Experience

PedsOne
• United States
• Medical Practices
• 1 - 100 Employee
• Pediatric Medical Billing Specialist (Remote)

  • May 2022 - Present


Pediatrix Medical Group

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Integrity Account Specialist (Remote)

  • Mar 2001 - Oct 2021

  Support business objectives and drive revenue growth by efficiently managing charge capture, claim edits and account billing errors.  Identified missed billing and charge related issues. Collectively worked with physicians, neonatal nurse practitioners and leadership to diligently assess and solve in a timely manner.  Analyzed daily reports and work queues, including Power BI, claims edit and holds, data repair, unbilled and missing CPT reports to ensure optimum charge capture.  Reconciled daily census and charge validation reports, research and analyze missed charges documentation in company billing system applications and EPIC, complete billing hold codes and claim edits for timely filing and reduced rejections.  Collaborated with various personnel and departments to address and resolve varying patient account issues. Serves as resource contact for parents, physicians and managers in matters related to insurance, billing and accounts.  Provided support to several Nationwide teams during Revenue Division restructuring March 2021 and was awarded top performer.  Directed a shadow training session to assist new RCM company in assessment of 3 key account functions, June 2021 Hospital Associate Medical Biller (Remote) 2001 - 2021  Registered daily admissions, verified demographics and insurance information, contact parents and insurance companies. Obtained authorization numbers.  Reviewed daily registration and billing reports, monitored accounts for billing issues and aging deadlines.  Received daily census, reconciled with charge validation reports. Submitted month end birth stats to Medical Director and Corporate by deadline.  Oversaw A/R averaging $1M+ monthly. Released numerous EOM close clean claims, greatly impacting a large percentage released in region. Achieved quarterly and annual bonus based on A/R/cash and collection goals.  Provided administrative support to Medical Director/providers and support services to Corporate/Regional offices. Show less



Ralph Dunn M.D.

• C.O.A. / Account Reconciliations

  • Mar 1990 - Mar 2000

  Billing, AP/AR, collections, patient education, surgical consultation and scheduling. Billing, AP/AR, collections, patient education, surgical consultation and scheduling.