Kristina James
OR Schedule Coordinator at USPI, INC.- Claim this Profile
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English -
Topline Score
Bio
Credentials
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Certified Biller and Coder
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Experience
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USPI, INC.
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United States
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Hospitals and Health Care
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300 - 400 Employee
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OR Schedule Coordinator
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Jan 2018 - Present
Maintains master schedule to ensure coordination between doctors, anesthesia, lab and insurance carriers. Schedules surgeries/procedures, coordinates schedule between Surgery Center and doctor's offices. Gathers all detailed information for the patient's chart, such as type of procedure, supplies, special equipment required, insurance information, etc. Enters all patient information in computer system. Schedules all surgical anesthesia services required according to doctor preference and availability. Accurately uses procedure codes to ensure proper billing.Verifies information being entered into system is correct, i.e. spelling of name, DOB, gender, insurance information, etc. Assures that precertifications/referrals are in order for Insurance Coordinator. Confers with OR Nurse Manager, Charge Nurse and /or Administrator to determine status of scheduled surgeries. Alters schedules to meet unforeseen conditions. Works closely with the Administrator and CSO Credentialing person when maintaining approved privileges for each physician or as documents are updated, etc. Provides relief for the front business office, Receptionist and all other business functions, as needed. Crossed trained to fill in and effectively perform all. Initiates safe practices and is knowledgeable about current center policies and procedures. Assists with environmental hazard and infection control surveillance participate in emergency preparedness drills. Follows all equipment safety guidelines and is personally responsible for knowledgeable use and care for all business equipment. Promote positive relationships with scheduling coordinators, physicians and nursing staff members throughout the scheduling process.
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Revenue Cycle Specialist
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Nov 2015 - Jun 2017
Revenue Cycle Specialists ∙ Precisely completed appropriate claims paperwork, documentation and system entry.∙ Worked denials, appeals, refunds, write-offs approval and follow up unpaid claims∙ Correctly coded and billed medical claims various hospital and nursing facilities.∙ Verified patients eligibility, benefits and claims status with insurance agencies.∙ Worked accounts receivables, cash collection, AR over 60 day or older ∙ Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.∙ Research CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy∙ Initiated, performed and documented quarterly coding audits for physicians. ∙ Actively maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third requirements regarding billing. ∙ Print and reviewed monthly patient aging report and solicited overdue payments. ∙ Submitted electronic/paper claims documentation for timely filing. ∙ Researched missing eob and unidentified missing/unapplied payments.
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Office Coordinator
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Jun 2014 - Nov 2015
Oversees the clinical liaison of the entire office. Maintaining a demanding schedule between the physician and patients. Front office duties include check in and out processes, telephone communication between patients and office staff. Insurance verification process as well as coding and billing for the office. Heavy data entry and organizational skills. Post incoming insurance payments in addition to the explanation of benefits to accounts and manage daily monetary collections. Assist with back office in the care of the patients needs. Marketing for the office to increase revenue and improve patient cliental. Managed surgery center communication, physician credentialing, physician states license renewal and certificates. My job is to make sure the clinic is successively operational and the patient satisfaction is achieved. EMR system used is Eclinical Works.
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Office Manager
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Sep 2013 - Mar 2014
Office manager for a Pediatric office, with a staff of four and two physicians. Handled all billing within the office. Trained staff for office protocols for OSHA, and training for their specific job descriptions. Handled monetary for office bills and made sure office bills were paid in a timely manner. Handled daily deposits for the clinic. Performed time and payroll for the office. Credentialed physicians with insurance companies and hospitals. Ordered supplies for front office and clinic. Handle employees reviews and performed evaluations on my employees. I handled marketing for office as well. Assisted in working in different areas of the office as needed to get the job done. EMR system used was Athena Health and Eclinical Works.
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Hometown Pediatrics
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United States
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Medical Practices
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1 - 100 Employee
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Billing Specialist
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Jan 2012 - May 2013
Medical billing and collections, Extensive customer service in patient and physician interaction, comprehending and explaining EOB’s to patients and staff, posted insurance and patient payments daily, processed refunds, adjustments, and claim resubmissions. Secured insurance reimbursements, set up collection process for office and produced and increased additional revenue on patient portions. Maintained reports for collections department. Worked closely with the front office to secure patient payments on accounts were collected, and explained balances and EOB’s with staff to utilize the team to achieve overall collection process. Trained management and staff in various internet sites to achieve ultimate information on insurance benefits and claims. Assisted in working the front desk as needed per management. Handled displeased patients for management to fulfill patient satisfaction. Certified ICD Coder and Biller.
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HCA Healthcare
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United States
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Hospitals and Health Care
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700 & Above Employee
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Office Manager
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Dec 2009 - Sep 2011
Managed a family practice office while working closely with physicians and staff to insure daily office operations were successful. Credentialing, marketing, payroll, extensive customer service, billing, front office duties, medical assisting, office and medical supply inventory, maintaining daily cash deposits, and routine office duties. Managed a family practice office while working closely with physicians and staff to insure daily office operations were successful. Credentialing, marketing, payroll, extensive customer service, billing, front office duties, medical assisting, office and medical supply inventory, maintaining daily cash deposits, and routine office duties.
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Texas Children's Hospital
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United States
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Hospitals and Health Care
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700 & Above Employee
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Front office specialist
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Nov 2000 - Dec 2009
Heavy medical billing and collections, comprehending and explaining EOB’s, processing refunds, adjustments, and claim resubmissions. Securing insurance reimbursements, collecting patient portions, auditing patient charts for accuracy in regards to collections. Posting daily charges received each day. Extensive customer service in patient and physician interaction on a daily basis. Knowledge of ICD-9 and CPT coding, as well as insurance verification. Immense scheduling, demographics, as well as check in and checkout processes. Experienced front office specialist that is knowledgeable in all aspects of healthcare customer service.
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Education
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2005 -
Lone Star College-CyFair
Basics -
1998 - 1998
Langham Creek
Graduated, Basics
Community
