentation for services denied by insurance
- Responding to incoming calls from patients, insurance representatives, and attorneys offices regarding insurance carriers that are assigned to me
- Consistently surpassing production quotas while maintaining a high quality of service
- Reviewing diagnosis and CPT codes to ensure proper coding, routing claim denials to the relevant departments for review
Anesthesia Billing Services Representative at Health Billing Systems (2024-02 – 2026-02)
Processing of anesthesia claims for services rendered by anesthesiologists and CRNAs. Insurance denials, rejects, requests for information, and general remittance processing for major government insurers and commercial insurance plans. Extensive experience submitting appeals on behalf of the provider for including but not limited to; Blue Cross Blue Shield of MN commercial and Medicare plans, Blue Plus medical assistance, and Aetna plans.
- Daily usage of several EMR systems including Cerner PowerChart and Epic
- High level of knowledge and ability to use online insurance portals including but not limited to Availity, MNits, Forward Health, HealthPartners, Noridian, Cigna, Medica, Ucare, United Healthcare/UMR, and various out of state Medicaid portals
- Extensive experience billing for a multi-state practice and their respective state specific insurance plans including Minnesota, Iowa, South Dakota, Montana, Alaska, Wisconsin and California
- Reviewing patient accounts for collections, using a multi step process to ensure all avenues have been explored before sending a patient to collections
- Flagging accounts for medical coding reviews and adjustments
- Assisting the customer service phone lines and taking patient payments, setting up payment plans, answering questions about patient bills and billing policies and procedures
- Working remotely full time while maintaining all performance metrics and expectations
Patient Care Coordinator at Ear, Nose and Throat Specialty Care of MN PA (2022-05 – 2024-01)
Scheduling in-office procedures and office visits for patients in person and over the phone. Maintaining 90-120 daily patient calls in a high volume contact center, verifying insurance benefits, obtaining medical authorization(s) for services rendered.
- Regularly exceeding call metrics while maintaining a hybrid schedule
- High level of communication with patients, providers, billing department, and department leads in person and over phone
- Forwarding of patient questions, inquiries and concerns to nursing triage, medical assistants, surgery schedulers, billing department, and supervisors when necessary
- Scheduling directly with otolaryngologists, coordinating follow up care with the provider and patient for post surgical care, ensuring correct timelines for post and pre surgical appointments per each provider's guidelines
- Responsible for oversight of urgent fax requests for hospital consultations, and ensuring the provider receives them in a timely manner
Pharmacy Technician/Store Manager at Walgreens (2020-10 – 2022-04)
Counting and filling prescriptions for pharmacist review, ordering for daily medication deliveries, assisting patients and pharmacists as needed with vaccine scheduling, insurance prior authorizations, insurance coverage questions and inquiries. Extensive knowledge of pharmaceutical drugs, interactions, and indications, and direct phone communication with insurance payers.
- Responsible for opening and closing of the retail store, overseeing associate performance, documenting performance reports, reviews and concerns
- Maintaining security clearance as a store key holder, resolving customer/patient escalations in the retail store and pharmacy
- Ensuring financial record accuracy and daily transaction reports are maintained with accuracy
- Reporting to district manager(s), law enforcement and Human Resources as needed
